Clinical Outcomes in Distal Radius Fractures Accompanied by Volar Lunate Facet Fragments: A Comparison between Dorsal and Volar Displaced Fractures

• Published in: The Journal of Hand Surgery Asian-Pacific Volume Vol. 25; no. 4; pp. 417 - 422
• Main Authors: Obata, Hiroyuki, Naito, Kiyohito, Kaneko, Ayaka, Goto, Keniji, Sugiyama, Yoichi, Nagura, Nana, Kawakita, So, Iwase, Yoshiyuki, Kaneko, Kazuo
• Format: Journal Article
• Language: English
• Published: Singapore World Scientific Publishing Co. Pte., Ltd 01.12.2020
• Subjects: Adult; Bone Plates; Bone surgery; Disability Evaluation; Female; Fracture Fixation; Fracture Fixation, Internal; Fractures; Humans; Male; Middle Aged; Patients; Radius; Radius Fractures - diagnostic imaging; Radius Fractures - surgery; Range of motion; Range of Motion, Articular; Surgery; Tomography, X-Ray Computed; Visual Analog Scale; Young Adult; Distal radius fractures; Volar locking plate; Volar lunate facet fragment; Direction of displacement
• ISSN: 2424-8355; 2424-8363; 1793-6535
• DOI: 10.1142/S2424835520500447

The treatment strategy for distal radius fractures accompanied by volar lunate facet fragment is controversial. In most cases, only the bone fragment size was discussed and a plate for distal placement is selected due to the accompanying volar lunate facet fragment regardless of the direction of bone fragment displacement. In this study, we divided distal radius fractures accompanied by volar lunate facet fragment into dorsal and volar displaced fractures, and treated these surgically based on different treatment strategies. The subjects were 25 patients with distal radius fractures accompanied by volar lunate facet fragment treated by reduction and fixation using a volar locking plate (VLP) (male: 14, female: 11, mean age: 57.8 years old). A proximal VLP (PVLP) was selected for 13 dorsal displaced fractures and a distal VLP (DVLP) was selected for 12 volar displaced fractures. The range of motion, VAS, Q-DASH, and Mayo score were evaluated at 12 months after surgery, and compared. No significant difference due to the difference in the direction of displacement was noted in the range of motion, VAS, Q-DASH, or Mayo score at 12 months after surgery and there were no perioperative complications. In addition, no re-displacement of volar lunate facet fragment was noted after surgery in any patient and bone fusion was observed. Reduction and fixation with a PVLP are possible even for dorsal displaced distal radius fractures accompanied by volar lunate facet fragment. For the volar displaced distal radius fractures, a favorable postoperative outcome is possible by applying a DVLP to the distal ulnar.