Surgical treatment of intra-articular distal radius fractures, with polyaxial angular stability plate

Abstract

Introduction. Distal radius fractures are about 2 times more common than fractures in other areas of the human body. The annual incidence is 24 cases per 10,000 people per year. Predominantly affected are women, of >55 years old, than men of the same age, the ratio being 2/1. While in younger age, more common cases are encountered among men. Polyaxial angular stability plate is the type of implant that ensures a stable fixation of the fracture due to its anatomical shape and the locking of the screw at the optimal angle for reduction. Once the acceptable reduction is made, the fixation with such a plate assures that during the manipulations, the fragments will be kept in the initial position. The main advantage of this plate is that it is not necessary to move the plate in the sagittal or axial plane in order to be able to fix the screw, in comparison with uniaxial plate, this type does not disturb the underlying cortical bone infusion as much as conventional plates do. Case presentation. Patient X, 60 years old. The woman fell, as she got off the trolleybus, leaning on her left hand palm. The patient has been complaining of pain in the region of the left radio-carpal joint, limited movement, edema. She has been transported to IMSP IMU, emergency department for further treatment. RX examination has revealed a fracture of left distal segment radial bone, radiological AO2RC1.2. An orthopedic closed reduction of the fracture has been performed, radiologically the reduction is not acceptable, the patient is being prepared for surgical treatment. Modified Henry approach. Open reduction of the left distal radius fracture with polyaxial angular stability plate, radiologically fracture is reduced anatomically, stable. The patient followed the postoperative regimen. She came for an examination a year after surgical treatment, function: flexion-extension amplitude 65-70 grades, adduction 35-40 grades and abduction 15 grades. Discussion. Great postoperative results. Functionally, the movements in the left radio-carpal joint are good and coincide with that of the right upper limb. Postoperative complications did not occur. The patient returned to her daily routine. Conclusion. Based on the diagnosis and treatment tactics performed, we have chosen a correct fixator that allowed us to obtain a stable reduction, which did not change postoperatively. Due to the polyaxial angular stability plate, its adaptation to the bone was optimal, and maintained a good vascularity of the periosteum, which allowed us a faster and qualitative bone regeneration. Polyaxial angular stability plate has been shown to be an optimal implant for intra-articular distal radius fractures in elderly people.