Spanning Bridged Plate in Comminuted Distal Radius Fractures

Distal Radius Fracture Clinical Trial

Official title:

Result of Spanning Bridge Plate Fixation for Comminuted Intra Articular Distal Radial Fractures.

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT04100317
• Other study ID #: Bpf in distal radius fractures
• Status: Not yet recruiting
• Start date: September 20, 2019
• Est. completion date: October 20, 2020

Study information

• Verified date: September 2019
• Source: Assiut University
• Contact: Anass Dr Hanzaz, Master
• Phone: +201026081677
• Email: Doctoranass[@]gmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This study To evaluate the result of using spanning bridge plate in comminuted distal radius fractures.

Description:

Distal radius fractures are the most common long bone fracture and the incidence appears to be increasing worldwide. They have been found to account for approximately 17% of all fracture-related emergency department visits. These types of injuries have a bimodal age distribution. The first peak represents young patients involved in high energy traumas, and the second peak represents elderly patients with lower to moderate energy injuries secondary to osteoporosis.Surgical treatment for distal radius fractures varies, as there are numerous techniques for fixation. The goals of fixation are anatomic reduction and stability, as this has been shown to result in improved chances for functional recovery . The use of volar locking plateshas become the standard for treatment of the majority of distal radius fractures requiring surgery . However, adequate fixation for high energy comminuted fractures with or without metadia-physeal extension remains a major treatment challenge. Severely comminuted articular fractures are technically challenging in terms of obtaining an adequate reduction and achieving stabilization with a standard periarticular volar plating technique. The small fracture fragments are often not able to be stabilized with the screws from the volar plate, and the proximally-oriented tension from the forearm musculature acts to pull on the carpus causing further collapse of the articular surface. As an alternate to the volar plate, these types of injuries have been historically treated with an external fixator with or without Kirschner wires. However, it has been reported that highly comminuted distal radius fractures are associated with a 52%-63% complication rate when treated with external fixation . Therefore, despite poor fixation capabilities withthese fracturetypes,thevolarplate remainsthego-to devicefor most surgeons when faced with comminuted articular distal radial fractures. In these circumstances, the dorsal distraction plate (also called dorsal "bridge" plating technique) can serve as an improved fixation technique by allowing comminuted articular fragments to reduce under ligamentotaxis and provide a buttress for the dorsal cortex of the distal radius. In addition, a long dorsal plate can bridge past metaphyseal comminution, which cannot be so easily addressed with standard volar plating . The bridge plate can also be left in place for an extended period of time without the risk of the aforementioned complications of prolonged external fixation use . Finally, the dorsal distraction plate is technically a much easier operation to perform than volar plating for complex articular fractures. Recently, there has been increased use of dorsal distraction plating for these types of injuries .

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 20
• Est. completion date: October 20, 2020
• Est. primary completion date: September 20, 2020
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• age 18-60 years old

• early trouma (within two weeks)

Exclusion Criteria:

• open fractures

• concomitant limb injuries

• old fractures more than two weeks

• sever osteoporosis and osteopenia.

Related Conditions & MeSH terms

• Distal Radius Fracture
• Fractures, Bone
• Radius Fractures

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

References & Publications (3)

Geller L, Bernstein M, Carli A, Berry G, Reindl R, Harvey E. Efficacy of different fixation devices in maintaining an initial reduction for surgically managed distal radius fractures. Can J Surg. 2009 Oct;52(5):E161-6. — View Citation

Mann T, Lee DJ, Dahl J, Elfar JC. Can Radiocarpal-Spanning Fixation Be Made More Functional by Placing the Wrist in Extension? A Biomechanical Study Under Physiologic Loads. Geriatr Orthop Surg Rehabil. 2016 Mar;7(1):23-9. doi: 10.1177/2151458515621109. — View Citation

Matullo KS, Dennison DG. Outcome following distally locked volar plating for distal radius fractures with metadiaphyseal involvement. Hand (N Y). 2015 Jun;10(2):292-6. doi: 10.1007/s11552-014-9713-z. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Wrist range of movement	Degree measurment of wrist Flexion. Extension radial and ulnur deviatin	Baseline
Secondary	Radilogical parameters	By taking new xrays and exactly calculate the distal radius angels and parameters by calculate the exact deviatin	Baseline
Secondary	Grip strength	By using grip strength power	Baseline
Secondary	Union	Assesment of union condition by Dexa scan	Baseline