Osteosíntesis percutánea con placas volares bloqueadas en fracturas metafisarias distales de radio Descripción de la técnica y resultados preliminares

Introduction: Purpose: To evaluate objective and subjective outcomes after closed reduction and minimally invasive volar locked T plate osteosynthesis for distal radius fractures with metaphyseal involvement. Methods We retrospectively evaluated six patients treated by minimally invasive volar locked T plate osteosynthesis for unstable extra-articular or partial articular distal radius fractures with metaphyseal involvement between 2007-2012. Age averaged 40, 6 years. All were closed fractures classified as type 23A3 (n: 5) and 23B1 (n: 1) according to the AO/OTA system.  Indirect reduction was performed. Two volar small incisions were made; a volar locked compression T plate was introduced in the sub-muscular plane, under radioscopic guidance. Analysis included radiological parameters (volar angulation, radial inclination, and radial height); range of motion and strength. Subjective results were assessed using DASH Score and Visual Analogue Scale. Results All fractures healed within 2, 3 months. Radiographic outcomes showed no difference between the first postoperative control and the last Rx at one year of follow up. Flexion and extension averaged 70° and 60°, pronation and supination 79° and 80°. Grip Strength 78, 4%. DASH Score 19, 84 and VAS 1, 5 points. Conclusions Minimally Invasive technique decrease surgical injury and complications (infections and re fractures). It is an option in patients with metaphyseal comminution severe soft tissue injuries and high energy trauma. Small incisions away from the fracture site preserve soft tissues, bone biology and improve healing. Percutaneous volar LCP allows obtaining stable fixation and restoring distal radius anatomy in radius fractures with metaphyseal involvement. It is technically demanding procedure. The most common problem is bone misalignment.