Bridge plating in the setting of radiocarpal instability:Does distal fixation to the second or third metacarpal matter?A cadaveric study
作者机构：Department of Orthopedic SurgeryAlbert Einstein College of MedicineMontefiore Medical CenterNew YorkNY 10461United States Houston Methodist Institute for Academic MedicineHouston Methodist Orthopedics and Sports MedicineHoustonTX 77479United States Hand Center of San Antonio and the Department of Orthopedic SurgeryUniversity of Texas Health Science CenterThe Hand Center of San AntonioSan AntonioTX 78240United States University of Texas Health Science Center at San AntonioUniversity of North Carolina at Chapel HillSan AntonioTX 78229United States Surgeon in the Division of Acute Care Surgery in the Department of Surgery at Henry Ford Hospital in DetroitUT Health San AntonioSan AntonioTX 78229United States Naval Hospital YokosukaYokosuka96350-1600Japan Department of Orthopedic SurgeryLa Paz University Hospital-IdiPazMadrid 28046Spain
出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)
年 卷 期：2023年第14卷第4期
页 面：207-217页
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
主 题：Wrist Instability Bridge plate Dorsal spanning plate Radiocarpal dislocation model Cadaveric study
摘 要：BACKGROUND Radiocarpal dislocations are rare but potentially devastating *** outcomes are associated with inadequate or lost reduction,such as ulnar translocation,but no consensus exists on the ideal fixation *** bridge plate fixation has been described for various settings in the treatment of complex distal radius fractures and can be fixed distally to the second or third metacarpal,but its application for radiocarpal dislocations has not been *** To determine whether distal fixation to the second or third metacarpal *** Using a cadaveric radiocarpal dislocation model,the effect of distal fixation was studied in two stages:(1)A pilot study that investigated the effect of distal fixation alone;and(2)a more refined study that investigated the effect of described techniques for distal and proximal *** were measured in various parameters to determine the quality of the reduction *** The pilot study found that focusing on distal fixation alone without changing proximal fixation results in ulnar translocation and volar subluxation when fixing distally to the second metacarpal compared with the *** second iteration demonstrated that anatomic alignment in coronal and sagittal planes could be achieved with each *** In a cadaveric radiocarpal dislocation model,anatomic alignment can be maintained with bridge plate fixation to the second metacarpal or the third metacarpal if the described technique is *** considering dorsal bridge plate fixation for radiocarpal dislocations,the surgeon is encouraged to understand the nuances of different fixation techniques and how implant design features may influence proximal placement.
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