A STUDY OF SURGICAL MANAGEMENT OF VOLAR BARTON’S FRACTURES USING ELLIS PLATE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 8
Abstract
BACKGROUND The distal end of radius fractures continue to pose a therapeutic challenge. Post-traumatic osteoarthrosis decreased grip strength, and endurance, as well as limited motion and carpal instability, are the complications because of intraarticular and extra-articular malalignment1 Barton’s fracture was named after the American surgeon John Rhea Barton. Barton’s fracture is a fracture of the distal end of the radius that involves the articular surface of distal radius and is usually accompanied by subluxation or luxation of the radiocarpal joint. These fractures may result from high- or low-energy injuries, and they account for approximately 1.2 % to 4.2 % of distal radial fractures. Barton’s fractures are classified into volar or dorsal Barton’s fractures based on the site and shifting the direction of fragments. According to AO classification, volar Barton’s fractures are classified as type B3 fractures of the distal radius. Conservative treatment is usually unsuccessful and fraught with complications, such as early osteoarthrosis, deformity, subluxation, and instability. ORIF with a volar Ellis plate system is currently practised for the treatment of volar Barton’s fracture as it results in good reduction and provides immediate stability. Moreover, the patients can be mobilised early and quickly potentially reducing wrist stiffness. MATERIALS AND METHODS This clinical study includes 20 patients with volar Barton’s fracture, which were admitted through OPD and casualty of Government General Hospital, Kurnool.The study was done for a period of 2 years i.e. from November 2016 to November 2018. RESULTS All cases were followed up periodically during the period 2016 to 2018 at 1, 3, 6, 12 months postoperative period, and results evaluated at the end, and scored by Gartland and Werley scoring system. 11 (55%) had an excellent result, 7 (35%) had good result, 1 (5%) had fair and 1 (5%) had a poor result. CONCLUSION Ellis plates gave successful results for the volar Barton’s distal radius fractures. This method, which is effective in anatomic realignment, allows early joint motion, owing to its fixation strength.Close placement to joint interface and screwing capability in different orders are its biomechanical superiorities.The volar approach provides both access with minimal surgical trauma on distal radius and fixation with a better adoption to surrounding tissues. In the subjects of our study, a successful anatomic alignment was acquired with the volar approach, regardless of the direction of fracture angulation. The patients who were young adults in the majority went back to their daily activities with 90% recovery. These Ellis plates not only provide restoration of radial length but also help in stabilizing palmar angulation. They maintain intraarticular congruity thus reducing radiocarpal arthritis and decrease in grip strength. At last, not the least they also provide quicker recovery and better functional range of movement and provide better fixation in an osteoporotic bone.
Authors and Affiliations
Rajesh Kolla, Pavan Kumar Babu Aasupathri, Rajaiah D, Rajesh Kumar Mallepogu, Raghavendra Rao Thadi, Amar Tej B
Keywords
Related Articles
- EP ID EP610992
- DOI 10.18410/jebmh/2019/111
- Views 69
- Downloads 0
MR IMAGING IN INFECTIOUS SPONDYLITIS
BACKGROUND Spondylodiscitis is characterized by infection involving the intervertebral disc and adjacent vertebrae. MRI is the imaging modality of choice due to its very high sensitivity and specificity. It is also usefu...
POST INFARCT LEFT VENTRICULAR ANEURYSMS: 5YEAR SURGICAL EXPERIENCE IN A RURAL CARDIAC CENTRE
This is a long term follow up of 54 patients with post infarct left ventricular aneurysm, operated over a period of 5 years, from 2005 to 2010, in a rural cardiac centre. This study aims at assessing efficacy of simple l...
ACUTE LUNG INJURY IN DROWNING AND OTHER TYPES OF DEATHS ASSOCIATED WITH ASPIRATION – A COMPARATIVE STUDY
BACKGROUND Drowning still remains as a diagnostic dilemma in forensic pathology owing to the lack of characteristic autopsy findings with any general acceptance so far. The lung is the most commonly affected organ in cas...
COMPARATIVE STUDY OF EFFICACY OF TWO ANTIRETROVIRAL REGIMENTS (ZIDOUVDINE+LAMIVUDINE+NEVIRAPHINE VS STAVUDINE+LAMIVUDINE+NEVIRAPINE) IN HIV/AIDS PATIENTS
BACKGROUND: AIDS, the acquired immunodeficiency syndrome, is the worst disease in the history of medicine due to HIV infection in many sexually active people. This disease is treated with two regimens of drugs in the ART...
MODIFIED ALVARADO SCORE VERSUS ULTRASOUND EXAMINATION IN ACUTE APPENDICITIS
BACKGROUND Appendicitis, one of the most common causes of acute surgical abdomen, presents with a myriad of symptoms and signs resulting in a potential for delay in diagnosis or misdiagnosis. As a result, timely diagnosi...