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Volar plate position, prominence are risk factors for flexor tendon rupture after fixation
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CHICAGO – Higher Soong grades, plate prominence and plate positioning are risk factors of flexor tendon ruptures after volar plating of distal radius fractures, according to a study presented at the American Society for Surgery of the Hand 2012 Meeting.
“Our data suggests that we can identify patients at risk for flexor tendon rupture by finding those with plate prominence more than 2 mm volar to the critical line or plate position within 3 mm of the volar rim or Soong grade 2,” study presenter Alison Kitay, MD, said here.
Alison Kitay
No guidelines existed that recommend when a plate is too prominent or too distal, she said. Kitay and the researchers compared eight patients with flexor tendon ruptures to 23 patients without ruptures for Soong grades, distances between the plates and the volar critical line and distances between the plates and volar rims of the distal radius. They used Chi square analysis and independent sample t tests to make associations between Soong grades, distance from the volar critical line and distance from the volar rim of the distal radius and flexor tendon ruptures.
Higher Soong grades signaled flexor tendon ruptures, with six patients in the rupture group labeled grade 2 and two patients grade 1. No patients in the nonrupture control group rated grade 2, and 13 patients were rated grade 1 and 10 patients were grade 0. Researchers found that plate prominence greater than 2 mm and plate position distal to 3 mm from the volar rim were associated with flexor tendon ruptures.
“To decrease the risk of tendon rupture, we recommend considering elective hardware removal after union in symptomatic patients with plate to critical line values over two or plate to volar rim values less than three,” Kitay said.
Reference:
Kitay A, Swanstrom M, Schreiber JJ, et al. Volar plate position is associated with flexor tendon rupture after distal radius fracture fixation. Paper #36. Presented at the American Society for Surgery of the Hand 2012 Meeting. Sept. 6-8. Chicago.
Disclosure: Kitay has no relevant financial disclosures.
