Minimally invasive anterior plate osteosynthesis of the distal radius: A 710 case-series.
INTRODUCTION
Since the 2000s, internal fixation of distal radius fracture by volar locking plate on an extended flexor carpi radialis (FCR) approach has become the gold standard.


OBJECTIVE
The present study aimed to assess medium-term results of minimally invasive plate osteosynthesis (MIPO) in distal radius fracture.


MATERIAL AND METHODS
The series comprised of 710 cases (512 female; mean age, 58 years). The 15mm approach was on the lateral edge of the FCR. The plate was slipped under the pronator quadratus. Closure used intradermal running suture without drain or orthosis.


RESULTS
At a mean 7 months' follow-up, mean scar length was 17mm (range, 10-40mm), pain 1.13/10 (0-8), Quick-DASH 13.28 (0-86.36), and patient-rated wrist evaluation (PRWE) 11.48 (0-91). Compared to contralateral values, mean flexion was 87.23%, extension 88.52%, pronation 96.17%, supination 93.41%, and grip strength 79.68%. Hardware was removed in 45.92% of cases. There were 16 cases of secondary displacement, with 4 revision procedures, one of sepsis at 6 months, 10 of complex regional pain syndrome, and 14 of median nerve paresthesia, with 4 carpal tunnel release procedures.


DISCUSSION
The minimally invasive FCR approach can be used for volar plate fixation of distal radial fracture. It has the advantage of conserving ligamentotaxis, facilitating reduction and improving scar esthetics. The incision can be extended if need be.


LEVEL OF EVIDENCE
III; single-centre retrospective study.
['Vernet|Paul|P|', 'Gouzou|Stéphanie|S|', 'Hidalgo Diaz|Juan José|JJ|', 'Facca|Sybille|S|', 'Liverneaux|Philippe|P|']
D001860:Bone Plates D005260:Female D005593:Fracture Fixation, Internal D006801:Humans D008875:Middle Aged D011884:Radius D011885:Radius Fractures D016059:Range of Motion, Articular D012189:Retrospective Studies D016896:Treatment Outcome
Minimally invasive Anterior plate Distal radius fracture MIPO