Bridge plating in the setting of radiocarpal instability:Does distal fixation to the second or third metacarpal matter?A cadaveric study  

作　　者：Eloy Tabeayo James M Saucedo Ramesh C Srinivasan Amita R Shah Efstathios Karamanos Jason Rockwood E Carlos Rodriguez-Merchan 

机构地区：[1]Department of Orthopedic Surgery,Albert Einstein College of Medicine,Montefiore Medical Center,New York,NY 10461,United States [2]Houston Methodist Institute for Academic Medicine,Houston Methodist Orthopedics and Sports Medicine,Houston,TX 77479,United States [3]Hand Center of San Antonio and the Department of Orthopedic Surgery,University of Texas Health Science Center,The Hand Center of San Antonio,San Antonio,TX 78240,United States [4]University of Texas Health Science Center at San Antonio,University of North Carolina at Chapel Hill,San Antonio,TX 78229,United States [5]Surgeon in the Division of Acute Care Surgery in the Department of Surgery at Henry Ford Hospital in Detroit,UT Health San Antonio,San Antonio,TX 78229,United States [6]Naval Hospital Yokosuka,Yokosuka,96350-1600,Japan [7]Department of Orthopedic Surgery,La Paz University Hospital-IdiPaz,Madrid 28046,Spain

出　　处：《World Journal of Orthopedics》2023年第4期207-217,共11页世界骨科杂志（英文版）

摘　　要：BACKGROUND Radiocarpal dislocations are rare but potentially devastating injuries.Poorer outcomes are associated with inadequate or lost reduction,such as ulnar translocation,but no consensus exists on the ideal fixation technique.Dorsal 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 established.AIM To determine whether distal fixation to the second or third metacarpal matters.METHODS 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 fixation.Radiographs were measured in various parameters to determine the quality of the reduction achieved.RESULTS 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 third.The second iteration demonstrated that anatomic alignment in coronal and sagittal planes could be achieved with each technique.CONCLUSION 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 followed.When 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.

关 键 词：WRIST Instability Bridge plate Dorsal spanning plate Radiocarpal dislocation model Cadaveric study 

分 类 号：R687.3[医药卫生—骨科学]