Minimally invasive plate osteosynthesis for distal radius fractures using a 3-point positioning technique

AbstractIn this study, we perform a retrospective analysis of the mid-term clinical results of distal radius fractures treated with the 3-point positioning technique using a minimally invasive plate osteosynthesis (MIPO) while preserving the pronator quadratus (PQ). The 3-point positioning technique was applied: the Kirschner wire was inserted after fluoroscopy and was correctly adjusted the position of the plate above the PQ. With the aid of Kirschner wires positioning the PQ stripping was performed only once, and the plate then placed in a correct and satisfactory position. Operation time, incision length, wrist pain score, upper extremity function DASH score, wrist Gartland-Werley score, wrist grip strength, and range of motion (ROM) were among the quantitative variables recorded. Qualitative variables including AO fracture classification, intraoperative and postoperative complications were evaluated. Twenty patients were enrolled in the study with an average follow-up of 6.8 ± 0.76 months. Of these, 8 males and 12 females were enrolled. the DASH score for the upper limb was 4.7 ± 1.3, and the Gartland-Werley score for wrist function was 11.9 ± 2.5 at the last follow-up. Mean flexion was 97.3%, extension was 97.1%, pronation was 98.8%, supination was 98.6%, and grip strength was 86.1% compared to contralateral values. No unfavorable intraoperative or postoperative complications occurred. The 3-point positioning technique can greatly minimize the damage to the PQ muscle and is a safe and effective method for MIPO for distal radius fractures.