The Die Punch Fragment: Analysis of Fragment Geometry and Need for Fixation

Sezai Özkan; Svenna H. W. L. Verhiel; Samantha A. Jayasinghe; Chaitanya S. Mudgal

doi:10.1055/s-0040-1712328

Journal of Hand and Microsurgery, Inhaltsverzeichnis

J Hand Microsurg 2022; 14(02): 127-131
DOI: 10.1055/s-0040-1712328

Original Article

The Die Punch Fragment: Analysis of Fragment Geometry and Need for Fixation

Sezai Özkan

¹Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States

²Department of Trauma Surgery, VU University Medical Center, VU University, Amsterdam, The Netherlands

,

Svenna H. W. L. Verhiel

¹Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States

,

Samantha A. Jayasinghe

³School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, United States

,

Chaitanya S. Mudgal

¹Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States

› Institutsangaben

Abstract

Introduction Die punch (DP) fragments are among the most common fracture fragments to lose reduction after volar locked plating of articular distal radius fractures (DRFs). We aimed to report the number of patients in our institution who had a computed tomography (CT)-confirmed DP fragment and who had open reduction and internal fixation (ORIF) through a dorsal approach; to report the length of the radioulnar portion of the DP fragment relative to the total distal radioulnar joint (DRUJ) length; and to identify if an association exists between this length and the choice for a volar versus a dorsal operative approach to the DP fragment.

Materials and Methods We performed measurements on the preoperative CT scans of 94 skeletally mature patients with a DP fragment. We also collected data related to their demographics, injury, and treatment. Of the 94 patients in this study, 84 (89%) had AO type C fractures.

Results Thirteen out of 94 patients (14%) who had ORIF of their DRF with a DP fragment had a separate dorsal incision. The mean proportion of the DP fragment length relative to the total DRUJ length was 0.51 ± 0.19. There was no association between the length of the DP fragment and volar versus dorsal approach.

Conclusion DP fragment size is not an indicator of the need for or use of a dorsal approach in DRF fixation.

Level of Evidence This is a Level IV,—retrospective study.

Keywords

distal radius fractures - die punch - dorsal-ulnar corner

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Referenzen

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