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Mullikin, Ian, DELA CRUZ, Jeffrey, Srinivasan, Ramesh, Mithani, Suhail, Novicoff, Wendy, Chhabra, Abhinav Bobby, Tabeayo Alvarez, Eloy. (1402). Relative Increase in Distal Radius Exposure with Extension of the FCR Approach. , 11(11), 690-695. doi: 0.22038/ABJS.2023.71179.3326
Ian Mullikin; Jeffrey Allen DELA CRUZ; Ramesh C. Srinivasan; Suhail K. Mithani; Wendy Novicoff; Abhinav Bobby Chhabra; Eloy Tabeayo Alvarez. "Relative Increase in Distal Radius Exposure with Extension of the FCR Approach". , 11, 11, 1402, 690-695. doi: 0.22038/ABJS.2023.71179.3326
Mullikin, Ian, DELA CRUZ, Jeffrey, Srinivasan, Ramesh, Mithani, Suhail, Novicoff, Wendy, Chhabra, Abhinav Bobby, Tabeayo Alvarez, Eloy. (1402). 'Relative Increase in Distal Radius Exposure with Extension of the FCR Approach', , 11(11), pp. 690-695. doi: 0.22038/ABJS.2023.71179.3326
Mullikin, Ian, DELA CRUZ, Jeffrey, Srinivasan, Ramesh, Mithani, Suhail, Novicoff, Wendy, Chhabra, Abhinav Bobby, Tabeayo Alvarez, Eloy. Relative Increase in Distal Radius Exposure with Extension of the FCR Approach. , 1402; 11(11): 690-695. doi: 0.22038/ABJS.2023.71179.3326

Relative Increase in Distal Radius Exposure with Extension of the FCR Approach

The Archives of Bone and Joint Surgery
مقاله 5، دوره 11، شماره 11، بهمن 2023، صفحه 690-695    اصل مقاله (1.08 M)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 0.22038/ABJS.2023.71179.3326
نویسندگان
Ian Mullikin1؛ Jeffrey Allen DELA CRUZ2؛ Ramesh C. Srinivasan3؛ Suhail K. Mithani4؛ Wendy Novicoff5؛ Abhinav Bobby Chhabra5؛ Eloy Tabeayo Alvarez* 6
1The Hand Center of San Antonio, San Antonio, Texas; University of Texas San Antonio, San Antonio, Texas, USA/Tripler Army Medical Center, Honolulu, Hawaii, USA
2University of Florida College of Medicine, Gainesville, Florida, USA
3The Hand Center of San Antonio, San Antonio, Texas; University of Texas San Antonio, San Antonio, Texas, USA
4Division of Hand Surgery, Duke University Medical Center, Durham, North Carolina, USA
5Department of Orthopaedic Surgery, University of Virginia; Charlottesville, Virginia, USA
6Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York, USA
چکیده
Objectives: Major surgical approaches for volar plating of the distal radius include the standard flexor carpi radialis (FCR) approach, the extended FCR (eFCR) approach, and the extended FCR approach combined with radial-sided carpal tunnel release (eFCR+CTR). The purpose of this study was to determine which of these three surgical approaches offers the greatest exposure and visualization of the distal radius.
Methods: Sequential dissections were performed on each of 30 fresh frozen below elbow cadaveric samples in order to simulate the three surgical approaches for distal radius volar plating, starting with the standard FCR approach, advancing to eFCR, and finishing with eFCR+CTR. Prior to the initial dissection of each cadaveric sample, radiographs were taken in order to calculate the total area of the distal radius. Then, following each sequential dissection, photographs were taken of each specimen and analyzed with an image measuring software in order to obtain the area of distal radius exposed. The percentage of total distal radius exposure was then calculated for each of the three surgical approaches.
Results: The eFCR+CTR approach offered the greatest average distal radius exposure at 87% of total distal radius visualized. The eFCR approach provided the next greatest exposure with an average of 73% visualized, followed by the standard FCR approach with an average of 61% visualized.
Conclusion: The extended FCR approach with radial-sided carpal tunnel release is both safe and efficacious for osteosynthesis of distal radius fractures in the setting of concomitant carpal tunnel syndrome. This study demonstrates that an additional advantage of this approach includes improved surgical exposure and visualization of the distal radius. This surgical approach is a valuable addition to any upper extremity surgeon’s armamentarium and should be considered when treating difficult distal radius fractures.
Level of evidence: V
کلیدواژه‌ها
Carpal tunnel syndromes؛ Distal radius fracture؛ Fracture osteosynthesis؛ Internal fracture fixation؛ Open fracture reductions
مراجع
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