Arch Hand Microsurg 2018; 23(3): 150-157  
Limited Dorsal Approach for Intra-Articular Distal Radius Fracture Involving the Sigmoid Notch
Bum-Suk Oh1, Yun-Rak Choi2, Il-Hyun Ko2, Won-Taek Oh2, Nam-Hoo Kim2, Ho-Jung Kang2
1Department of Orthopedic Surgery, Duson Hospital, Ansan, Korea
2Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Ho-Jung Kang
Department of Orthopedic Surgery, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea
TEL: +82-2-2019-3412, FAX: +82-2-573-5393, E-mail: kangho56@yuhs.ac, ORCID: http://orcid.org/0000-0003-0273-1264
Received: July 24, 2018; Revised: August 15, 2018; Accepted: August 16, 2018; Published online: September 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: The purpose of this study was to analyze the 16 patients, with distal radius fracture involving sigmoid notch fracture, who were treated by limited dorsal approach retrospectively.
Methods: Between June 2003 and December 2013, 743 patients with distal radius fracture underwent operative treatment. Among them, 16 patients received conventional treatment, with additional limited dorsal approach. The fracture patterns involved sigmoid notch with dorsal lunate fossa depression, as well as distally displaced dorsal rim fragment. Radiologic results were evaluated based on dorsal tilt, radial inclination, and radial shortening. Clinical results were evaluated based on grip strength, motion range of the wrist joint, arm disabilities, shoulder & hand (DASH) score, and visual analogue scale (VAS) score.
Results: The average radial inclination was 21°, with 5.6° of volar tilt and 0.1 mm of radial shortening. The average range of motion were 42.6° of flexion, 56.5° of extension, 23.4° of radial tilt, and 24.8° of ulnar tilt. The average grip strength was 81.3% of the opposite side. The average VAS and DASH scores were 1.1 and 21.3, respectively.
Conclusion: In the case of sigmoid notch fracture involving dorsal lunate fossa depression fractures and distally displaced dorsal rim fractures, we were able to reduce and fix the fragment conveniently using limited dorsal approach.
Keywords: Distal radio-ulnar joint, Distal radius fracture, Limited dorsal approach, Lunate fossa depression fracture, Dorsal rim fracture


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