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Arch Hand Microsurg > Volume 23(3); 2018 > Article
Archives of Hand and Microsurgery 2018;23(3):150-157.
Published online September 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.3.150   
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. kangho56@yuhs.ac
Received: 24 July 2018   • Revised: 15 August 2018   • Accepted: 16 August 2018
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.
Key Words: Distal radio-ulnar joint, Distal radius fracture, Limited dorsal approach, Lunate fossa depression fracture, Dorsal rim fracture
 


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