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Influence of volar margin of the lunate fossa fragment fixation on distal radius fracture outcomes: A retrospective series

Authors
  • Meng, Hua
  • Yan, Jia-Zhi
  • Wang, Bing
  • Ma, Zong-Bo
  • Kang, Wei-Bo
  • Liu, Bao-Ge
Type
Published Article
Journal
World Journal of Clinical Cases
Publisher
Baishideng Publishing Group Inc
Publication Date
Aug 26, 2021
Volume
9
Issue
24
Pages
7022–7031
Identifiers
DOI: 10.12998/wjcc.v9.i24.7022
PMID: 34540957
PMCID: PMC8409212
Source
PubMed Central
Keywords
Disciplines
  • Retrospective Study
License
Unknown

Abstract

BACKGROUND Distal radius fractures accompanied by the volar margin of the lunate fossa (VMLF) lesions are often overlooked or inadequately reduced in clinical practice. AIM To investigate the impact of VMLF fragment in distal radius fractures on the stability and function of the wrist joint. METHODS This was a retrospective study of patients with distal radius fractures who underwent surgical treatment between January 2013 and December 2017. The patients were divided into two groups according to whether the VMLF fragments were fixed or not. X-rays and computed tomography were performed before surgery, immediately postoperatively, and at 1, 3, and 6 mo to measure the scapholunate angle, radiolunate angle, capitolunate angle, and effective radiolunate flexion (ERLF). The Mayo wrist score and disabilities of the arm, shoulder, and hand (DASH) score were determined at 1 year. RESULTS Thirty-five patients were included. There were 15 males and 20 females. Their mean age was 52.5 ± 14.3 (range: 19-70) years. There were 38 wrists (17 on the left side, 15 on the right, and three bilateral; 16 in the fixed group, and 22 in the unfixed group). The interval between trauma and surgery was from 1 h to 1 mo. The incidence of postoperative wrist instability in the unfixed group (86.4%) was higher than in the fixed group (25.0%) ( P ≤ 0.001). Ten patients had ERLF > 25° in the unfixed group and none in the fixed group ( P = 0.019). The Mayo wrist score was 94 ± 5.7 in the fixed group and 68 ± 15.1 in the unfixed group ( P < 0.001). The DASH score was 4.6 ± 2.5 in the fixed group and 28.5 ± 19.5 in the unfixed group ( P < 0.001). CONCLUSION Injuries of VMLF, even small fractures, might damage the radial-lunar ligament, leading to postoperative wrist instability, sagittal force line imbalance, and poor recovery of wrist joint function.

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