ObjectiveTo study the effect of intraoperative fluoroscopy of wrist joint combined with internal fixation of volar "T" type universal locking titanium plate on distal radius fracture.

MethodsA retrospective analysis was made on 42 cases of distal radius fractures treated with open reduction and locking plate internal fixation.Henry's approach was adopted for the operation.Four position fluoroscopy of wrist joint (standard anteroposterior lateral position, lateral tangent position and carpometacarpal flexion tangent position) was performed during the operation to determine whether the screws entered the joint cavity, lower radioulnar joint and penetrated the dorsal cortex of distal radius.All patients underwent routine three-dimensional CT reconstruction of wrist joint after the operation, and imaging evaluation was performed.The quality of fracture reduction before and after the operation of distal radius fracture was compared, the Cooney wrist function score before the operation and at the last follow-up was compared, and the detection rate of the screws with problems in the anteroposterior and lateral positions of the wrist joint and the four position films during the operation was compared.

ResultsAll patients had a surgical time of 45-90 minutes, a surgical bleeding volume of 20-100 mL, and all surgical incisions healed clinically in the first stage.There were no complications such as incision infection or steel plate exposure.At the last follow-up, the excellent and good rate of Cooney wrist joint function score was significantly higher than before surgery (P < 0.01).After treatment, the radius height, palm inclination angle, and ulnar deviation angle of the patient were significantly higher than before treatment (P < 0.01).There was a statistically significant difference in the detection rate of screw problems between anteroposterior and lateral fluoroscopy and four position X-ray fluoroscopy (P < 0.01).All problematic screws during the surgery were promptly adjusted. Postoperative three-dimen sional CT examination of the wrist revealed that in one of the 42 cases, a screw in the radial column penetrated the dorsal cortex by about 2 mm.No symptoms of dorsal tendon irritation were observed during follow-up.

ConclusionsThe application of "T" type universal locking titanium plate at the volar side of the distal radius in the treatment of distal radius fractures can achieve satisfactory fracture reduction and better clinical effect.Patients can achieve rapid rehabilitation exercise.