PMC5306963_01
Patient 1. Plain radiographs (a) and CT (b, c, d) at the time of injury. A 10 x 8 mm VLF fragment is observed, with volar displacement.
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A 10 x 8 mm VLF fragment was observed on plain radiography, with volar displacement (Figure 1).
Plain radiographs of Patient 1. (a) Immediately after the first surgery. (b) Two weeks after the first surgery; redisplacement is seen. (c) Immediately after reoperation. (d) Five days after reoperation; redisplacement is seen. (e) Immediately after the third surgery. (f) One year after the third surgery; bone union was achieved without redisplacement.
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In the first surgery, reduction and fixation were achieved with a MODE VLP for proximal placement (Medical Dynamic Marketing Inc., Tokyo, Japan), used as a buttress plate (Figure 2(a)). However, redisplacement was noted 2 weeks after surgery (Figure 2(b)). At reoperation via a dual-window approach, reduction and fixation were achieved again with an Acu-Loc 2 VLP for distal placement (Acumed Co., Oregon, USA) (Figure 2(c)). However, redisplacement was again noted 5 days after surgery (Figure 2(d)). At second reoperation via a dual-window approach, the displaced VLF fragment was reduced from the ulnar side and fixed with a VariAx handplate (Stryker Co., Michigan, USA) used as a buttress plate; concomitant external fixation was applied for 4 weeks (Figure 2(e)). At 1 year after surgery, bone union was achieved without redisplacement (Figure 2(f)).
PMC5306963_02
Patient 2. Plain radiographs (a) and CT (b, c, d) at the time of injury. A 12 x 12 mm VLF fragment is observed, with volar displacement.
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A 12 x 12 mm VLF fragment was observed on plain radiography, with volar displacement (Figure 3).
Plain radiographs of Patient 2. (a) Immediately after the first surgery. (b) Six weeks after the first surgery; redisplacement is seen. (c) Immediately after reoperation. (d) Nine months after reoperation; bone union was achieved without redisplacement.
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In the first surgery, reduction and fixation were achieved with a VA-TCP VLP for proximal placement (Depuy Synthes Co., Zuchwil, Switzerland), used as a buttress plate (for the distal screw, monoaxial screws were inserted over the guide block); however, redisplacement was noted after surgery (Figures 4(a) and 4(b)). Co., Oregon, USA) (Figure 4(c)). Concomitant external fixation was applied for 5 weeks. At 9 months after surgery, bone union was achieved without redisplacement (Figure 4(d)).