Oral presentations / Injury, Int. J. Care Injured 42 (2011) S3, S1–S24 S15

and populations. No HIT was reported in 826 patients with lower

extremity injuries requiring immobilisation.

Conclusions: Only a few studies have reported on the incidence

of HIT in trauma patients who receive prophylactic LMWH. In the

heterogenous populations of the available studies, the incidence of

HIT appears to be very low (0.36%) and comparable to other patient

populations. There is hardly any literature on the incidence of HIT

in patients with isolated lower leg injuries receiving LMWH, but

incidence appears very low. Monitoring of platelet count could be

considered in hospitalised patients with a high risk for development

of HIT. A pre-test scoring system may identify these patients.

A53

Different methods of osteosynthesis for Bennett’s fracture

R. Pavic1, M. Malovic1. 1University Hospital of Traumatology, Zagreb,

Croatia

Purpose & Aim: To determine if osteosynthetic material is a

determining factor in the healing of a Bennett’s fracture.

Material & Methods: We present 90 patients, with fracture of

the first metacarpal base (thumb) – Bennett’s fracture (two part

fracture), who were injured over a period of 6 years (2004–2009).

All patients were treated surgically with osteosynthesis of the

metacarpal base. The average age of the patient group at the

time of injury was 33 years. All patients were injured either in

a sport activity or from a fall from height. The surgical approach

we used is a modification of the radiopalmar curving incision.

Our operative incision was 2–3 cm long. Osteosynthetic materials

which were used varied. Kirschner wires were used on patients who

presented with very small dislocated bone fragment in Buechler’s

zone 1 and 3. Patients with fractures in Buechler’s zone 2 were

treated with a variety of screws (AO screws, mini Herbert screws,

standard Herbert screws, or Twin-Fix screws). Osteosynthesis was

preformed with a 1.3mm thick mini-T plate with 6 holes where

there were larger fracture fragments and it was questionable that

the screw could hold the reduced position.

Results: Positive results were found in all patients. Bennett fracture

united and full radial abduction and opposition function was found

between 4–8 weeks.

Conclusions: We believe that it is important to choose

osteosynthetic material according to the type of Bennett fracture

to be treated, the earliest possible surgical treatment, even if

the fracture dislocation is 1mm, and the early start of physical

rehabilitation.

A54

Functional outcome after orif versus external fixation in type-C

distal radius fractures

J.M. Van Buijtenen1, R.J. Derksen2, J. de Haan1, W.P. Zuidema2.1Westfriesgasthuis, Hoorn, 2VU Medical Center, Amsterdam, The

Netherlands

Aim: The aim of this study was to retrospectively investigate

the difference in functional outcome between ORIF and external

fixation in type-C distal radius fractures in young patients

(18–60 years).

Material & methods: The hospital and outpatient records of

all patients with intra-articular, distal radius fractures between

January 2008 and December 2010, were analyzed. All patients

were interviewed and reexamined for measurement of functional

outcomes. The mayo-wrist score, DASH-score, SF-36 and VAS score

were retrieved. Examination of the wrist included testing of range

of motion and grip-strength.

Results: We identified 51 patients in our hospital. The majority

(86.3%) sustained a C2-type fracture. Most fractures were caused

by low-energy trauma (33.3%), falls on ice (27.5%) and by motor

vehicle accidents (13.7%). The 3 most frequently used options for

treatment were volar plating (35.3%), Kapandji K-wire insertion

(31.4%) and external fixation (11.8%). The preliminary data from

patients charts showed a functional outcome classified as ‘good’

in 72.2% in patients treated by volar plating, 68.8% in Kapandji

insertion and 50% in the external fixation group.

Conclusions: This study describes the functional outcome of

different treatment modalities in C-type distal radius fractures.

In this series of patients volar plating and K-wire osteosynthesis

showed a better functional outcome than external fixation. Further

research was initiated with expansion of number of patients.

A55

Numbers and locations of screws influence fixation stability

in palmar locked plating of distal radius fractures

G. Stein1, C. Reissig2, G. Gradl2, K.J. Burkhart1, L.P. Muller1.1University of Cologne, Department of Orthopaedic and Trauma

Surgery, 2University of Rostock, Department of Trauma and

Reconstructive Surgery, Germany

Aim: To compare the biomechanical properties of different numbers

and locations of screws in a multidirectional volar fixed-angle plate

in a distal radius osteotomy cadaver model.

Materials and Methods: An extraarticular 10mm dorsally open

wedge osteotomy was created in 16 pairs of fresh frozen human

radii to simulate an AO–A3-fracture. The fractures were stabilized

using a multidirectional locking palmar plate. A maximimum of

2 screws in the proximal row and 4 screws in the distal row can

be used to to fix the distal fragment. Following different screw

configurations were tested:

Group A: All 6 screws were placed in the distal fragment. vs.

Group B: Only the 4 screws of the distal row were set in the distal

fragment.

Group C: All 6 screws were set: The 4 screws of the distal row were

placed in the distal fragment, the 2 screws of the proximal row

were placed in the fracture gap. vs.

Group D: Only the 4 screws of the distal row were set in the distal

fragment.

The specimens were loaded axially 200 N and dorsal-excentrically

with 80 N 4 cycles each. Then 2000 cycles of dynamic axial loading

were performed.

Results and Conclusion: The study is in work. We would like to

present the results. We will be able to compare full occupation of

both distal plate rows with single row occupation of the screws.

Furthermore we will be able to quantify the effect of placing the

screw of the proximla row in the distal fragment vs. placement of

these screws in the facture gap.

A56

Surgical treatment for trans-scaphoid perilunate dislocations

R. Pavic1, M. Malovic1. 1University Hospital of Traumatology, Zagreb,

Croatia

Purpose & Aim: To present a method of TSPLD treatment.

Material & Methods: We present 35 patients with TSPLD. A volar

approach was used to reduce the scaphoid fragments with Twin-fix

screw (3.2mm) fixation in all cases. Repositioning the dislocated

scaphoid for temporary arthrodesis is then conducted using 3

Kirschner wires (1.4mm). The wires are place from inside to out

so that there is only one end percutaneously. After the scaphoid

is repositioned, the palmar lunotriquetral interosseous ligament

is repaired. K-wires are removed 6–8 weeks after surgery. The

titanium Twin-fix screws are not removed. A volar short arm splint

was applied for 4 weeks. Gentle range of motion was introduced at

the completion of 4 weeks.

Results: Following 8 weeks and removal of the k-wires patients

were sent to the hospital rehabilitation center. The rate of

scaphoid union was 100%. The average time to scaphoid union

was 14–16 weeks.

Conclusions: None of the patients developed VISI (Volar

Intercalated Segment Instability) deformity. At the final