Hardware Repair

Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma

Authors: Brandon P. Lucke-Wold, PhD1*, Patrick C. Bonasso, MD2, and Glen Jacob, MD3

Author Affiliations:

1 Department of Surgery, West Virginia University School of Medicine.  Medical student author.

2 Dept. of Surgery, West Virginia University School of Medicine. Co-author, pbonass3@hsc.wvu.edu.

3 Dept. of Surgery, West Virginia University School of Medicine. Faculty author, gjacob@hsc.wvu.edu

[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2016/12/HardwareRepairEpub.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button]

Corresponding Author: Brandon Lucke-Wold, PhD, Bwold@mix.wvu.edu

Key Words: Volar locking plate-distal radius fracture-open reduction-internal fixation



Distal radius fractures are one of the most common fractures in the elderly. Falls and motor vehicle collisions lead to increased risk for this type of fracture. A seventy-three year-old female had a previous history of distal radius fracture with repair by open reduction and internal fixation. She was involved in a motor vehicle collision that re- fractured the distal radius. The plate was bent and required removal, which is a very rare but potentially serious complication. Surgery was done to fix the open reduction and internal fixation with volar locking plates while removing damaged hardware. Only a select few cases have reported hardware failure as a cause of complications. Among those cases, high-energy activities and maintained stress on the hardware were likely causes. Distal radius fractures are the most common upper extremity fracture in the elderly. We highlight a unique case of re-fracture in the setting of trauma with prior hardware failure and describe the strategy for hardware repair.


Published on date: December, 2016


DOI: 10.15404/msrj/11.2016.0009

Citation: Lucke-Wold B, Bonasso P, Jacob G. Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma. Medical Student Research Journal (2016). doi:10.15404/msrj/11.2016.0009


  1. Sebastin SJ, Chung KC. An Asian perspective on the management of distal radius fractures. Hand Clin. 2012;28(2):151-156.
  1. Kose A, Aydin A, Ezirmik N, Topal M, Can CE, Yilar S. Intramedullary nailing of adult isolated diaphyseal radius fractures. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES. 2016;22(2):184-191.
  1. Berglund LM, Messer TM. Complications of volar plate fixation for managing distal radius fractures. The Journal of the American Academy of Orthopaedic Surgeons. 2009;17(6):369-377.
  1. Lattmann T, Meier C, Dietrich M, Forberger J, Platz A. Results of volar locking plate osteosynthesis for distal radial fractures. Journal of trauma. 2011;70(6):1510-1518.
  1. Harness NG. Fixation Options for the Volar Lunate Facet Fracture: Thinking Outside the Box. J Wrist Surg. 2016;5(1):9-16.
  1. Ezzat A, Baliga S, Carnegie C, Johnstone A. Volar locking plate fixation for distal radius fractures: Does age affect outcome? J Orthop. 2016;13(2):76-80.
  1. Dasari CR, Sandhu M, Wisner DH, Wong MS. Approaches to Distal Upper-Extremity Trauma: A Comparison of Plastic, Orthopedic, and Hand Surgeons in Academic Practice. Ann Plast Surg. 2016;76 Suppl 3:S162-164.
  1. Geissler WB, Clark SM. Fragment-Specific Fixation for Fractures of the Distal Radius. J Wrist Surg. 2016;5(1):22-30.
  1. Pillukat T, Fuhrmann R, Windolf J, van Schoonhoven J. [The volar locking plate for extension fractures of the distal radius]. Oper Orthop Traumatol. 2016;28(1):47-64.
  1. Korpelainen R, Korpelainen J, Heikkinen J, Vaananen K, Keinanen-Kiukaanniemi S. Lifelong risk factors for osteoporosis and fractures in elderly women with low body mass index–a population-based study. Bone. 2006;39(2):385-391.
  1. Gyuricza C, Carlson MG, Weiland AJ, Wolfe SW, Hotchkiss RN, Daluiski A. Removal of locked volar plates after distal radius fractures. The Journal of hand surgery. 2011;36(6):982-985.
  1. De Baere T, Lecouvet F, Barbier O. Breakage of a volar locking plate after delayed union of a distal radius fracture. Acta orthopaedica Belgica. 2007;73(6):785-790.
  1. Naito K, Zemirline A, Sugiyama Y, Obata H, Liverneaux P, Kaneko K. Possibility of Fixation of a Distal Radius Fracture With a Volar Locking Plate Through a 10 mm Approach. Tech Hand Up Extrem Surg. 2016;20(2):71-76.
  2. Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC. A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. The Journal of hand surgery. 2011;36(5):824-835 e822.
  1. Cao J, Ozer K. Failure of volar locking plate fixation of an extraarticular distal radius fracture: A case report. Patient safety in surgery. 2010;4(1):19.
  1. Yukata K, Doi K, Hattori Y, Sakamoto S. Early breakage of a titanium volar locking plate for fixation of a distal radius fracture: case report. The Journal of hand surgery. 2009;34(5):907-909.
  1. Wall LB, Brodt MD, Silva MJ, Boyer MI, Calfee RP. The effects of screw length on stability of simulated osteoporotic distal radius fractures fixed with volar locking plates. The Journal of hand surgery. 2012;37(3):446-453.
  1. Arora R, Gabl M, Erhart S, Schmidle G, Dallapozza C, Lutz M. Aspects of current management of distal radius fractures in the elderly individuals. Geriatric orthopaedic surgery & rehabilitation. 2011;2(5-6):187-194.
  1. Chung KC, Squitieri L, Kim HM. Comparative outcomes study using the volar locking plating system for distal radius fractures in both young adults and adults older than 60 years. The Journal of hand surgery. 2008;33(6):809-819.
  1. Sugun TS, Gurbuz Y, Ozaksar K, Toros T, Bal E, Kayalar M. A new complication in volar locking plating of the distal radius: longitudinal fractures of the near cortex. Acta Orthop Traumatol Turc. 2016;50(2):147-152.
  1. Yu YR, Makhni MC, Tabrizi S, Rozental TD, Mundanthanam G, Day CS. Complications of low-profile dorsal versus volar locking plates in the distal radius: a comparative study. The Journal of hand surgery. 2011;36(7):1135-1141.

Scrotal Rupture

Scrotal Rupture in a Premature Neonate with Cystic Fibrosis as a Consequence of Meconium Periorchitis

Authors: Michael Bedgood1* BS, Christine Cortelyou1 MD, Cynthia Blanco1, MD, MSc, Rafael Fonseca2, MD, Alvaro Moreira1, MD

Author Affiliations:

1University of Texas Health Science Center (UTHSC), San Antonio, TX;

2University of Texas Medial Branch (UTMB), Galveston, TX

[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2016/12/ScrotalRuptureEpub.pdf” type=”big” color=”green” newwindow=”yes”] Full Text Article PDF[/button]

Corresponding Author: Michael Bedgood BS, bedgood@uthscsa.edu

Key Words: neonate, meconium peritonitis, meconium periorchitis



Neonatal meconium periorchitis is a rare condition, with less than 60 cases described in the literature. Of the reported cases, only one describes the complication of a congenital rupture of the scrotum. We present a case of a Hispanic preterm neonate who was diagnosed with cystic fibrosis after scrotal rupture secondary to meconium periorchitis. The neonate was taken to the operating room for exploratory laparotomy and scrotal exploration. No calcification was noted and the patient’s left scrotum was surgically packed as well as creating a colostomy. The surgery proved successful and the patient was discharged home on day of life 79. This case of a neonate presenting with meconium periorchitis and scrotal rupture notes the varying degree of initial presentations for cystic fibrosis in a neonate. Successful outcomes for neonates presenting with a ruptured scrotum depend on early clinical assessment.


Published on date: December, 2016


DOI: 10.15404/msrj/11.2016.0008

Citation: Bedgood M, Cortelyou C, Blanco C, Fonseca R, & Moreira A. Scrotal Rupture in a Premature Neonate with Cystic Fibrosis as a Consequence of Meconium Periorchitis. Medical Student Research Journal (2016). doi:10.15404/msrj/11.2016.0008


  1. Lange, M. Meconium peritonitis presenting in scrotal hydroceles. J. Surg. 1964; 51(12): 942-4
  2. Varkonyi I, Fliegel C, Rosslein R, Jenny P, Ohnacker H. Meconium periorchitis: Case report and literature review. Eur J Pediatr Surg. 1998; 10: 404-407
  3. Regev RH, Markovich O, Arnon S, Bauer S, Dolfin T, Litmanovitz I. Meconium periorchitis: Intrauterine diagnosis and neonatal outcome: case reports and review of the literature. Journal of Perinatology. 2009: 29; 585-7
  4. Salle JLP, Fraga JCS, Wojciechowski M, Antunes CRH. Congenital rupture of scrotum: An unusual complication of meconium peritonitis. The Journal of Urology. 1992; 148: 1242-43
  5. Jeanty C, Bircher A, Turner C. Prenatal Diagnosis of Meconium Periorchitis and Review of the Literature. J Ultrasound Med.2009; 28: 1729-1734.
  6. Williams HJ, Abernethy LJ, Losty PD, Kotiloglu E. Meconium periorchitis – a rare cause of paratesticular mass. Pediatr Radiol. 2004; 34: 421-423
  7. Soferman R, Ben-Sira L, Jurgenson U. Cystic fibrosis and neonatal calcified scrotal mass. Journal of Cystic Fibrosis. 2003; 2: 214-216
  8. Wax JR, Pinette MG, Cartin A, Blackstone J. Prenatal sonographic diagnosis of meconium periorchitis. J Ultrasound Med. 2007; 26: 415-417
  9. Herman TE, Siegel MJ. Meconium Periorchitis. Journal of Perinatology. 2004; 24: 188-190
  10. Alanbuki, Ammar Hameed, Ashwith Bandi, and Nick Blackford. “Meconium Periorchitis: A Case Report and Literature Review.” Canadian Urological Association Journal 7.7-8 (2013): E495–E498. PMC. Web. 27 Apr. 2016.