Nuances of Radiographic Assessment of Distal Radius Fractures to Avoid Missed Fragments

Hand Clinics ◽  
2021 ◽  
Vol 37 (2) ◽  
pp. 197-204
Author(s):  
Jeremy E. Raducha ◽  
Christopher J. Got
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radiographic Assessment ◽  
Radius Fractures

Radiographic assessment of ligamentous injuries in distal radius fractures after open reduction and internal fixation

2013 ◽  
Vol 24 (7) ◽  
pp. 1151-1154 ◽  
Author(s):  
Sanjay Naran ◽  
Yaron Zaulan ◽  
Sameer Shakir ◽  
Louis A. Gilula ◽  
Frederick W. Werner ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Distal Radius Fractures ◽  
Radiographic Assessment ◽  
Radius Fractures

Distal radius fractures and radiographic assessment: a systematic review of measurement accuracy

2019 ◽  
Vol 60 (11) ◽  
pp. 1482-1489 ◽  
Author(s):  
Janni Jensen ◽  
Benjamin SB Rasmussen ◽  
Louise A Duus ◽  
Trine Torfing ◽  
Helle Precht ◽  
...  
Keyword(s):  
Systematic Review ◽  
Distal Radius ◽  
Measurement Accuracy ◽  
Distal Radius Fractures ◽  
Radiographic Assessment ◽  
Radius Fractures

scholarly journals Standard radiographic assessments of distal radius fractures miss involvement of the distal radioulnar joint: a diagnostic study

2021 ◽  
Author(s):  
Laura A. Hruby ◽  
Thomas Haider ◽  
Roberta Laggner ◽  
Claudia Gahleitner ◽  
Jochen Erhart ◽  
...  
Keyword(s):  
Distal Radius ◽  
Ct Scanning ◽  
Distal Radius Fractures ◽  
Joint Involvement ◽  
Radiographic Assessment ◽  
Radius Fractures ◽  
Joint Congruency ◽  
Sigmoid Notch ◽  
Radiocarpal Joint ◽  
Standard Radiographs

Abstract Introduction Distal radius fractures account for one-fifth of all fractures in the emergency department. Their classification based on standard radiographs is common practice although low inter-observer reliabilities and superiority of computer tomography (CT) scanning in evaluation of joint congruency have been reported. Materials and methods We retrospectively analyzed 96 displaced distal radius fractures scheduled for open reduction and internal fixation using standard radiographic assessment. The radiographs were classified with the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA), Fernandez and Frykman classifications by three observers and inter-rater reliabilities were calculated. Additional CT scanning was performed in all cases and the following parameters were assessed: radiocarpal joint involvement, fracture extent into the radial sigmoid notch, i.e. the distal radio-ulnar joint, comminution of the metaphysis, and concomitant ulnar styloid fracture. The CT scans were used as a reference standard to determine sensitivity and accuracy of standard radiographic assessment in evaluation of distal radius fractures. Results The inter-rater agreement for the AO classification was 35.4%, 68.8% for the Fernandez and 38.5% for the Frykman classification. Fracture extension into the radiocarpal joint was present in 81 cases (84.4%). Sigmoid notch involvement was found in 81 fractures (84.4%). Involvement of both joints was present in 72 cases (75%). The sensitivity of standard radiographs regarding radiocarpal joint involvement was 93.8%. Considering involvement of the distal radio-ulnar joint the false-negative rate using standard radiographs was 61.7% and the test’s accuracy for sigmoid notch involvement was 45.8%. Conclusion This study demonstrates that involvement of the sigmoid notch is frequently missed in standard radiographs. The presented data support the frequent use of CT imaging to allow the holistic illustration of a fracture’s complexion and to ensure optimal pre-operative planning.

The Effect of Volarly Angulated Distal Radius Fractures on Forearm Rotation: In Vitro Biomechanical Study

2015 ◽  
Vol 04 (S 01) ◽  
Author(s):  
Masao Nishiwaki ◽  
Mark Welsh ◽  
Louis Ferreira ◽  
James Johnson ◽  
Graham King ◽  
...  
Keyword(s):  
Distal Radius ◽  
Biomechanical Study ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Forearm Rotation

scholarly journals Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study

2011 ◽  
Vol 93 (1) ◽  
pp. 57-60 ◽  
Author(s):  
DC Perry ◽  
DMG Machin ◽  
JA Casaletto ◽  
DJ Brown
Keyword(s):  
High Risk ◽  
Distal Radius ◽  
Plate Fixation ◽  
Tendon Injury ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Fixed Angle ◽  
Volar Plate Fixation

INTRODUCTION Rupture of extensor pollicis longus (EPL) tendon is a recognised complication following volar plate fixation of distal radius fractures, usually from attrition caused by prominent screws. We sought to identify the screw holes in some of the most commonly used plates which may precipitate tendon injury. SUBJECTS AND METHODS Three fixed-angle volar locking plates were sequentially positioned into 18 cadaveric arms. A wire was passed through each of the holes in the plates using a locking guide and the dorsal relationships noted. RESULTS Each plate had specific ‘high-risk’ holes which directed the wire towards the EPL groove. The central screw holes appeared mostly implicated in EPL injury. CONCLUSIONS Awareness of ‘high-risk’ holes and appropriate minor alterations in surgical technique may consequently decrease the incidence of EPL irritation and rupture.

A Multimodal Pain Management Regimen for Open Treatment of Distal Radius Fractures: A Randomized Blinded Study

Hand ◽  
2020 ◽  
pp. 155894472097514
Author(s):  
Julian Zangrilli ◽  
Nura Gouda ◽  
Armen Voskerijian ◽  
Mark L. Wang ◽  
Pedro K. Beredjiklian ◽  
...  
Keyword(s):  
Pain Management ◽  
Distal Radius ◽  
Bone Healing ◽  
Pain Control ◽  
Distal Radius Fractures ◽  
Study Group ◽  
Radius Fractures ◽  
Multimodal Pain Management ◽  
Regional Block ◽  
Rebound Increase

Background Adequate pain control is critical after outpatient surgery where patients are not as closely monitored. A multimodal pain management regimen was compared to a conventional pain management method in patients undergoing operative fixation for distal radius fractures. We hypothesized that there would be a decrease in the amount of narcotics used by the multimodal group compared to the conventional pain management group, and that there would be no difference in bone healing postoperatively. Methods Forty-two patients were randomized into 2 groups based on pain protocols. Group 1, the control, received a regional block, acetaminophen, and oxycodone. Group 2 received a multimodal pain regimen consisting of daily doses of pregabalin, celecoxib, and acetaminophen up until postoperative day (POD) #3. They also received a regional block with oxycodone for breakthrough pain. Results From POD#3 to week 1, there was a significant increase in oxycodone use in the study group correlating with the point in time when the multimodal regimen was discontinued. The shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) scores taken at 2 weeks postoperation showed a significantly lower average score in the study group compared to the control. There was no difference in bone healing. Conclusions The 2 regimens yielded similar pain control after surgery. The rebound increase in narcotic use after the multimodal regimen was discontinued, and significant difference in QuickDASH scores seen at 2 weeks postoperatively supported that multimodal regimens may not necessarily lead to decreased narcotic use in outpatient upper extremity surgery, but in the short term are shown to improve functional status.

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