Dorsal (AO/ASIF) Pi-Plate Osteosynthesis in the Treatment of Distal Intraarticular Radius Fractures

2006 ◽  
Vol 31 (6) ◽  
pp. 673-679 ◽  
Author(s):  
A. SUCKEL ◽  
S. SPIES ◽  
P. MÜNST
Keyword(s):  
Plate Osteosynthesis ◽  
Extensor Tendon ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Tendon Ruptures ◽  
Tunnel Syndrome ◽  
Poor Outcomes ◽  
A Prospective Study

The results and complications using the dorsal 2.4 mm 2.7 mm (AO/ASIF) pi-plate for the treatment of distal radius fractures were evaluated in a prospective study of 42 patients followed up clinically and radiologically and seven patients followed up with telephone call and radiological follow-up for an average time of 12.1 (range 4–32) months in a group of 50 patients with intraarticular distal radial fractures treated consecutively using this method. Twelve complications occurred in 10 patients including two extensor tendon ruptures, two transient cases of CRPS Type 1 (Reflex Sympathetic Dystrophy, Algodystrophy), two instances of screw loosening, three cases of posttraumatic carpal tunnel syndrome and three permanent sensory irritations on the dorsum of the hands. Using the AO score, there were 37 successful and 12 tolerable results, with no unsatisfactory outcomes. Using the NYOWR scale, there were 17 very good and 25 good results, with no satisfactory or poor outcomes. These results suggest that this osteosynthesis provides adequate fixation of comminuted distal intraarticular radius fractures with a reasonable incidence of complications.

scholarly journals Impact of mental disorders on COVID-19 outcomes

2021 ◽  
Vol 13 (5) ◽  
pp. 40-47
Author(s):  
N. N. Petrova ◽  
V. E. Pashkovskiy ◽  
M. S. Sivashova ◽  
A. N. Gvozdetsky ◽  
G. A. Prokopovich
Keyword(s):  
Mental Disorders ◽  
Mental State ◽  
Cox Model ◽  
Prognostic Significance ◽  
Risk Of Death ◽  
Poor Outcome ◽  
Coronavirus Infection ◽  
Poor Outcomes ◽  
A Prospective Study

Objective: to analyze clinical and follow-up indicators in patients with mental disorders and COVID-19 and to identify on their basis predictors of poor outcomes associated with mental state.Patients and methods. We conducted a prospective study in a multidisciplinary hospital. The severity of coronavirus infection was determined according to the temporary guidelines. Data collection was carried out using a patient chart consisting of 109 variables. Predictors of poor outcomes were determined using predictive models (logit regression, Cox model). The study included 97 patients: 41 men (42.3%) and 56 (57.7%) women, mean age – 62.3±15.3 years. 26 patients died; 71 patients recovered.Results and discussion. The death occurred on 11.5 day. The mental state of these patients was severe, with a predominance of delirium cases. With increasing age, the probability of non-lethal outcome decreases [hazard ratio (HR) 1.03; 95% confidence interval (CI) 1.00–1.06; p=0.037]. The risk of death increased by 1.03 (p=0.037) for each year of life. An improvement in the mental state of patients during psychotropic therapy is associated with an 11.11-fold decrease in the risk of poor outcome of coronavirus infection (HR 0.09; 95% CI 0.01–0.76; p=0.027). Delirium is a predictor of low patient survival, especially in prolonged hospitalizations (HR 4.55; 95% CI 1.66–12.48; p=0.003). The severity of coronavirus infection makes the greatest contribution to the poor outcome: the risk of death increases by 33.17 times (CR 33.17; 95% CI 4.01–274.65; p<0.001). The severity of the mental disorder had a greater impact on the risk of death compared with age, increasing it by 4.55 times (p=0.003).Conclusion. We found significant differences between the groups of deceased and surviving patients with COVID-19 concerning the variables related to certain mental disorders, their severity and dynamics, and the severity of coronavirus infection. In addition, the age of the patients had a significant impact on the prognosis of COVID-19. The results reflect the special prognostic significance of delirium in the structure of mental disorders developing in patients with coronavirus infection.

scholarly journals Below-elbow or above-elbow cast for conservative treatment of extra-articular distal radius fractures with dorsal displacement: a prospective randomized trial

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Gaetano Caruso ◽  
Francesco Tonon ◽  
Alessandro Gildone ◽  
Mattia Andreotti ◽  
Roberto Altavilla ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Clinical Outcomes ◽  
Distal Radius ◽  
Randomised Trial ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Radiological Parameters ◽  
Cast Group

Abstract Background Distal radial fractures are common traumatic injuries, but their management remains controversial also in case of conservative treatment regarding the type of immobilisation. Hence, we conducted a two-arm, parallel-group, prospective randomised trial to compare the capacity of long casts (above-elbow) and short casts (below-elbow) to maintain the reduction of extra-articular distal radius fractures with dorsal displacement (AO/OTA classification: 2R3A2.2). Methods Seventy-four eligible patients with AO/OTA 2R3A2.2 fractures treated with closed reduction and cast immobilisation were randomised to the long cast group (n°= 37) or to the short cast group (n°= 37). Baseline radiological parameters, radial inclination (RI), radial height (RH), ulnar variance (UV) and palmar tilt (PT) were taken, and compared with clinical (DASH, Mayo Wrist and Mayo Elbow) and radiological scores taken at 7–10 days, 4 weeks and 12 weeks. Furthermore, to evaluate correlations between radiological parameters and functional outcomes, patients were divided into two groups according to whether or not their radiological parameters at Follow-ups 2 and 3 were acceptable, i.e. within the range 11–12 mm for RH, 16°–28° for RI, − 4–+ 2 mm for UV and 0°–22° for PT. Results Patient demographic and baseline radiological parameters were similar between groups. At follow-up, there were no statistically significant differences between the two types of cast in terms of RI, RH, UV or PT, or Mayo wrist or DASH scores. Short cast group patients displayed better Mayo elbow score at follow-up 2 (4 weeks), but this difference was no longer statistically significant at follow-up 3 (12 weeks). No statistically significant differences in clinical outcomes were found between patients who presented acceptable radiographic parameters at follow-up and those who did not. Conclusion As there were no significant differences between short casts and long casts in terms of fracture reduction maintenance or clinical outcomes, short casts are an effective method of post-reduction immobilisation in AO/OTA 2R3A2.2 fracture of the radius. Radiological parameters outside the range conventionally considered acceptable do not preclude a satisfactory clinical outcome. Trial registration ClinicalTrials.gov PRS, NCT04062110. Registred 20 August 2019.

Relationship between the Self-Administered Boston Questionnaire and Electrophysiological Findings in Follow-Up of Surgically-Treated Carpal Tunnel Syndrome

2000 ◽  
Vol 25 (2) ◽  
pp. 128-134 ◽  
Author(s):  
M. MONDELLI ◽  
F. REALE ◽  
F. SICURELLI ◽  
L. PADUA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Conduction Velocities ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
Electrophysiological Examination ◽  
A Prospective Study ◽  
And Function

A prospective study of electrophysiological examination and the Boston self-administered questionnaire (BQ) was carried out in patients with surgically-treated carpal tunnel syndrome. There were 104 hands in 93 patients (13 men and 80 women, mean age 56 years). The BQ was used to assess the severity of symptoms and function, and nerve conduction studies were done before surgical release by short incision at the palm, and at follow-ups 1 and 6 months after surgery. The BQ severity score improved or became normal in 98% of hands. The mean BQ scores and distal sensory and motor conduction velocities in the median nerve showed significant improvement at the 1 month follow-up. Further significant improvement was found at 6 months. There was no relationship between the improvements in BQ scores and the distal conduction in the median nerve. The degree of improvement in sensory and motor distal conduction velocities could be forecast from presurgical values, whereas the degree of improvement in the symptoms and the functional status after release could not be predicted from the presurgical BQ scores.

scholarly journals Evaluation of Results of Fixation of Unstable Distal Radial Fractures by Volar Locking Plating System

2017 ◽  
Vol 11 (2) ◽  
pp. 62-66
Author(s):  
Md Maiyeen Uddin ◽  
Anadi Ranjan Mondal ◽  
Narayan Chandra Karmakar ◽  
Md Masudur Rahman ◽  
Syed Asif Ul Alam
Keyword(s):  
Locking Plate ◽  
Volar Locking Plate ◽  
Wrist Flexion ◽  
Distal Radial Fractures ◽  
Surgical Fixation ◽  
Single Bone ◽  
Trauma Surgeons ◽  
Type 3

Distal radial fractures are most common fractures accounts 15% of whole skeletal injuries, as high as 40% to 49% are considered to be unstable that requires surgical fixation. The purpose of the study was to ascertain good functional hand by using volar locking plate & screws, as with locking system, distal screws are locked to the plate, which stabilized the screws against lateral movement (toggle effect), thus providing a "single bone-plate-screws construct" which producing a scaffold in the mostly cancellous distal radial metaphysis, so preventing from collapse. This study was done from January 2007 to December 2008 at National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR). Total numbers of cases were 17. All patients were admitted in hospital & most of them returned home within 4 days. Most patients were managed early within 1-10 days of injury. Most patients were Fernandez type 1, type 2, and type 3. Most patients were in the age group of 4th decade. All patients were followed up for a period of at least 3 months, mean follow up period was 6 months. Results showed that wrist pain, wrist stiffness, reduced grip strength were minimum with volar locking plate & screws as there is minimal radial shortening, radial angulation, volar tilt & ulnar variance and wrist flexion, wrist extension, ulnar deviation, supination, pronation were very good. So, the trauma surgeons can safely use this procedure.Faridpur Med. Coll. J. Jul 2016;11(2): 62-66

Long-Term Results of Carpal Tunnel Decompression

1993 ◽  
Vol 18 (4) ◽  
pp. 471-474 ◽  
Author(s):  
W. F. HAUPT ◽  
G. WINTZER ◽  
A. SCHOP ◽  
J. LÖTTGEN ◽  
G. PAWLIK
Keyword(s):  
Carpal Tunnel ◽  
Long Term Results ◽  
Variable Degree ◽  
Patients With Diabetes ◽  
Tunnel Syndrome ◽  
Long Term Prognosis ◽  
A Prospective Study ◽  
Variable Analysis

The long-term prognosis of 60 patients operated on for carpal tunnel syndrome has been assessed in a prospective study with a median follow-up period of 5.5 years (range 2–11 years). Analysis of motor, sensory, trophic, and electrodiagnostic findings and assessment of pain were performed pre- and post-operatively using a standardized grading system. The results were generally favourable with a variable degree of improvement in 86% of cases. Statistical evaluation using multiple Dunn-Rankin tests revealed pain to be the most prominent pre-operative finding. On post-operative reexamination, pain was found to be improved to a significantly greater extent than any other variable. Analysis of several potential prognostic factors showed that pain lasting for more than 5 years prior to surgery indicates a poor prognosis. Only patients with diabetes mellitus exhibited a trend toward less pain relief.

Risk factors for return with a second trigger digit

2012 ◽  
Vol 39 (7) ◽  
pp. 704-707 ◽  
Author(s):  
S. Ferree ◽  
V. Neuhaus ◽  
S. J. E. Becker ◽  
J. B. Jupiter ◽  
C. S. Mudgal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 1 Diabetes ◽  
Carpal Tunnel Syndrome ◽  
Type 1 Diabetes Mellitus ◽  
Carpal Tunnel ◽  
Syndrome Type ◽  
Tunnel Syndrome

The purpose of this study was to determine predictors of return to the same practice with a second idiopathic trigger digit. A total of 2234 patients with Quinnell grade 2 or greater (objective triggering) of one or more digits were retrospectively analysed. A total of 490 of 2234 (22%) patients returned to the same practice with a second trigger digit, with an average follow-up time of 2.1 years (range, 7 days to 10 years). Predictors of return with a second trigger digit included carpal tunnel syndrome, Type 1 diabetes mellitus and duration of follow-up in years. Patients diagnosed with idiopathic trigger digit can be advised that about one in five will return to the same practice with another trigger digit, with approximately double the risk in patients that have carpal tunnel syndrome or Type 1 diabetes.

scholarly journals Lipid profile as a predictor of Neuropathy: The Sheffield Prospective Diabetes Study

2018 ◽  
Vol 2 (2) ◽  
pp. 47-51
Author(s):  
Satyan Rajbhandari ◽  
Fahad Syed Hamid ◽  
Nigel Harris ◽  
Solomon Tesfaye
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Epidemiological Studies ◽  
Base Line ◽  
Perception Threshold ◽  
Reduction Strategies ◽  
Potential Risk Factors ◽  
A Prospective Study

Background : Despite being a very common complication, the aetiology and potential risk factors of diabetic neuropathy (DN) have not been clearly determined in a prospective study. Aims: The aim of Sheffield Prospective Diabetes Study was to identify the abnormalities of physiological, biochemical, haemorrhelogical and cellular function for complications of diabetes in type 1 diabetes. Materials and Methods: 66 newly diagnosed type 1 diabetic subjects (mean age 31 ± 9 (SD) duration (3 years ± 2) were identified and followed for 9 years. They had detailed neurological assessment (symptoms and signs score, nerve conduction, vibration perception threshold, warm thermal discrimination threshold and autonomic function tests) and blood samples taken for detail biochemical and haemorrheological analysis at base line and at follow up. Results: At the 9 years follow up, 51 subjects were studied of whom 18 were found to have DN using Dyck’s criteria. As expected subjects with DN had significantly higher (p <0.01) mean HbA1 over 9 years of follow up (11.8% vs 9.8%), but it was not significantly different at base line (10.2% vs 8.9%; p= 0.37). In addition, total cholesterol and LDL cholesterol at baseline were found to be risk factors for the development of neuropathy (5.9 vs 4.7 mmol; p=0.01 and 3.7 vs 2.8 mmol; p=0.03 respectively). Conclusions: This prospective study confirms the findings of recent large epidemiological studies linking cardiovascular risk factors to the development of DN, and perhaps suggest a vascular aetiology for DN. Improvement of potentially modifiable risk factors for neuropathy may be useful for the development of risk reduction strategies.

Dynamic Traction After Extensor Tendon Repair in Zones 6, 7, and 8: A Retrospective Study

1989 ◽  
Vol 14 (1) ◽  
pp. 21-22 ◽  
Author(s):  
C. D. Kerr ◽  
J. R. Burczak
Keyword(s):  
Retrospective Study ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Extensor Retinaculum ◽  
Tendon Ruptures ◽  
Full Flexion ◽  
Extensor Lag

Review of the notes of 46 extensor tendon repairs in 21 patients treated by post-operative dynamic traction without an M.P. flexion block, no tendon ruptures or extensor lag and only one digit without full flexion after a mean follow-up of seven weeks. Re-examination of 26 treated repairs in nine patients for this study demonstrated a mean T.A.M. of 259° at an average 14 months follow-up. No bow-stringing occurred because the extensor retinaculum was not excised, and no tenolyses were necessary.

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