High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures

2008 ◽  
Vol 27 (4) ◽  
pp. 160-166 ◽  
Author(s):  
J. van Aaken ◽  
J.-Y. Beaulieu ◽  
D. Della Santa ◽  
O. Kibbel ◽  
C. Fusetti
Keyword(s):  
Distal Radius ◽  
Kirschner Wire ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Radius Fractures

Operative Treatment of Distal Radius Fractures in Patients With Parkinson Disease

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Anthony L. Logli ◽  
Marco Rizzo
Keyword(s):  
Parkinson Disease ◽  
Operative Treatment ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Successful Outcome ◽  
Time To Failure ◽  
Radius Fractures ◽  
Locked Plating

Background: Owing to the many unique disease characteristics of Parkinson disease (PD)—namely resting tremors, muscular rigidity, and poor bone quality—we hypothesized that this patient population would have inferior outcomes with surgical management of acute distal radius fractures (DRFs) compared with the literature available on the general population. Methods: This is a retrospective observational study performed at a single, level 1, academic center from 2001 to 2020 capturing all adult patients with an isolated, acute, and closed DRF that ultimately underwent operative treatment. International Classification of Diseases 10 codes were used to identify 30 patients for manual chart review. Several patient and fracture characteristics were accounted for and complications, reoperations, and failures of surgical intervention were recorded. Results: There was a total of 7/30 failures (23%), 6/30 reoperations (20%), and 12 complications in 9/30 wrists (complication rate, 30%) at a mean latest follow-up of 11 months (1.2-158 months). Of the 7 failures, 5 were due to loss of reduction, and 2 of them were deep infections with mean time to failure of 8.3 weeks (range, 11 days-5.2 months). Conclusions: This study found a high rate of complications, reoperations, and early failure despite a short follow-up period and a small cohort of patients with PD treated surgically for a DRF. We recommend locked plating if suitable for the fracture type and early involvement of a multidisciplinary team to assist with medical optimization of PD to increase chances of a successful outcome.

scholarly journals Technique for Intramedullary Stabilization of Ulnar Neck Fractures

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 563-571
Author(s):  
Jack Abboudi ◽  
Scott M. Sandilands ◽  
C. Edward Hoffler ◽  
William Kirkpatrick ◽  
William Emper
Keyword(s):  
Distal Radius ◽  
Kirschner Wire ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Percutaneous Approach ◽  
Intramedullary Stabilization ◽  
Ulna Fractures ◽  
Neck Fracture ◽  
Reproducible Method

Background: Distal ulna fractures at the ulnar neck can be seen in association with distal radius fractures, and multiple techniques have been described to address the ulnar neck component of these injuries. We have found that treatment of ulnar neck fractures can be challenging in terms of anatomy and fracture fixation. We present a new percutaneous fixation technique for ulnar neck fractures commonly seen with distal radius fractures. Technique: Fixation of the ulnar neck fracture is performed after fixation of the distal radius fracture. Our technique uses anterograde intramedullary fixation to stabilize the fracture with a 1.6-mm (0.062 inch) Kirschner wire or a commercially available metacarpal fixation intramedullary nail. The fixation is introduced into the intramedullary space of the ulnar shaft 4 to 6 cm proximal to the fracture at a separate surgical site along the subcutaneous border of the ulna. The fixation is also supported with a sugar-tong splint for the first few weeks after surgery and requires removal of the ulnar implant approximately 10 weeks after implantation. Conclusion: Our technique utilizes a percutaneous approach with minimal fracture exposure. It provides a relatively simple and reproducible method to address ulnar neck fractures commonly seen in association with distal radial fractures.

scholarly journals External and internal fixation for comminuted intra-articular fractures of distal radius

1970 ◽  
Vol 7 (4) ◽  
pp. 369-373 ◽  
Author(s):  
RL Pradhan ◽  
S Lakhey ◽  
BK Pandey ◽  
RR Manandhar ◽  
KP Rijal ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Volar Plating ◽  
Radius Fractures ◽  
Articular Fractures

Background: Distal radius fractures are a common injury and without proper treatment leads to high functional impairment and frequent complications. Objective: The aim of this study was to see the functional outcome in patients with comminuted distal radius fractures treated with combined external fixation and open reduction with volar plating. Materials and methods: All comminuted distal radius fractures classified as type C in AO/OTA classification were enrolled for the study from 2005 till 2008. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome. Results: There were twenty-two patients with the average age of 42.18 years (range 19-60) with 15 male and 7 females. The follow-up period was from 14 to 46 months. Accordingly, there were 11 (50%) excellent, 7 (31%) good, 2 (9%) fair and 2 (9%) poor results. There were very few complications in our series. In three patients additional K-wire supplementation was necessary along with external and open internal fixation. Conclusions: Comminuted intra-articular fractures of distal radius should be treated by open reduction and combined internal and external fixation to achieve a high rate of patient satisfaction and satisfactory functional outcome. Key words: distal radius fractures; volar plating; external fixationDOI: 10.3126/kumj.v7i4.2756 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 369-373

scholarly journals Partially Healed Malaligned Distal Radius Fracture. Surgical Treatment in Patients older than 70 Years

2020 ◽  
Vol 48 (01) ◽  
pp. 020-026
Author(s):  
Marcos Cruz-Sánchez ◽  
Jaime De la Torre-Rojo ◽  
Cristóbal Martínez-Andrade
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Fracture Pattern ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Mayo Wrist Score

Abstract Introduction Management of distal radius fractures remains controversial despite their high frequency. Elderly patients specifically present a high rate of secondary displacement, sometimes requiring a complex reconstructive surgery. The surgical treatment of displaced fractures evolving for several weeks in elderly patients has not been clearly reflected in the literature. This study aims to show clinical and radiological outcomes from this particular situation. Material and Methods Retrospective study of 31 cases of distal radius fractures with more than 2 weeks of evolution. Fractures were graded according to the Fernández's classification. Pre- and postoperative radiological studies were carried out to evaluate the degree of correction achieved. A clinical evaluation was performed using the Mayo Wrist Score. Data on arthroscopy and bone substitutes use, specific surgical tips and complications were also collected. Results Thirty-one patients with a mean age of 76 years old were operated for distal radius fracture with a delay in surgical treatment of 22 days. The most frequent fracture pattern was Fernández type III (38.7%). The clinical outcome according to the Mayo Wrist Score was 81.94 points with no relationship to fracture pattern or arthroscopic assistance. A statistically significant improvement was achieved for the correction of radial inclination, joint gap and ulnar variance. No statistically significant improvement was achieved in volar tilt correction. Complications were observed in 12.9% of the cases. Conclusions Delayed surgical treatment of distal radius fracture in elderly patients provides similar results to those observed in other age groups and time of evolution. Despite not being the ideal scenario for the surgeon, it should be considered to avoid functional deterioration in this fragile age group.

REOPERATION FOR METALWORK COMPLICATIONS FOLLOWING THE USE OF VOLAR LOCKING PLATES FOR DISTAL RADIUS FRACTURES: A UNITED KINGDOM EXPERIENCE

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 113-118 ◽  
Author(s):  
A. Sahu ◽  
C. P. Charalambous ◽  
S. P. Mills ◽  
S. Batra ◽  
M. J. Ravenscroft
Keyword(s):  
United Kingdom ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Locking Plates ◽  
Radius Fractures ◽  
Technical Aspects ◽  
Work Related ◽  
Radiocarpal Joint ◽  
Metal Work

Volar locking plates are increasingly used in the management of distal radius fractures. As with any new implant, understanding the rate and type of potential metalwork related complications is important. In this study, we reviewed 114 distal radius fractures treated with volar locking plating. Our aim was to determine the type and rate of metalwork complications requiring reoperation. In our series, 12 cases (10%) underwent further surgery for metalwork related complications mainly for screw protrusion into the radiocarpal joint following fracture collapse. Our results suggest that volar locking plates are associated with a high rate of metal work related complications requiring further surgery. Technical aspects to reduce such complications are discussed.

UNSTABLE DISTAL RADIUS FRACTURES TREATED BY MODIFIED KIRSCHNER WIRE PINNING

1994 ◽  
Vol 36 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Hans Habernek ◽  
Reinhard Weinstabl ◽  
Christian Fialka ◽  
Lothar Schmid
Keyword(s):  
Distal Radius ◽  
Kirschner Wire ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals Strain as a Function of Time in Extrinsic Wrist Ligaments Tensioned Through External Fixation

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 60-64
Author(s):  
Joseph P. Rectenwald ◽  
K. Ashley Bentley ◽  
Peter M. Murray ◽  
Subrata Saha
Keyword(s):  
Stress Relaxation ◽  
External Fixation ◽  
Distal Radius ◽  
Kirschner Wire ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Fracture Length ◽  
Significant Difference ◽  
Fresh Frozen ◽  
Average Loss

Background: The objective of this study is to determine the time-dependent dissipation of extrinsic wrist ligament tension following the application external fixation with axial distraction of the wrist in a cadaveric model. Methods: Six paired fresh-frozen cadaveric specimens underwent mechanical testing simulating external fixation with 1 arm of each pair osteotomized to simulate a distal radius fracture. The change in tension was then recorded over 24 hours. Results: The rate of stress relaxation decreased with time. The average loss in tension in the control arms and osteotomized arms was 55% and 59%, respectively, over a 24-hour period. There was no statistically significant difference in the stress relaxation behavior between the 2 groups. Conclusion: This study further supports the recommendation that comminuted distal radius fractures treated with an external fixator should have Kirschner wire augmentation or other additional means of fixation to help maintain fracture length and alignment. The results of this study call in to question the efficacy of ligamentotaxis alone through external fixation as the sole means of maintaining reduction of displaced, unstable distal radius fractures.

scholarly journals INTRA-ARTICULAR DISTAL RADIUS FRACTURES

2015 ◽  
Vol 22 (07) ◽  
pp. 944-948
Author(s):  
Qazi Muhammad Furquan ◽  
Naveed Ahmed Solangi ◽  
Muhammad Bux Chachar ◽  
Ghulam Mustafa Kaimkhani ◽  
Malik Wasim Ahmed ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Kirschner Wire ◽  
Case Series ◽  
Styloid Process ◽  
Distal Radius Fractures ◽  
Study Patient ◽  
Radius Fractures ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

Objectives: To determine functional outcome of percutaneous Kirschner wirefixation and short arm cast in intra-articular distal radius fractures in patients of 20-70 years.Study Design: Descriptive case series. Setting: Department of Orthopedic Surgery, DowUniversity of Health Sciences / Civil Hospital Karachi. Period: 1st April, 2013 to 30th September,2013. Methods: A total of 62 patients with closed type III distal fractures according to Frykmanclassification were included in this study. Patient lying in supine position and after generalanesthesia, closed reduction was done with the forearm in prone position, aiming to restorenormal anatomical position. Two Kirschner wires were inserted from radial styloid process inparallel and oblique fashion to the medial cortex of the radius and one transversely from lateralto medial for intra-articular fragments. Final functional outcome was assessed after 12 weeks ofsurgery and recorded on pre-designed Proforma. Results: Acceptable functional outcome ofpercutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractureswas observed in 80.65% (50/62) cases. Conclusions: It is concluded that functional outcomeof percutaneous Kirschner wire fixation and short arm cast procedure is satisfactory in intraarticulardistal radius fractures and it appears to be an easy, technically less demanding andeffective method for stabilization, so this procedure can be applied for patients with thesefractures.

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