scholarly journals Conservative treatment of distal ulna metaphyseal fractures associated with distal radius fractures in elderly people

2018 ◽  
Vol 104 (7) ◽  
pp. 1101-1105 ◽  
Author(s):  
Kotaro Sato ◽  
Kenya Murakami ◽  
Yoshikuni Mimata ◽  
Norio Numata ◽  
Hideo Shiraishi ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly People ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Distal Ulna ◽  
Metaphyseal Fractures

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

2017 ◽  
Vol 43 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Daniel Martinez-Mendez ◽  
Alejandro Lizaur-Utrilla ◽  
Joaquin de-Juan-Herrero
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Surface ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Loss Of Reduction

We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures. Level of evidence: I

Predictors of early and late instability following conservative treatment of extra-articular distal radius fractures

2004 ◽  
Vol 124 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Jaydeep K. Moro ◽  
R. Brett Dunlop ◽  
Anthony Adili ◽  
Scott McKenzie ◽  
James Leone ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Late Instability

Management of Distal Ulnar Fracture Combined with Distal Radius Fracture

2016 ◽  
Vol 21 (02) ◽  
pp. 155-160 ◽  
Author(s):  
Jae Kwang Kim ◽  
Jong-Oh Kim ◽  
Yong-Do Koh
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Surgical Approaches ◽  
Radius Fractures ◽  
Ulnar Styloid ◽  
Cast Immobilization ◽  
Distal Ulna ◽  
Ulnar Styloid Fracture

The distal ulna is composed of the ulnar styloid, ulnar head, and distal ulnar metaphyseal area. Most of distal ulnar metaphyseal fractures are associated with distal radius fractures and this incidence tends to be greater in osteoporotic elderly. Consideration of the treatment of distal ulna metaphyseal fracture should be addressed after treating a distal radius fracture. If it is stable, cast immobilization is preferred, however, if it shows malalignment or instability, an operative method should be considered. More than half of distal radius fractures are combined with an ulnar styloid fracture, and considerable cases of ulnar styloid fractures result in nonunion. However, ulnar styloid nonunion usually does not cause any problems on the wrist. Recent studies of distal radius fractures treated using a volar locking plate have reported that neither the initial displacement nor the size of a concomitant ulnar styloid fracture affects clinical outcome, which suggests surgical approaches may usually not be indicated for ulnar styloid fractures.

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.

Surgical versus conservative treatment of distal radius fractures in elderly

2013 ◽  
Vol 25 (S1) ◽  
pp. 83-84 ◽  
Author(s):  
C. Trevisan ◽  
R. Klumpp ◽  
V. Nava ◽  
D. Riccardi ◽  
W. Recalcati
Keyword(s):  
Conservative Treatment ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals The Radiographic Quality of Distal Radius Fracture Reduction Using Sedation Versus Hematoma Block

2017 ◽  
Vol 26 (2) ◽  
pp. 99-103 ◽  
Author(s):  
Lior Koren ◽  
Eyal Ginesin ◽  
Shahem Elias ◽  
Ronit Wollstein ◽  
Shlomo Israelit
Keyword(s):  
Conservative Treatment ◽  
Distal Radius ◽  
Closed Reduction ◽  
Soft Tissue Injury ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Surgeon Experience ◽  
Sedation Group

Introduction: Distal radius fractures (DRFs) are treated in the emergency department (ED) with a closed reduction in order to decrease neurovascular and soft tissue injury and as a first definitive step in conservative treatment. The type of anesthesia used may affect the ability to reduce the fracture and remains controversial. Objective: The purpose of this study was to compare the quality of radiographic reduction achieved in the ED of DRF reduced using sedation anesthesia to those reduced with hematoma block anesthesia. Methods: A retrospective case–control study of 240 DRF reductions, 30 treated with sedation and 210 with a hematoma block, was performed. Complications and time spent in the ED were documented. Pre- and postreduction radiographs were reviewed for volar tilt, radial angulation, radial height, and ulnar variance. Results: Both groups were similar in gender, background illnesses, concomitant injuries, surgeon experience, and fracture radiographic classification. Postreduction values of volar tilt were better in the sedation group ( P = .03). Volar tilt and ulnar variance improved more in the sedation group ( P = .001). The sedation group spent more time in the ED ( P = .001). Discussion: Sedation seemed to be more efficient than hematoma block in supporting closed reduction of distal radius fractures in the ED. However, this method requires specialized personnel and more time spent in the ED. Conclusion: We suggest using this method when the patient is planned to continue with conservative treatment.

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