scholarly journals Analysis of loss of reduction as risk factor for additional secondary displacement in children with displaced distal radius fractures treated conservatively

2020 ◽  
Vol 106 (1) ◽  
pp. 193-198 ◽  
Author(s):  
Vito Pavone ◽  
Andrea Vescio ◽  
Ludovico Lucenti ◽  
Emanuele Chisari ◽  
Federico Canavese ◽  
...  
Keyword(s):  
Risk Factor ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Loss Of Reduction ◽  
Secondary Displacement

Secondary displacement of distal radius fractures treated by bridging external fixation

2013 ◽  
Vol 39 (4) ◽  
pp. 423-428 ◽  
Author(s):  
N. Farah ◽  
L. Nassar ◽  
Z. Farah ◽  
F. Schuind
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Loss Of Reduction ◽  
Ulnar Fracture ◽  
Secondary Displacement ◽  
Type Of Fracture ◽  
Gender Type

Loss of reduction remains an important problem after treatment of distal radius fractures, whatever the type of bone fixation. We assessed retrospectively the rate of secondary displacement after external fixation of distal radius fractures in order to identify possible risk factors for instability. We reviewed the pre-operative and serial post-operative radiographs of a retrospective series of 35 distal radius fractures treated by bridging external fixation. When classified according to the Société Française d’Orthopédie et Traumatologie (SOFCOT) criteria, the rate of secondary displacement was 48.5%. At final follow up, the reduction was anatomical in 12% and acceptable in 83%. There was malunion in 5%. The loss of reduction concerned primarily the distal radius palmar tilt and was moderate. No correlation was found with age, gender, type of fracture, degree of initial displacement, associated ulnar fracture, or seniority of the treating surgeon.

Classification and Management of Failed Fixation of the Volar Marginal Fragment in Distal Radius Fractures

2021 ◽  
Author(s):  
M. Carolina Orbay ◽  
Jorge L. Orbay
Keyword(s):  
Distal Radius ◽  
Patient Characteristics ◽  
Distal Radioulnar Joint ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Fracture Patterns ◽  
Loss Of Reduction ◽  
Operative Fixation ◽  
Specific Fracture

AbstractGreater understanding of specific fracture patterns following distal radius fractures has arisen with the advent of volar plating. The volar marginal fragment (VMF) is a small peripheral piece of bone which is critical to carpal stability. Failure to achieve good fixation of the VMF can result in volar subluxation of the carpus and distal radioulnar joint instability. Due to its small, distal nature, this fragment can be easily missed and difficult to fix. Loss of reduction of the VMF following operative fixation presents specific challenges and surgical considerations dictated by patient characteristics and timing. Our goal of this review is to present a classification system for these failed VMFs which can help guide surgical treatment as well as expected outcomes.

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

scholarly journals Dorsal Plate Osteosynthesis in Simple and Complex Fractures of the Distal Radius: A Radiological Analysis of 166 Cases

2021 ◽  
Author(s):  
Haval Ghafoor ◽  
Mathias Haefeli ◽  
Regula Steiger ◽  
Philipp Honigmann
Keyword(s):  
Distal Radius ◽  
Plate Osteosynthesis ◽  
Distal Radius Fractures ◽  
Dorsal Plate ◽  
Radius Fractures ◽  
Radiographic Findings ◽  
Radiographic Measurements ◽  
Loss Of Reduction ◽  
Level Of Experience ◽  
Dorsal Plating

Abstract Background To report the radiologic outcome and rate of complications of open reduction and internal fixation (ORIF) using a dorsal plate fixation of simple and complex distal radius fractures in adult patients. Methods Patients treated with dorsal ORIF of simple and complex distal radius fractures between December 2008 and April 2013 were included in this single-center retrospective study. Type of fracture, radiographic measurements, and complications were documented. Results One-hundred and sixty-six patients/fractures were included. Restoration of radial inclination (22° ± 3°) was achieved in 38%. Radial height (14 ± 1 mm) was least likely to be restored to normal values postoperative in 25%. Normal ulnar variance (0.7 ± 1.5 mm) could be observed in 60% and adequate volar tilt (11° ± 5°) was achieved in 50% at final follow-up. We observed one loss of reduction in an AO type C2 fracture and a total of 15 nonimplant-related minor clinical complications. Conclusion Our radiographic findings after dorsal plating are comparable to those published on volar plating. The changes in radial height and volar tilt could be attributed to projection-related differences in the radiographs and did not signify a loss of reduction in all cases. Clinical Relevance Dorsal plating of distal radius fractures is safe and remains an important approach in the treatment of complex distal radius fractures. Complications in our study were even less compared to those reported in the literature. Type of Study/Level of Evidence This is a Type IV study. Level of Experience of Surgeons The level of experience of surgeons is III–V.

scholarly journals Fracturas de radio distal. ¿Progresa el desplazamiento entre la segunda y la sexta semana?.

2020 ◽  
pp. 61-65
Author(s):  
IRINA CAPO-SOLIVERES ◽  
BENITO R PICAZO-GABALDON ◽  
SONIA ORENGA-MONTOLIU ◽  
M GRACIA-OCHOA ◽  
S ESCRIBANO-ZACARES ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Distal Radius ◽  
Demographic Data ◽  
Distal Radius Fractures ◽  
Displacement Rate ◽  
Radius Fractures ◽  
Cast Immobilization ◽  
Wrist Fractures ◽  
Secondary Displacement

Distal radius fractures are the most frequent in our specialty. Conservative treatment with cast immobilization, based on radiographic criteria, is still the most widely used nowadays. The aim of our study is to evaluate the secondary displacement of these fractures between the second and sixth week of evolution. To this end, we have evaluated the distal radius fractures treated conservatively at our Service, during 2016. Out of 53 wrist fractures treated conservatively, 49% of the cases presented some type of displacement, although most of these took place before the second week. Our results were similar to those reviewed in the literature, in terms of demographic data and displacement rate. For this reason, we recommend inserting some weekly radiographic controls in fractures that expose some instability parameters from the beginning.

scholarly journals Redisplacement of paediatric distal radius fractures: what is the problem?

2021 ◽  
pp. 1-8
Author(s):  
Diogo M.C. Constantino ◽  
Luis Machado ◽  
Marcos Carvalho ◽  
João Cabral ◽  
Pedro Sá Cardoso ◽  
...  
Keyword(s):  
Risk Factor ◽  
Distal Radius ◽  
Closed Reduction ◽  
Significant Risk ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Cast Immobilization ◽  
Significant Difference

Purpose Distal radius fractures represent one of the most common fractures in children. Our purpose is to analyze risk factors for redisplacement in children with distal radius fractures treated by means of closed reduction and plaster cast immobilization. Methods Retrospective study, including children under the age of 17 years, who underwent closed manipulation and cast immobilization for a distal third radius fracture, between 2012 and 2015. Preoperative radiographs were reviewed for initial translation, angulation and shortening, distance of the fracture from the physis, degree of fracture obliquity and the presence of an ulna fracture. Postoperative radiographs were analyzed for translation, angulation and shortening, as well as the quality of closed reduction. Cast index, gap index and three-point index, were measured on the postoperative radiographs. Redisplacement and re-intervention during follow-up were registered. Results A total of 26 patients were included in this study. Comparison between post-reduction and immediate post-cast removal radiographs did not show any statistically significant difference between translation or shortening. Coronal (p = 0.002) and sagittal (p = 0.002) angulation showed a statistically significant difference, but both median values remained below cut-off values for redisplacement. Redisplacement was observed in four patients. Only one patient underwent remanipulation. All four had full remodelling and proper radiological alignment at final follow-up. Quality of reduction was found to be a statistically significant risk factor for redisplacement (p = 0.013). Conclusion Closed reduction and cast immobilization under general anaesthesia yields good results in the treatment of distal forearm fractures in paediatric patients. Quality of reduction was the only risk factor that we found to be predictive of redisplacement. Level of Evidence: Level III – Retrospective comparative study

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