Corrective Osteotomies after Injuries of the Distal Radial Physis in Children

1997 ◽  
Vol 22 (6) ◽  
pp. 699-704 ◽  
Author(s):  
L. M. HOVE ◽  
L. B. ENGESÆTER
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Range Of Motion ◽  
Distal Radius ◽  
Iliac Crest ◽  
Distal Forearm ◽  
Growth Disturbance ◽  
Radial Inclination ◽  
Lengthening Osteotomy ◽  
Post Traumatic

Six children had corrective osteotomies of the distal forearm because of growth disturbance from post-traumatic closure of the distal radial physis. Lengthening osteotomy of the radius was performed in three patients with grafts from the iliac crest. All osteotomies healed in a satisfactory position. Three patients had only moderate mal-angulation of the radius and were treated by shortening of the ulna. The median postoperative palmar angulation of the distal radius was 4 (0–13)°, the radial inclination 22 (15–28)°, and the ulnar variance was –2 (–4 – +2) mm. The postoperative pain relief was complete in all patients and the total range of motion was 96 (93–100)% compared with the opposite side.

DISTAL RADIOULNAR JOINT DORSAL INSTABILITY TREATED WITH DORSAL CAPSULAR RECONSTRUCTION

Hand Surgery ◽  
2004 ◽  
Vol 09 (01) ◽  
pp. 55-61 ◽  
Author(s):  
Kwok-Ho Wong ◽  
Tak-Hing Yip ◽  
Wing-Cheung Wu
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Radioulnar Joint ◽  
Complex Injury ◽  
Triangular Fibrocartilage ◽  
Post Traumatic

Six patients with post-traumatic distal radioulnar joint dorsal instability were treated with dorsal capsular reconstruction. This new technique of reconstruction requires less extensive dissection than the previously described methods in the literature and requires no tendon graft. A total of six patients treated from 1999 to 2001 were included in this study. Two were males and four were females. The average age of patients was 30 years and all the instabilities were secondary to trauma. One of them had associated minimally displaced distal radius fracture. All patients had arthrogram and arthroscopy done before the reconstruction and had no significant triangular fibrocartilage complex injury. The surgery consisted of duplication capsulorrhaphy of the dorsal capsular structures of the distal radioulnar joint. All patients had satisfactory results after the operations in terms of pain relief, range of motion and stability.

scholarly journals Early hybrid nonbridging external fixation of unstable distal radius fractures in patients aged ≥50 years

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051987956
Author(s):  
Pengfei Cheng ◽  
Fan Wu ◽  
Hua Chen ◽  
Chaoyin Jiang ◽  
Ting Wang ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Fixation ◽  
Scale Score ◽  
Distal Radius ◽  
Visual Analog Scale Score ◽  
Dash Score ◽  
Radius Fractures ◽  
Analog Scale ◽  
Radial Inclination ◽  
K Wires

Objective We evaluated hybrid nonbridging external fixation (NBEF) supplemented by K-wires as an effective and safe treatment option for osteoporotic distal radius fractures (DRFs) in a retrospective case series. Methods Sixteen extra-articular and one intra-articular DRF were treated by NBEF from 2016 to 2018 (mean patient age, 61.8 years; 15 women, 1 man). Radiographic parameters (volar tilt, radial inclination, and ulnar variance), range of motion, grip power, the visual analog scale score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed at 4 weeks, 6 weeks, 6 months, and 12 months postoperatively. Results The volar tilt and radial inclination were restored after surgery and maintained well. The mean visual analog scale score was 4 ± 1 at 4 weeks. Range of motion was restored to 79% to 91% at 6 weeks. The DASH score was good before NBEF device removal. Two superficial pin-tract infections were easily treated with antibiotics. Conclusions Hybrid NBEF transfixes DRFs in a multiplanar fashion, and augmentation with percutaneous K-wires provides direct fixation in radial shift and withstands axial loads in fracture fragments. It allows early mobilization with rigid fixation. Hybrid NBEF is reliable for unstable extra-articular and simple intra-articular DRFs in older patients. Clinical Study registration number ChiCTR1900021712

Dual Plating Technique for Volar Rim Fracture of the Distal Radius Using DePuy-Synthes 2.0 m and 2.4 mm Locking Plates

2017 ◽  
Vol 22 (04) ◽  
pp. 423-428 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiro Suzuki ◽  
Hiromasa Wakita
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Locking Plates ◽  
Radius Fractures ◽  
Radial Inclination ◽  
The Mean

Background: To assess the surgical results of distal radius fractures with the involvement of a volar rim fragment using the DePuy-Synthes 2.0 mm and 2.4 mm locking plates.Methods: Subjects were six women and one man of average age 57 years (range, 31–83 y) and a mean follow-up period of 9 months (range, 5–19 mo) with AO B3 (volar shearing) distal radius fractures. Time of the procedure, physical examination of wrist range of motion, grip strength compared with the contralateral healthy wrist, and radiographic evaluation (volar tilt, radial inclination, and ulnar variance) were evaluated. The Visual Analog Scale (VAS: 0 points represents no pain, 100 points represents the worst pain possible) and the Quick Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH, 0 = no disability, 100 = extreme disability) were completed by patients at the final follow-up.Results: The average time of the procedure was 74 min. There were no perioperative complications. Average radiographic measures were: volar tilt, 8°; radial inclination, 23°, and ulnar variance, 0 mm. Wrist range of motion averaged 63° in wrist extension (range, 55–80°) and 55° in wrist flexion (range, 45–65°). Grip strength averaged 81% of the contralateral side at final evaluation (range, 67–100%). The mean QuickDASH score was 3.0 points (range, 0–9.1 points) and the mean VAS for pain was 9.3 at final follow-up.Conclusions: Open reduction internal fixation with the DePuy-Synthes 2.0 mm and 2.4 mm locking plates is an effective means of fixing a distal radius fracture that includes a volar rim fragment without interfering with flexor tendon gliding.

Continuous Infusion of Local Anesthetic at Iliac Crest Bone-Graft Sites for Postoperative Pain Relief

2006 ◽  
Vol 88 (12) ◽  
pp. 2606-2612 ◽  
Author(s):  
Steven J. Morgan ◽  
Kyle J. Jeray ◽  
Laurel H. Saliman ◽  
Howard J. Miller ◽  
Allison E. Williams ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Bone Graft ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Iliac Crest ◽  
Postoperative Pain Relief ◽  
Iliac Crest Bone Graft

scholarly journals Safety and efficacy of a novel retrograde route for femoral bone graft harvesting by Reamer-Irrigator-Aspirator: a pilot study on 24 patients

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Fernando Bidolegui ◽  
Sebastián Pereira ◽  
Cristina Irigoyen ◽  
Robinson Esteves Pires
Keyword(s):  
Postoperative Pain ◽  
Bone Graft ◽  
Iliac Crest ◽  
Bone Defects ◽  
Femoral Bone ◽  
Femoral Route ◽  
Bone Graft Harvesting ◽  
Post Traumatic ◽  
Graft Volume

Abstract Background The Reamer–Irrigator–Aspirator system was initially developed to reduce fat embolism and thermic necrosis during reamed intramedullary nail fixation of femoral shaft fractures. Currently, this system is used in extended applications including accessing large volume of autologous bone graft, as alternative for iliac crest harvesting. Antegrade femoral bone graft harvesting using the Reamer-Irrigator-Aspirator system is considered the standard technique. The aim of our study is to evaluate the efficacy (bone graft volume) and the complications (blood loss, postoperative pain, and incidence of iatrogenic fractures) of the Reamer–Irrigator–Aspirator system through the retrograde femoral route in a series of patients with post-traumatic bone defects or nonunions. Methods A non-controlled single center retrospective observational cohort study was conducted in a level1 trauma center to evaluate all patients who were treated using the RIA system. Between November 2015 and May 2019, 24 patients (8 women and 16 men; mean age: 41 years [range 27–55 years]) with bone defects or nonunions underwent bone graft harvesting using the Reamer–Irrigator–Aspirator system through retrograde femoral route. Postoperative pain, complications, and bone graft volume were analyzed. Inclusion criteria was patients older than 18 years with a diagnosis of post-traumatic bone defect or associated tibial or femoral nonunion, with minimum 6-months follow, treated using the RIA. We hypothesized that the retrograde route of the RIA system is a safe and efficacious method for bone harvesting. Results The average volume of collected graft was 45 cc (range 30–60 cc). In 83% of the cases, bone grafting was sufficient, while in 17% it was necessary to add iliac crest bone graft to completely fill the bone defect. A mean drop in postoperative hemoglobin of 4.1 g / dL (range 0.5–6.0 g / dL) was evidenced. In 4 cases (33%), a unit of packed red blood cells was required. Regarding postoperative pain, visual analogue scale after 3 months postoperatively was 1.6 in average. After 6 months, the value has decreased to 0.4. There were no perioperative or postoperative complications at 6-month follow-up. Conclusion In this limited case series, large volumes of bone graft were harvested using the retrograde route of the RIA system and there were no intra-/ postoperative complications observed at 6-month follow-up. Therefore this novel technique appears safe and efficacious. However, it’s important to highlight that future prospective controlled studies are necessary to validate the insights from this pilot study.

scholarly journals Single-stage Distal Radius Dome Osteotomy with Ulnar Diaphyseal Shortening and Distal Ulnar Epiphysiodesis in A Case of Manus Valgus Deformity Secondary to Post-Traumatic Physeal Growth Arrest – A Case Report

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Aniruddha Sinha Sarkar ◽  
Ranadeb Bandyopadhyay ◽  
Pathikrit Guha Niyogi
Keyword(s):  
Case Report ◽  
Grip Strength ◽  
Distal Radius ◽  
Growth Arrest ◽  
Valgus Deformity ◽  
Left Wrist ◽  
Radial Inclination ◽  
Radial Deviation ◽  
Dome Osteotomy ◽  
Post Traumatic

Introduction: Distal radius physeal growth arrest in children secondary to trauma is a rare complication. Various modalities of surgical treatment exist. Correction of severe deformity by a single-stage surgery is rare in current literature. We describe a case of surgically treated post-traumatic manus valgus deformity in an adolescent female with a satisfactory surgical outcome. Case Report: A 13-year-old right-hand dominant girl presented to us with a painless, gradually progressive left wrist deformity for the past 3 years. She sustained a left wrist injury 3.5 years back for which she received native treatment. She was able to do most of her daily activities and cosmetic disability was her primary concern. She had a 20° fixed radial deviation deformity with further radial deviation up to 60°. Forearm rotation was from 70° supination to 60° pronation. Her pre-operative Mayo Modified Wrist Score was 25/10/10/25/70 (Pain/Satisfaction/Range of motion/Grip strength/Total). Radiologically, there was the obliteration of lateral distal radial physis with overgrowth of medial physis. Distal ulnar physeal overgrowth led to positive ulnar variance. Radiologically, the magnitude of deformity was 43° manus valgus (+24° radial inclination). We performed dome osteotomy at distal radius metaphysis with distal radius plating through modified Henry approach. Simultaneous ulnar diaphyseal shortening osteotomy with plate fixation was done through a dorsal approach and distal ulnar epiphysiodesis was done by physeal drilling to prevent future overgrowth. At 13 months follow-up, the wrist has clinically no deformity and radiologically 5° manus valgus (+24° radial inclination). Both the osteotomy sites have united and ulnar variance is restored. Now, her ulnar deviation was 20° and radial deviation was 30°. Her forearm rotational arc was maintained. Mayo Modified Wrist Score was 25/25/10/25/85 (Pain/Satisfaction/Range of motion/Grip strength/Total) with no hindrance of daily activity.

CONTINUOUS INFUSION OF LOCAL ANESTHETIC AT ILIAC CREST BONE-GRAFT SITES FOR POSTOPERATIVE PAIN RELIEF

2006 ◽  
Vol 88 (12) ◽  
pp. 2606-2612 ◽  
Author(s):  
STEVEN J. MORGAN ◽  
KYLE J. JERAY ◽  
LAUREL H. SALIMAN ◽  
HOWARD J. MILLER ◽  
ALLISON E. WILLIAMS ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Bone Graft ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Iliac Crest ◽  
Postoperative Pain Relief ◽  
Iliac Crest Bone Graft

scholarly journals THE EARLY KNEADING OF THE RADIOCARPAL JOINT WITH A CLOSED FRACTURE OF THE DISTAL RADIUS METAEPIPHYSIS

2017 ◽  
Vol 16 (4) ◽  
pp. 216-218
Author(s):  
Marat Mazgarovich Valeev ◽  
E. M Biktasheva
Keyword(s):  
Range Of Motion ◽  
Distal Radius ◽  
Successful Treatment ◽  
Clinical Case ◽  
Full Range ◽  
Working Capacity ◽  
Closed Fracture ◽  
Radiocarpal Joint ◽  
Post Traumatic ◽  
Type C

This paper presents a clinical case of the successful treatment of a patient with a closed Association of osteosynthesis type C fracture of the distal metaepiphysis of the left radius. The early three-week rehabilitation using kinesitherapy by the «Artromot H» device within 2 postoperative weeks made it possible to avoid the development of positional stiffness of the radiocarpal joint. Within 6 post-traumatic weeks the full range of motion of the joint and the patient’s working capacity were restored.

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