Volar Lunate Facet Rim Fractures: K-I Classification and Technique

2021 ◽  
Author(s):  
Junya Imatani ◽  
Hidenori Kondo
Keyword(s):  
Surgical Technique ◽  
Distal Radius ◽  
Case Series ◽  
Ct Images ◽  
Consecutive Series ◽  
Dash Score ◽  
Management Options ◽  
Initial Fixation ◽  
Low Profile ◽  
Case Series Study

Abstract Background and Purpose It is difficult to capture and safely support a small volar lunate facet (VLF) fragment and obtain sufficient initial fixation. The challenge in treating VLF rim fractures has resulted in various management options. The purpose of this study was to evaluate the clinical and radiological outcomes of a consecutive series of VLF rim fractures of the distal radius treated surgically and to report the Kondo–Imatani (K-I) classification of these fractures, using computed tomography (CT) images and surgical technique, which is termed the Plate buttress and Double tiered subchondral support (PD) technique. Patients and Methods A retrospective review was conducted on 35 patients with VLF rim fractures that included postoperative clinical evaluations, CT images, and radiographs. Description of Technique The PD technique to stabilize the VLF fragment with an anatomical and low-profile volar locking plate (VLP). Results All fractures healed at the final follow-up; Mayo wrist performance score average was 81.7 points (45–100), and the quick disabilities of the arm, shoulder, and hand (quick-DASH) score average was 9.5 points (0–31.8), showing relatively good clinical results. Conclusion VLF rim fragments are not amenable to standard VLP fixation. Unstable fixation may result in postoperative correction loss, aseptic necrosis, malunion, radiocarpal subluxation, and wrist dysfunction. This report described the K-I classification for VLF rim fractures of the distal radius and surgical technique, termed the PD technique, to stabilize the VLF rim fragment with an anatomical and low-profile VLP. Level of Evidence This is a Level IV, case series study.

scholarly journals DISTAL RADIUS FRACTURE

2015 ◽  
Vol 22 (10) ◽  
pp. 1245-1249
Author(s):  
Mohammad Saeed ◽  
Muhammad Inam ◽  
Imran Khan ◽  
Alamzeb Durrani ◽  
Abdul Satar
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Case Series ◽  
Dash Score ◽  
Cast Immobilization ◽  
Case Series Study ◽  
First Choice ◽  
Mild Disability ◽  
Minimum Age ◽  
Series Study

Objectives: The objective of the study is to find out functional outcome inpatients with distal radius fractures irrespective of radiographic deformities after close reductionand cast splint age. Design: Case series study. Setting: Department of Orthopedics and SpineSurgery, Hayatabad Medical Complex Peshawar. Period: May 2010 to April 2015. Materialsand Methods: 28 consecutive patients of either sex with age above 40 years, having distalradius fracture. Functional outcome was assessed with disability of arm, shoulder and hand(DASH) and Patient Rated Wrist/Hand Evolution (PRWHE) questionnaire. Results: Out of 28patients male were 12(42.9%) and female were 16(57.1%). minimum age was 40 maximum81 and average was 50. Right side was involved in 17 (60.7%) while left side was involved in11(39.3%). The DASH Score Record shows that no Disability was seen in 13(46.4%), MinimalDisability in 7(25%), Mild Disability in 5(17.9%), Moderate Disability in 1(3.6%) and SevereDisability in 2(7.1%) patients. While the PRWHE Score Record shows that no Disability wasseen in 14(50%), Minimal Disability in 6(21.4%), Mild Disability in 5(17.9%), Moderate Disabilityin 1(3.6%) and Severe Disability in 2(7.1%) patients. Conclusion: A majority of the distal radiusfractures can achieve good results after treatment by closed reduction and cast immobilization,for which conservative treatment should be the first choice. Deformity of the distal radius cannotaffect the functional outcome of the wrist and hand.

scholarly journals Radius distraction could contribute to long-term stability for treating distal radioulnar joint instability during volar plating of distal radius fracture: a retrospective case series study

2021 ◽  
Author(s):  
Cheng-Yu Yin ◽  
Hui-Kuang Huang ◽  
Duretti Fufa ◽  
Jung-Pan Wang
Keyword(s):  
Surgical Technique ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Druj Instability

Abstract BackgroundThe surgical technique of radius distraction for stabilization of distal radioulnar joint (DRUJ) if intraoperative DRUJ instability was found after the fixation of distal radius fracture has been previously described, but this surgical technique lacks clinical and radiographic effect in minimal 3 years follow-up. We therefore evaluated the clinical outcome and radiographic results of radius distraction in minimal 3 years follow-up.MethodsWe reviewed the case series of distal radius fracture with concomitant DRUJ instability receiving radius distraction from the senior author over a 5-year period (January 1st, 2013 to June 30th, 2017) retrospectively, and the evaluation of clinical and radiographic outcomes was performed at clinic as long-term follow-up; a total 34 patients had been evaluated.ResultsAt minimal post-operative 36 months follow-up, all cases demonstrated acceptable wrist range of motion with stable DRUJs and low NRS of wrist pain (0.6, SD 0.7) and DASH score (mean 9.1, SD 6.2), and there were no cases suffering from nonunion of distal radius. The mean ulnar variance of injured wrist and uninjured wrist were − 1.2 mm and 0.2mm, respectively (SD 1.0 and 0.6) with significant statistical difference.ConclusionsRadius distraction during volar fixation of distal radius fracture should be consider if DRUJ instability was found by the radioulnar stress test intraoperatively, and the long-term DRUJ stability could be achieved by maintenance of normal-to-negative ulnar variance, with decreased wrist pain and satisfactory function outcome.Level of EvidenceTherapeutic Level IV

Mini-Invasive Surgery for Distal Radius Fractures: A Double Incision under 12 mm

2020 ◽  
Author(s):  
Elisabete Ribeiro ◽  
Gustavo Campanholi ◽  
Marcelo Acherboim ◽  
Gustavo Mantovani Ruggiero
Keyword(s):  
Distal Radius ◽  
Surgical Techniques ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Radiological Results ◽  
Normal Ranges ◽  
Case Series Study ◽  
Clinical And Radiological Results

Abstract Background Distal radius fracture is one of the most common lesions in adults. Surgical techniques have evolved considerably with a clear tendency toward mini-invasive techniques. Objective Our aim is to push the limits to a 12 mm approach and evaluate its clinical and radiological results. Patients and Methods Ten fractures in nine patients were operated by a double incision with mean size 11.50 ± 3.41 mm (range 8.00–1.00) and using a specially designed volar distal locking plate. Results At the latest follow-up, visual analogue scale score for pain (0.20 ± 0.63 during rest and 0.60 ± 1.07 while making efforts) and quick DASH (quick Disabilities of the Arm, Shoulder and Hand) score (6.14 ± 7.43) were extremely low. All the range of motion parameters and grip strength were above the 95% barrier of the contralateral side, with exception of ulnar deviation. Radiological parameters obtained were located within the normal ranges. Time to return to independent daily tasks and work was 6.67 ± 5.15 and 10.14 ± 14.24 days, respectively. One case of transient carpal tunnel syndrome was solved with watchful waiting and one case of extensor tendons impingement was improved after plate removal. All patients were completely satisfied at the end of the treatment. Conclusion In conclusion, mini-invasive volar technique for distal radius fractures with special designed plates in carefully selected patients allowed us to obtain good clinical and radiological results, minimal complications, fast recovery, and high-satisfactory rates. Level of Evidence This is a Level IV, case series study.

scholarly journals Medium-Long-Term Radiographic and Clinical Outcomes after Surgical Treatment of Intra-Articular Tibial Pilon Fractures by Three Different Techniques

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Carlo Biz ◽  
Andrea Angelini ◽  
Marco Zamperetti ◽  
Filippo Marzotto ◽  
Silvano Pierluigi Sperotto ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Late Complications ◽  
Anatomical Reconstruction ◽  
Consecutive Series ◽  
Tibial Pilon ◽  
Radiographic Outcomes ◽  
Case Series Study ◽  
Pilon Fractures

Introduction. The goal of this retrospective, observational, case series study was to evaluate the medium-long-term clinical and radiographic results of the three most common surgical osteosynthesis techniques used for the treatment of articular tibial pilon fractures: ORIF, MIPO, and EF. Materials and Methods. A consecutive series of patients with articular pilon fractures who underwent surgery at our institution were enrolled in this study. Fractures were classified according to the Müller AO classification system. Overall outcomes took the following into account: radiographic quality of reduction, evaluated using Ovadia and Beals’ criteria; clinical assessment, evaluated using the AOFAS questionnaire; and general health, evaluated with the SF36-v2 Health Survey. Results. A total of 94 articular pilon fractures (34 type 43-B and 60 43-C) were evaluated with a mean follow-up of 56.34 months (range 33–101). The techniques used were ORIF, MIPO, and EF in 63 (67%), 17 (18.9%), and 14 cases (14.1%), respectively. According to Ovadia and Beals’ criteria, good, fair, and poor results were reported in 61 (64.89%), 26 (27.66%), and 7 (7.45%) cases, respectively. The mean AOFAS score was 82.41 for MIPO, 79.83 for ORIF, and 50.57 for EF, respectively. Thirty-nine patients (41.49%) presented early and/or late complications. Conclusion. Satisfactory outcomes using the three different techniques were reported. In particular, the radiographic outcomes were inversely proportional to the fracture comminutions and statistically different between internal and external osteosynthesis, but comparable between ORIF and MIPO techniques. On the other hand, the clinical outcomes were closely related to the soft tissue conditions and the anatomical reconstruction of the joint.

Outcome of Plaster Splintage in the Management of Closed Extraarticular Fracture of Distal Radius

2021 ◽  
Vol 15 (9) ◽  
pp. 2382-2383
Author(s):  
Akbar Shah ◽  
Shaheryar Aziz ◽  
Muhammad Usman Aslam ◽  
Syed Wasif Ali Shah
Keyword(s):  
Informed Consent ◽  
Visual Analogue Scale ◽  
Distal Radius ◽  
Orthopaedic Surgery ◽  
Analogue Scale ◽  
Case Series ◽  
Inclusion Criteria ◽  
Case Series Study ◽  
Series Study ◽  
Fracture Of Distal Radius

Aim: To determine the outcome of extra-articular distal radius fracture treated with plaster splintage. Methodology: This descriptive case series study was done in the Department of Orthopaedic Surgery, at Jinnah Hospital, Lahore from 01-08-210 to 31-01-2011 which includes 50 patients who fulfill the inclusion criteria of age 40-80 years of either sex. After the approval of Hospital Ethical Committee, informed consent taken from every patient. Results: The average age was 63.70±11.64 years. Seventeen (34%) patients were male and 33 (66%) patients were female. On visual analogue scale of pain, 23 (46%) patients had no pain and 27 (54%) patients had mild pain. Forty six percent patients shows excellent results and 54% patient shows good results. Conclusion: Closed reduction and plaster splintage was used to assess the functional outcome in distal radius extraarticular fractures. Overall results were excellent in 64% cases and good in 54% cases in the distal radial extraarticular fractures treated with plaster splintage. Keywords: Distal radius extraarticular fractures, Plaster splintage, Visual deformity, Pain and grip strength.

scholarly journals Subbrachial approach to humeral shaft fractures: new surgical technique and retrospective case series study

2013 ◽  
Vol 56 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Vladimir Boschi ◽  
Zenon Pogorelic ◽  
Gordan Gulan ◽  
Katarina Vilovic ◽  
Hrvoje Stalekar ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Humeral Shaft ◽  
Retrospective Case ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Retrospective Case Series ◽  
Case Series Study ◽  
Series Study ◽  
New Surgical Technique

scholarly journals A study of clinicoradiological and functional outcomes of intramedullary nailing in diaphyseal radius ulna fractures

2019 ◽  
Vol 5 (6) ◽  
pp. 1150
Author(s):  
Parag M. Tank ◽  
Yash S. Shah ◽  
Rutvik D. Dave ◽  
Vijay J. Patel
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Bone Fractures ◽  
Case Series ◽  
Functional Results ◽  
Dash Score ◽  
Retrospective Case ◽  
Non Union ◽  
Case Series Study

<p class="abstract"><strong>Background:</strong> The aim of this study was to evaluate the results of intramedullary nailing in diaphyseal fractures of radius and ulna in age group of 10 to 49 years and to understand its clinicoradiological and functional results.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective case series study of forearm bone fractures and the selected management for the same over a period of 3 years. We chose the cases in which intramedullary nailing was the treatment modality which were followed up over a period of minimum 6 months. Patients with galeazzi variety, monteggia variety, pathological fracture or non-union after previous surgery were excluded. The outcomes were then evaluated with disabilities of the arm, shoulder and hand (DASH) score, Green and O’Brien score, and Grace and Eversmann functional outcome score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the 22 patients, 10 patients had excellent functional outcome according to Grace and Eversmann score, 7 patients had good outcome, 4 patients had acceptable while 1 was unacceptable. Green and O’Brien also had similar results, except that patients among fair category were 3 and poor category were 3. The mean DASH score was 16.2.</p><p><strong>Conclusions:</strong> This study shows that closed method for fixation by intramedullary nailing of both bone forearm fractures leads to excellent to good functional outcomes (according to DASH score, Green and O Brien, and Grace and Eversmann score) with less complications. In 6 months follow up x ray there is radiological union in all cases with no angulation, malunion or non-union. </p>

scholarly journals Complications of Radial Column Plating of the Distal Radius

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 614-619 ◽  
Author(s):  
Samuel E. Galle ◽  
Neil G. Harness ◽  
Jacques H. Hacquebord ◽  
Raoul J. Burchette ◽  
Brett Peterson
Keyword(s):  
Distal Radius ◽  
Normal Function ◽  
Distal Radius Fractures ◽  
Consecutive Series ◽  
Dash Score ◽  
Radius Fractures ◽  
Outcomes Measures ◽  
Valuable Adjunct ◽  
Supplemental Fixation

Background: Distal radius fractures treated with open reduction and internal fixation are commonly stabilized with a volar locking plate; however, more complex fracture patterns may require supplemental fixation with fragment-specific implants. The objective of this study was to evaluate the outcomes of distal radius fractures treated with radial column plates. Methods: A consecutive series of 61 patients who sustained distal radius fractures underwent radial column plating alone or in conjunction with other implants between August 2006 and January 2014. Thirty-one patients returned for follow-up or returned a mailed questionnaire at an average of 4.1 years. The outcomes measures included Visual Analog Scale (VAS); Disabilities of the Arm, Shoulder and Hand (DASH); and Patient-Rated Wrist Evaluation (PRWE) scores. Results: Sixty-one patients with a mean age of 55 years (range, 20-87) met inclusion criteria and were available for follow-up or chart review at an average of 5.2 years (range, 1.6-9.0 years). Seventeen of 61 (28%) underwent radial column plate removal. Twenty patients returned for final follow-up examination, and 11 completed questionnaires via mail. Subjective scores included a mean postoperative VAS of 0.72, DASH score of 17.2, and PRWE score of 15.7. Hardware sensitivity and wrist stiffness were the most common complications at final follow-up. Conclusions: Radial column plating of the distal radius is a safe treatment modality and a valuable adjunct in the setting of complex distal radius fractures, but patients should be counseled that there is a 28% chance that hardware removal may be required. Our retrospective review found evidence of few complications and objective scores consistent with return to normal function.

Fracture of the Wrist and Incidence of the Complex Regional Pain Syndrome Type 1: A Case Series Study

2020 ◽  
Author(s):  
Payam Vezvaei ◽  
Soroosh Alizadeh ◽  
Saeed Reza Mehrpour ◽  
Leila Oryadi-Zanjani
Keyword(s):  
Distal Radius Fracture ◽  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Case Series ◽  
Pain Syndrome ◽  
Radius Fracture ◽  
Case Series Study ◽  
Budapest Criteria ◽  
Series Study

Background: Complex regional pain syndrome (CRPS) is a painful syndrome with signs such as swelling, restriction of motion, and discoloration of the skin and bone. CRPS is divided into two types based on neurological injuries. Type 1 CRPS (CRPS-I), which is more common, has no nerve damage. In this study, we used the Budapest Criteria to investigate the incidence of CRPS. We also evaluated the risk factors for the incidence of CRPS. Methods: This single-center case series study was performed at Shariati Hospital of Tehran University of Medical Sciences, Tehran, Iran, during 2018-2019. We evaluated CRPS-I, two and six weeks after treatment based on Budapest Criteria. The inclusion criteria included distal radius fracture confirmed by clinical and radiographic investigations. The exclusion criteria were patients with fractures in another part of the body, associated nerve damage, vascular injury, and an open fracture. Results: Sixty-two patients with distal radius fracture who underwent casting or surgical treatment enrolled in the study. A total of 9 (14.5%) patients had CRPS-I after distal radius fracture. In 5 (8.1%) patients, CRPS-I occurred within two weeks after fracture. Also, 4 (6.5%) patients had CRPS-I after six weeks from fracture. There was no significant difference between the two sex groups in terms of CRPS (P = 0.345). This complication was significantly higher in the surgical group than in the casting group (P = 0.004). Conclusions: Given the significant incidence of CRPS and its impact on patient's quality of life, further studies are recommended to explore solutions to reduce this complication.

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