scholarly journals Ten Years’ Follow-Up on Combined Palmar and Dorsal Internal Fixation of Complex Distal Radius Fractures

Medicine ◽  
2016 ◽  
Vol 95 (18) ◽  
pp. e3509 ◽  
Author(s):  
Lukas Daniel Iselin ◽  
Anne-Sophie Massy-Budmiger ◽  
Raoul A. Droeser ◽  
Tobias R. Mett ◽  
Reto Babst ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals Intramedullary Fixation of Distal Radius Fractures Using CAGE-DR Implant

2018 ◽  
Vol 07 (05) ◽  
pp. 358-365
Author(s):  
Schneider Rancy ◽  
Stephanie Malliaris ◽  
Eric Bogner ◽  
Scott Wolfe
Keyword(s):  
Internal Fixation ◽  
Grip Strength ◽  
Distal Radius ◽  
Fracture Fixation ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Promising Alternative ◽  
Pain Scores

Purpose CAGE-DR implant is a novel Food and Drug Administration approved intramedullary fracture fixation device used for distal radius fractures. We examine a series of 22 patients and report the outcomes with this device. Materials and Methods A total of 24 patients with distal radius fractures (8 articular AO type C1/C2; 16 extra-articular AO type A2/A3) underwent open reduction and internal fixation (ORIF) using CAGE-DR implant by a single surgeon. Data including fracture type, angle of displacement, radiographic consolidation, grip strength, wrist range of motion (ROM), patient-rated wrist evaluation (PRWE), and Visual Analog Scale (VAS) pain scores were recorded at time of surgery and at standard follow-up. Results All 24 patients underwent uneventful ORIF. At first follow-up visit (9 days), all patients had full digital ROM (measured as 0 cm tip-to-palm distance). Two patients were lost to follow-up. Eighteen of the remaining 22 patients had sufficient radiographic follow-up and all 18 demonstrated healing. At latest follow-up (mean 9.7 months, range, 3–20), VAS pain scores averaged 0.6 (range, 0–8) and PRWE averaged 12.1 (range, 0–53.5). Grip strength of the operated hand averaged 58 lbs (range, 20–130). ROM included: wrist flexion 73° (50–95), wrist extension 78° (60–110), pronation 77° (60–90), supination 79° (60–90), ulnar deviation 31° (5–45), and radial deviation 17° (10–30). Three patients underwent screw removal to prevent tendon irritation. One patient underwent hardware removal due to prominence on imaging but was asymptomatic. There were otherwise no major complications, including complex regional pain syndrome, in the series to date. Conclusion The CAGE-DR fracture fixation system is a promising alternative to established methods of distal radius internal fixation. This series has a low reported pain score starting immediately postoperatively and a low complication rate. This novel device is a promising option for internal fixation of displaced distal radius fractures with a low complication profile. Level of Evidence This is a level IV, therapeutic study.

Distal Radius Fracture Treatment Outcomes in Patients With Ipsilateral Hemiplegia or Hemiparesis

Hand ◽  
2021 ◽  
pp. 155894472199973
Author(s):  
Nicholas Munaretto ◽  
Adam Tagliero ◽  
Raahil Patel ◽  
Peter C. Rhee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Functional Classification ◽  
Radius Fractures ◽  
Radiographic Outcomes ◽  
Ipsilateral Hemiparesis

Background Little information exists to guide decision-making with regard to distal radius fractures in the setting of ipsilateral hemiparesis or hemiplegia. Methods Patients who sustained a distal radius fracture in the setting of ipsilateral hemiparesis or hemiplegia secondary to brain injury were evaluated. Investigated variables included perioperative pain, preinjury House functional classification score, length of immobilization, radiographic outcome measurements, and time to union. Results There were 15 patients with distal radius fractures with a mean age of 65.9 years. The mean clinical and radiographic follow-up was 2.8 and 2.9 years, respectively. Wrists were placed into the nonoperative group (NOG, n = 10) and operative group (OG, n = 5). Pain significantly decreased at final follow-up for both groups. Baseline House functional classification scores averaged 1.3 and 1.6 for the NOG and OG, respectively, and were maintained at final follow-up. Length of immobilization for the NOG was 46 days and OG was 37 days, P = .15. Radiographic outcomes at final follow-up in the NOG and OG, respectively, were a mean radial height of 9.3 versus. 11.6 mm, radial inclination of 18.3° versus 22.3°, 4.2° dorsal tilt versus 5.3° volar tilt, and tear drop angle of 45.6° versus 44.5°. There were no significant differences in these measurements. Time to radiographic union averaged 58 days for the NOG and 67 days for the OG, P = .42. There were no revision surgeries. Conclusions Based on this small case series, patients with distal radius fracture and ipsilateral hemiparesis or hemiplegia may have similar clinical, functional, and radiographic outcomes, regardless of nonoperative or operative treatment.

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.

145 Outcomes of Unstable Distal Radius Fractures – A Meta-Analysis of Bridging External Fixation Versus Volar Plating

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Mulrain ◽  
K Joshi ◽  
F Doyle ◽  
A Abdulkarim
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Volar Plating ◽  
Radius Fractures ◽  
Increased Risk

Abstract Introduction Distal radius fractures are common and trends for fixation have changed with increased use of volar locking plates in recent time. A meta-analysis will summarise the best evidence for treatment. Method A systematic review was conducted using PRISMA methodology to identify studies that reported clinical and/or radiological outcomes in patients with AO type C distal radius fractures when treated with external fixation versus ORIF. Results 10 randomised trials were included in this review, reporting on 967 patients. Clinical outcomes are in favour of volar plating at 3 months post-operation, but no difference between the two groups is seen at 6 or 12 months. Analysis of complication rates shows a minute increase in risk-ratio for volar plating versus external fixation. Subgroup analysis showed significantly higher re-operations after plate fixation and significantly higher infection after external fixation. Conclusions Internal fixation of complex distal radius fractures confers an improved clinical outcome at early follow up only and a minimally increased risk of complications. The improved grip strength with volar plating is only superior at early follow up and no long-term superiority is seen with either intervention. The type of surgery in this injury type therefore remains at the surgeon’s consideration on a case-by-case basis.

scholarly journals Quality of life after volar locked plating: a 10-year follow-up study of patients with intra-articular distal radius fractures

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Paul Ruckenstuhl ◽  
Gerwin A Bernhardt ◽  
Patrick Sadoghi ◽  
Mathias Glehr ◽  
Lukas A Holzer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Locked Plating ◽  
Follow Up Study

Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation

2021 ◽  
Author(s):  
Lili E. Schindelar ◽  
Richard M. McEntee ◽  
Robert E. Gallivan ◽  
Brian Katt ◽  
Pedro K. Beredjiklian
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Open Reduction ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Implant Design ◽  
Complication Rates ◽  
Radius Fractures ◽  
Hardware Failures

Abstract Background Distal radius fractures are one of the most common fractures seen in the elderly. The management of distal radius fractures in the elderly, especially patients older than 80 years, has not been well defined. The purpose of this study was to evaluate operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates. Materials and Methods A retrospective review was performed to identify patients 80 years or older who were treated for a distal radius fracture with open reduction and internal fixation (ORIF). Medical records were reviewed for demographics, medical history, functional outcomes including quick Disabilities of the Arm, Shoulder, and Hand (qDASH), radiographs, and postoperative complications. Results There were 40 patients included for review. Average age was 84 years. The preoperative qDASH score was 69. At 6 months follow-up, the postoperative qDASH score was 13 (p < 0.001). There were five (12.5%) complications reported postoperatively. All fractures healed with adequate radiographic alignment and there were no hardware failures. Conclusion Distal radius fractures in patients older than 80 years treated with ORIF have good functional outcomes and low complication rates. Increased functionality and independence of the elderly, as well as updated implant design can lead to the effective surgical management of these patients. When indicated from a clinical perspective, operative fixation of distal radius fractures should be considered in patients older than 80 years.

scholarly journals Routine follow-up radiographs for distal radius fractures are seldom clinically substantiated

2017 ◽  
Vol 137 (9) ◽  
pp. 1187-1191 ◽  
Author(s):  
N. L. Weil ◽  
M. El Moumni ◽  
S. M. Rubinstein ◽  
P. Krijnen ◽  
M. F. Termaat ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals Minimally angulated pediatric wrist fractures: Is immobilization without manipulation enough?

CJEM ◽  
2007 ◽  
Vol 9 (01) ◽  
pp. 9-15 ◽  
Author(s):  
Khalid Al-Ansari ◽  
Andrew Howard ◽  
Brian Seeto ◽  
Solina Yoo ◽  
Salma Zaki ◽  
...  
Keyword(s):  
Distal Radius ◽  
Sagittal Plane ◽  
Normal Function ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Post Injury ◽  
Radiographic Findings ◽  
Fractures In Children ◽  
Plaster Immobilization

ABSTRACT Background: Emergency department (ED) manipulation of complete minimally angulated distal radius fractures in children may not be necessary, due to the excellent remodeling potential of these fractures. Objectives: The primary objective of this study was to determine the proportion of minimally angulated distal radius fractures managed in the ED with plaster immobilization that subsequently required manipulation. Our secondary objective was to document, at follow-up, changes in angulation for each wrist fracture. Methods: This retrospective cohort study reviewed consecutive records of all children with bi-cortical minimally angulated (≤15° of angulation in the sagittal plane and ≤0.5 cm of displacement) distal metaphyseal radius fractures, alone or in combination with distal ulnar fracture. Details of treatment, radiographic findings, and clinical outcomes during the subsequent orthopedic follow up were recorded. Results: Of 124 patients included in the analysis, none required manipulation after their ED visit. All but 14 (11.3%) fractures were angulated ≤20° within the follow-up period. Two (1.6%) fractures that were initially angulated ≤15° progressed to 30°–35°, but remodeled within 2 years to nearly perfect anatomic alignment. By 6 weeks post-injury, no patients had clinically apparent deformity and all had normal function. Conclusions: Minimally angulated fractures of the distal metaphyseal radius managed in plaster immobilization without reduction in the ED are unlikely to require future surgical intervention.

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