Concurrent Minimally Invasive Carpal Tunnel Release Techniques in Distal Radius Open Reduction Internal Fixation

Carpal tunnel syndrome is a common complication associated with distal radius fractures. Open carpal tunnel release in the same setting as open reduction and internal fixation of distal radius fractures is widely accepted. In this paper, we describe the technical details of a minimally invasive carpal tunnel release in the same setting as the fixation of a distal radius fracture via the same incision. Two options of minimally invasive techniques are described: The Knifelight® (Stryker, Kalamazoo, Michigan, USA) instrument and the single portal carpal tunnel release system (Agee, 3M Healthcare, St Paul, Minnesota, USA). Being well known and accepted techniques of carpal tunnel release, we believe that the techniques described in this paper provide a viable alternative for carpal tunnel release in the setting of distal radius fracture fixation; with the added advantages of the original minimally invasive techniques.

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Single-Incision Carpal Tunnel Release and Distal Radius Open Reduction and Internal Fixation: A Cadaveric Study

Journal of Wrist Surgery ◽

10.1055/s-0036-1581053 ◽

2016 ◽

Vol 05 (03) ◽

pp. 241-246 ◽

Cited By ~ 2

Author(s):

Blane Sessions ◽

Bryan Dudoussat ◽

Patrick Kane ◽

Michael Gaspar

Keyword(s):

Internal Fixation ◽

Distal Radius ◽

Carpal Tunnel ◽

Open Reduction ◽

Single Incision ◽

Carpal Tunnel Release ◽

Cadaveric Study

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Comparison of Hand Grip Strength in patients with Distal Radius Fracture that are treated by Closed Reduction with Cast versus Open Reduction and Internal Fixation in Haji Adam Malik Hospital Medan

International Journal of ChemTech Research ◽

10.20902/ijctr.2019.130110 ◽

2020 ◽

Vol 13 (1) ◽

pp. 84-89

Author(s):

Adri Yandra Hidayat ◽

Nino Nasution ◽

Iman Dwi Winanto

Keyword(s):

Internal Fixation ◽

Grip Strength ◽

Distal Radius Fracture ◽

Distal Radius ◽

Closed Reduction ◽

Open Reduction ◽

Hand Grip Strength ◽

Radius Fracture ◽

Radius Fractures ◽

Hand Grip

Background- Distal radius fracture is quite often found in emergency settings. There are many options to assess the outcome of treatment in distal radius fracture cases. One option that can be done is to measure the strength of the injured handgrip. Patient often complained about the decrease in ability to grasp and rotate and bear the burden after distal radius fracture. Objective-To find out the comparison of the hand grip strength in patients with distal radius fractures that are treated by closed reduction and casting to open reduction and internal fixation. Material and Methods-The study was conducted in a retrospective, observational analytic study with a cross sectional approach, which aimed to analyze the comparison of hand grip strength in patients with distal radius fractures that are treated by closed reduction and casting to open reduction and internal fixation12 months after treatment. Target population was all patients with distal radius fracture who underwent closed reduction and casting and open reduction and internal fixation in all inpatient at Adam Malik Hospital, Medan. Results- In this study the distribution of the number of samples was as many as 57 subjects with 17 are women (29.8%) and 40 are men (70.2%). 18 years old is the youngest age of the samples and the oldest is 76 years old with a mean of 32.77 ± 14.03 years. Based on the mechanism of injury : motor vehicle accidents is the most common mechanism of injury, it accounts 45 people (78.9%). According to time arrivals mostly patient came <24 hours. There are 11 extraarticular fractures ( 19.3%) and 46 intraarticular fractures (80.7%), there were 24 people (42.1%) fracture in the right hand and 33 people (57.9%) in the left hand. Statistical analysis shows that there is no difference in the ratio of hand grip strength with significance value of (p value) 0.881 (> 0.05). Conclusion- There were no significant differences in the clinical outcome of the patient's hand grip strength in patients that are treated with closed reduction and casting to open reduction intenal fixation after 12 months post theraphy.

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Comparison of immobilization periods following open reduction and internal fixation of distal radius fracture: A systematic review and meta-analysis

Journal of Hand Therapy ◽

10.1016/j.jht.2021.06.004 ◽

2021 ◽

Author(s):

Abdullah A. Ghaddaf ◽

Ahmed S. Abdulhamid ◽

Mohammed S. Alomari ◽

Mohammed S. Alquhaibi ◽

Abdulaziz A. Alshehri ◽

...

Keyword(s):

Systematic Review ◽

Internal Fixation ◽

Distal Radius Fracture ◽

Distal Radius ◽

Open Reduction ◽

Meta Analysis ◽

Radius Fracture

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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

Journal of Hand and Microsurgery ◽

10.1055/s-0041-1729439 ◽

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.

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Analysis of Our Open Reduction and Internal Fixation of Distal Radius Fractures in Adults: Are We Over Operating?

Journal of Wrist Surgery ◽

10.1055/s-0041-1731384 ◽

2021 ◽

Author(s):

George W.V. Cross ◽

Ramandeep S. Saini ◽

Mohammed Monem ◽

Rajesh Sofat

Keyword(s):

Internal Fixation ◽

Distal Radius ◽

Open Reduction ◽

Plain Radiograph ◽

Distal Radius Fractures ◽

British Society ◽

Radius Fractures ◽

Level Of Evidence ◽

Radiological Parameters ◽

New Guidelines

Abstract Background Fractures of the distal radius are a common injury. The British Orthopaedic Association (BOA) and The British Society for Surgery of the Hand (BSSH) have released new guidelines outlining the management of these fractures, specifically identifying “thresholds for intervention,” based on radiological parameters for management with open reduction and internal fixation (ORIF). Questions/Purposes Have our distal radius fractures (DRFs), previously managed with ORIF, met the new guidelines' thresholds for intervention, based on radiological parameters? Patients and Methods A retrospective assessment of DRFs treated with ORIF was performed between January 2017 and August 2018. Patients were categorized into three cohorts based on their age. The five radiological parameters of ulnar variance, dorsal tilt, radial inclination, radial height, and intra-articular step were measured on the initial plain radiograph, “pre-manipulation film,” postplaster application radiograph, and “post-manipulation film.”These were compared with the “thresholds for intervention” outlined in the BOA/BSSH guidelines. Results A total of 94 patients underwent an ORIF with a mean age of 56 years (range 17–86 years). As many as 75.74% of patients on the ”pre-manipulation film” met the “threshold for intervention” on at least one radiological parameter, while 53.57% of patients on the “post-manipulation” met at least one “threshold for intervention.” Dorsal tilt was the parameter that most often met the threshold in both films at 53.37% and 40.11%, respectively. Conclusion Within our trust, there is a tendency to over manage the distal radius fracture with ORIF, potentially resulting in unnecessary operations. Education surrounding the new guidelines will better serve our decision-making. Level of Evidence This is a level III study.

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