Hematoma block for distal radius fractures – prospective, randomized comparison of two different volumes of lidocaine

Objective This study aimed to compare analgesic efficacy and safety of different volumes of lidocaine injected into a fracture hematoma (hematoma block [HB]) for reducing distal radius fractures. Methods Patients were randomly divided into two groups. Group A included patients in whom 10 mL of 2% lidocaine was injected into the fracture site and group B included patients in whom 20 mL of 1% lidocaine was injected. The fracture was manipulated after 15 minutes and the Visual Analogue Scale (VAS) score was recorded during manipulation. Patients were followed up for approximately 1 hour and complications were recorded. Results Twenty patients were enrolled in the study (12 women and eight men), with a mean age of 57 years (range, 32–87 years). Demographic findings were similar between the groups. The mean VAS score of group A was 5.50 ± 3.57 and that in group B was 3.09 ± 2.33, with no significant difference between the groups. Conclusion VAS scores between HB with 20 mL of 1% lidocaine and HB with 10 mL of 2% lidocaine are not significantly different. However, our study suggests that HB with 20 mL of 1% lidocaine has a better analgesic effect than HB with 10 mL of 2% lidocaine.

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A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20204588 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1222

Author(s):

Chhagan Lal Regar ◽

Siddharath Sharanappa Parmeshwar ◽

Ramesh Chandra Meena ◽

Shyoji Lal Sharma ◽

Jitesh Kumar Jain

Keyword(s):

Distal Radius ◽

Distal Radius Fractures ◽

Volar Plate ◽

Radius Fractures ◽

Fixed Angle ◽

Radial Inclination ◽

Variable Angle ◽

Group A ◽

Group B

Background: The current study is conducted to assess and compare the radiological and functional outcomes between variable and fixed angle volar plating in unstable intra-articular distal radius fractures.Methods: A prospective study was conducted from May 2018 to May 2020. A total of 156 patients were randomised into two groups A and B of 78 patients each. The plates were T or oblique fixed angle volar plate in group A and variable angle volar plate in group B. Patients were followed up for minimum 12 months. The functional outcome was measured by patient rated hand wrist evaluation score (PRHWE) and radiological outcome by radial height, volar tilt and radial inclination. The secondary objective was to correlate complications.Results: In our study average PRHWE score was better in group B (p<0.05). Radial height, volar tilt, radial inclination was much closer to anatomical wrist radiology was seen in group B. The most common complication was finger and wrist stiffness in group A.Conclusions: Patients treated with variable angle volar plate showed better results in functional and radiological outcomes at 12 months follow-up but limitations include short duration of follow up.

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Sparing the pronator quadratus for volar plating of distal radius fractures: a comparative study of two methods

Journal of International Medical Research ◽

10.1177/0300060519893851 ◽

2019 ◽

Vol 48 (8) ◽

pp. 030006051989385

Author(s):

Jun Zhang ◽

Yun-Qiang Zhuang ◽

Long Zhou ◽

Gang-Qiang Jiang ◽

Ya-Di Zhang ◽

...

Keyword(s):

Range Of Motion ◽

Grip Strength ◽

Distal Radius ◽

Volar Plating ◽

Radius Fractures ◽

Pronator Quadratus ◽

Group A ◽

Vas Scores ◽

Group B ◽

Radiation Time

Objectives The objective of this study was to compare the results of two methods for sparing the pronator quadratus in volar plating of distal radius fractures. Methods A total of 110 patients were randomized to volar plating with sparing of the pronator quadratus either by a transverse incision along the distal border of the pronator quadratus (Group A, 55 people) or by the brachioradialis splitting method (Group B, 55 people). The operative and radiation time, range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Visual Analog Scale (VAS) scores, and complications were recorded. Results There were no significant differences in the mean operative time, radiation time, mean bone union time, or total complication rate between the groups. We found no significant differences in range of motion, grip strength, VAS scores, and DASH scores at any of the study intervals between the groups. Although neurapraxia of the superficial branch of the radial nerve was more common in Group B than in Group A (6.7% vs. 0%), the difference was not significant. Conclusions Both methods were efficient approaches for sparing the pronator quadratus and had similar clinical outcomes, but they had different indications.

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A Comparative Study on Functional Outcome of Distal Radius Fractures Treated with POP Cast Versus Percutaneous K-Wire Fixation (Both After Closed Reduction) In Kannur Medical College, Kerala, India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/583 ◽

2021 ◽

Vol 8 (34) ◽

pp. 3205-3210

Author(s):

Adnan Siddique P ◽

Sasikumar Sasidharan ◽

Prateek Chandak

Keyword(s):

Functional Outcome ◽

Distal Radius ◽

Closed Reduction ◽

Final Outcome ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Wire Fixation ◽

Group A ◽

Group B ◽

Methods Of Treatment

BACKGROUND Closed reduction with plaster of Paris (POP) cast for extra-articular distal radius fractures was an accepted method of treatment worldwide. But the maintenance of reduced fracture fragments was unpredictable. Closed reduction and ‘K’ wire fixation with casting was also recommended widely. There was no definite option prescribed for either of the methods. In this study, we wanted to compare the final outcome of management of the distal radius fractures in adults with closed reduction and POP casing versus closed reduction with percutaneous K-wiring. METHODS A prospective, randomized, and comparative study was conducted on the final outcome of two methods of treatment for the fractures of distal end of radius. One method (Group A of 23 patients) consisted of closed reduction and POP casing and the other (Group B of 23 patients) consisted of K-wiring under C arm (23 patients in each group). Radiological and functional parameters were compared at fixed intervals for 15 months and final outcome scores were correlated and compared using Gartland and Werley functional scoring system. RESULTS In group A, AO type 2R3A2.1 fractures were observed in 03/23 (13.04 %) patients and 04/23 (17.39 %) in Group B patients. Type 2R3A2. 2 fractures were observed in 05/23 (21.73%) of the group A patients and 07/23 of the group B patients. Type 2R3A2.3 fractures were observed in 15/23 of the group A and 12/23 (52.17%) of the group B patients. Both the methods of treatment were correlating well with the various variables. CONCLUSIONS Closed reduction with percutaneous K wiring and below elbow cast application was a simple, minimally invasive technique that provided added stability and functional outcome with respect to treatment of extra-articular distal radius fracture. The conventional method of closed reduction and POP cast was closely correlating with the K wire immobilization method. There was no significant statistical difference between the two methods in the functional outcome after treatment of distal end radius fractures. KEYWORDS Radius, ‘K’ Wire, Closed Reduction, Stable Fracture, Bone Healing and Immobilize

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“COMPARATIVE STUDY OF DISTAL END RADIUS FRACTURE TREATED BY PERCUTANEOUS 5 PIN TECHNIQUE V/S CLOSED REDUCTION AND CASTING METHOD”.

10.36106/6900913 ◽

2021 ◽

pp. 29-31

Author(s):

Vibhor Khandal ◽

Ashwani Kumar Mathur ◽

Mohit Kumar ◽

Rajkumar Bairwa

Keyword(s):

Distal Radius ◽

Closed Reduction ◽

Soft Tissues ◽

Hand Function ◽

Early Mobilization ◽

Fracture Site ◽

Distal Radius Fractures ◽

Point System ◽

Casting Method ◽

Radius Fractures

Introduction: Distal end radius fractures crush the mechanical foundation of most useful tool, the hand. No other fracture has a such potential to devastate hand function, and no other metaphysis of bone is embraced by more soft tissues. Closed reduction and percutaneous pinning is one of the standard treatments for management of distal radius fractures, and its modication 'The percutaneous 5 pin technique improves the reliability of xation thus combining the benets of non-invasiveness as in casting and stability achieved is comparable to open reduction and plating. Material and method: This prospective study was done between December 2018 to December 2020 in department of orthopedics, including 60 patients with fracture of distal radius Among them 30 patients subsequently underwent ve pin xation and 30 patients were treated with closed reduction and casting method. Result: Radiological analysis of the data was done using Sarmiento's Modication of Lidstrom Criteria. Activities of daily life (ADL) were examined by using the demerit point system of Gartland and Wereley based on objective and subjective criteria, residual deformity and complications. Radiological parameters were assessed for at the end of 6months. There was signicant difference in all the three parameters i.e, Volar tilt, Radial length, Radial inclination between both groups at the end of 6 months. Closed reduction with ve pinning technique group had shown not only better but also statistically signicant anatomical reduction compared to other groups. Functional outcome was better in patients treated with percutaneous 5 pinning technique. Conclusion: The ve pin technique carries the advantage of early mobilization, DRUJ stability. Radio Ulnar pins and the pins across the fracture site provide enough stability to permit early mobilization leading to less post operative stiffness in joint. Although the study series is small and further research is essential to provide directions for treatment, it is safe to conclude that the ve pin technique is a technically less demanding, lessinvasive and an effective way of treating displaced distal radius fractures without severe articular or metaphyseal comminution

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The Treatment of Wrist Ganglion Cyst by the Chinese Acupotomy and Crisscross Thread

10.21203/rs.3.rs-94895/v1 ◽

2020 ◽

Author(s):

Shuliang Zhang ◽

Bin Xu ◽

Yangjun Lao ◽

Di Lu

Keyword(s):

Recurrence Rate ◽

Ganglion Cyst ◽

Combined Treatment ◽

Vas Score ◽

Ganglion Cysts ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Cost ◽

Open Excision

Abstract Background: The current treatments of wrist ganglion have considerable recurrence rate, we developed a new treatment for ganglion cysts in our clinical practice, which combined acupotomy with crisscross thread method, so we now to compare the clinical effectiveness of Chinese acupotomy and crisscross thread with aspiration followed by injection of steroid and open excision for ganglion cysts treatment. Methods: Recruited patients with wrist ganglion were divided into three groups according to the treatments. Among them, 27 patients who were treated by a new combined treatment of Chinese acupotomy and crisscross thread method in group A, 30 patients who were treated by aspiration followed by steroid injection in group B, and 28 patients who were treated by open excision in group C. The data of age, gender, weight, size of ganglion cysts, visual analogue scale (VAS) , cost were recorded and compared by One-way analysis of variance, followed by an LSD (Least Significant Difference)test. The recurrence rates were recorded were analysed by chi-square test.Results: At the first day and one week after treatment, VAS score of group A was similar to group B with no statistic difference. VAS score of group C was higher than group A and B with statistic difference. Six months later, there was no statistic difference among the three groups about VAS. The recurrence rate was 3.7% in group A and 36.7% in group B and 10.7% in group C. No patient infected in three groups. The cost of group A was more than group B with no statistic difference. The cost of group A was much less than group C with statistic difference.Conclusions: The combination of Chinese acupotomy and crisscross thread method was a simple, economical and effective procedure for wrist ganglion cysts.

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Clinical Outcomes in Distal Radius Fractures Accompanied by Volar Lunate Facet Fragments: A Comparison between Dorsal and Volar Displaced Fractures

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835520500447 ◽

2020 ◽

Vol 25 (04) ◽

pp. 417-422 ◽

Cited By ~ 1

Author(s):

Hiroyuki Obata ◽

Kiyohito Naito ◽

Ayaka Kaneko ◽

Keniji Goto ◽

Yoichi Sugiyama ◽

...

Keyword(s):

Range Of Motion ◽

Distal Radius ◽

Fragment Size ◽

Perioperative Complications ◽

Postoperative Outcome ◽

Distal Radius Fractures ◽

Bone Fragment ◽

Radius Fractures ◽

Mayo Score ◽

Significant Difference

Background: The treatment strategy for distal radius fractures accompanied by volar lunate facet fragment is controversial. In most cases, only the bone fragment size was discussed and a plate for distal placement is selected due to the accompanying volar lunate facet fragment regardless of the direction of bone fragment displacement. In this study, we divided distal radius fractures accompanied by volar lunate facet fragment into dorsal and volar displaced fractures, and treated these surgically based on different treatment strategies. Methods: The subjects were 25 patients with distal radius fractures accompanied by volar lunate facet fragment treated by reduction and fixation using a volar locking plate (VLP) (male: 14, female: 11, mean age: 57.8 years old). A proximal VLP (PVLP) was selected for 13 dorsal displaced fractures and a distal VLP (DVLP) was selected for 12 volar displaced fractures. The range of motion, VAS, Q-DASH, and Mayo score were evaluated at 12 months after surgery, and compared. Results: No significant difference due to the difference in the direction of displacement was noted in the range of motion, VAS, Q-DASH, or Mayo score at 12 months after surgery and there were no perioperative complications. In addition, no re-displacement of volar lunate facet fragment was noted after surgery in any patient and bone fusion was observed. Conclusions: Reduction and fixation with a PVLP are possible even for dorsal displaced distal radius fractures accompanied by volar lunate facet fragment. For the volar displaced distal radius fractures, a favorable postoperative outcome is possible by applying a DVLP to the distal ulnar.

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1224 Effect of Distal Brachioradialis Release During Open Reduction and Internal Fixation of Distal Radius Fractures

British Journal of Surgery ◽

10.1093/bjs/znab259.1033 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Hafez ◽

A Shaat ◽

M Zain ◽

M A Sajid ◽

A Butt

Keyword(s):

Internal Fixation ◽

Distal Radius ◽

Open Reduction ◽

Group Versus ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Volar Approach ◽

Normal Ranges ◽

Significant Difference ◽

The Impact

Abstract Aim The study aim is to determine the impact of the brachioradialis release during the open reduction and internal fixation of distal radius fractures using a volar approach Method Total of 40 patients was treated with Open reduction and internal fixation of intra articular distal radius fractures. Distal release of Brachioradialis was performed to 19 patients, while 21 patients had no release of BR during surgery. Radiological parameters including Radial height, Inclination and volar tilt were measured 1 month post-operatively, while functional outcomes assessed with modified mayo wrist scores and Quick-dash scores Results There is no significant difference between age, gender and pre-operative conditions indicating that both the groups (BR release and without BR release) have similar demographic characteristics. Pre-operatively both groups had disturbed values for radial height, inclination, and volar tilt. Postoperatively, the mean of both groups was closer to normal ranges for radial inclination and volar tilt; however, radial height was the least adequately restored radiological parameter for both study group (11.54 ± 1.35 for BR group versus 10.21 ± 2.29 for Non-BR group). Pain, functional status, and grip strength had similar values in both groups whereas BR group showed higher ROM and DASH scores with P values of 0.048 and 0.025 respectively. Conclusions Brachioradialis release enhances the reduction and operative fixation, restoring the necessary radiological and subsequent functional parameters in distal radius fractures with reported no complications.

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Comparative Observational Study on the Effects of Intra-articular Hominis Placenta Pharmacopuncture and Acupoint Hominis Placenta Pharmacopuncture for Knee Osteoarthritis Patients

Journal of Acupuncture Research ◽

10.13045/jar.2020.00451 ◽

2021 ◽

Vol 38 (1) ◽

pp. 60-65

Author(s):

Yeo-bin Park ◽

Chang Beohm Ahn ◽

Yun-Leong Park ◽

Ji-Won Baek ◽

Won-Ho Kong ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Medical Records ◽

Joint Space ◽

Osteoarthritis Of The Knee ◽

Analog Scale ◽

Degenerative Osteoarthritis ◽

Significant Difference ◽

Group A ◽

Vas Scores ◽

Group B

The aim of this case report was to observe the effects of intra-articular hominis placenta pharmacopuncture (HPP). Based on the medical records patients who received intra-articular treatment or received acupoint pharmacopuncture treatment, a comparison was made. There were 35 patients who were hospitalized for degenerative osteoarthritis of the knee joint from the 1st October 2019 to 26th September 2020. There were 14 patients who were treated with HPP in the intra-articular joint space (Group A), and 14 patients who were treated with HPP at specific acupoints (Group B). The outcome effects were measured using the Korean Western Ontario and Mc (KWOMAC) the visual analog scale (VAS) before the first treatment, and after the fifth treatment. The KWOMAC (p < 0.001) and the VAS scores (p < 0.001) in Groups A and B significantly improved after treatment compared with before treatment. When comparing Group A improvement with Group B improvement using the KWOMAC there was no statistically significant difference however, when using the VAS scores, Group A treatment was statistically more effective compared with Group B (p = 0.002). This study indicated that HPP may be an effective treatment for knee osteoarthritis. Moreover, intra-articular HPP may be more effective than acupoint HPP for knee osteoarthritis.

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Local injection of leukocyte rich platelet rich plasma produced higher radius union scoring system than local injection of pure platelet rich plasma in conservative therapy of intra-articular closed distal radius fractures

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20212502 ◽

2021 ◽

Vol 9 (7) ◽

pp. 1878

Author(s):

I. Made Sunaria ◽

I Wayan Suryanto Dusak ◽

I. Gede Eka Wiratnaya

Keyword(s):

Distal Radius ◽

Conservative Therapy ◽

Platelet Rich Plasma ◽

Distal Radius Fractures ◽

Local Injection ◽

Control Group ◽

P Value ◽

Homogeneity Test ◽

Radius Fractures ◽

Significant Difference

Background: Distal radius fracture often occurs both extra-articular and intra-articular, covering all ages. The use of autologous platelet rich plasma (PRP) consisting of leucocytes rich-PRP (L-PRP) and pure-PRP (P-PRP) thought can help in bone healing process. This study aimed to determine that the administration of L-PRP provides a better healing rate than P-PRP in intra-articular closed distal radius fractures after conservative treatment.Methods: This was a single-blinded experimental study with stratified randomized post-test only group design involving 51 patients with closed distal fractures undergoing closed reduction, consisting of 17 patients per study group. Group 1 received placebo, group 2 received P-PRP, and group 3 with L-PRP. Each group was then re-evaluated using x-ray at week 2, 3, and 6. RUSS score was then measured. Data was analysed using descriptive statistics and normality test, homogeneity test and inferential test were performed to determine the effect of L-PRP, P-PRP on the union rate of fracture distal radius. All obtained data was analysed using SPSS statistics 22 software.Results: Between control and P-PRP group, there was significant difference in mean RUSS with p value of 0.012. Between control and L-PRP injection group, there was a significant difference in mean RUSS with p value of 0.000. Between P-PRP and L-PRP group, there was also significant mean RUSS difference with p value of 0.003.Conclusions: There was a significant difference between the control group given placebo and the group P-PRP and L-PRP in closed fractures of the intraarticular radius after conservative therapy.

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Efficacy of laparoscopic guided transversus abdominis plane block in post operative analgesia requirement in elective laparoscopic cholecystectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20210928 ◽

2021 ◽

Vol 8 (3) ◽

pp. 925

Author(s):

Hanuman Ram Khoja ◽

Dhanush Kumar Kunchagi ◽

Praveen Kumar Joshi ◽

Prabha Om

Keyword(s):

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Vas Score ◽

Significant Difference ◽

Analgesia Requirement ◽

Group A ◽

The Mean ◽

Group B

Background: Minimal invasive surgery has many advantages. In order to maintain and control pain, one of the most effective technique is Transversus abdominis plane (TAP) block technique. Aim of the study was to demonstrate the efficacy of laparoscopic guided transversus abdominis plane block in post-operative analgesia requirement in elective laparoscopic cholecystectomy.Methods: It was a hospital based prospective interventional study. Sample size was calculated at 0.05 α error and 80% study power assuming mean difference of VAS score between TAP block +/A group and TAP block- /B group is 1 and standard deviation of VAS score 1.3 among patients undergoing elective laparoscopic cholecystectomy.Results: A total of 60 patients were enrolled in this study. The mean age of group A was 48.56 years and for group B was 43.53 years. In group A 80% patients were females and for group B 83.3% patients were females. There was significant difference in VAS score at immediate post operation, at 1 hour, at 6 hours, at 18 hours and at 24 hours as p value was <0.0001 for all these groups. The mean VAS score was recorded less in group A at all the time duration compared to group B.Conclusions: With advantages like maximum safety, efficacy, potential for lower visceral injury risk and shorter operational time and other numerous advantages (decreased analgesic requirements, etc.) laparoscopic-guided TAP block counts as an ideal abdominal field block in the patients.

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