scholarly journals Comparison of radiographic and functional results of die-punch fracture of distal radius between volar locking plating (VLP) and external fixation (EF)

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yanqing Zhou ◽  
Yanbin Zhu ◽  
Xiong Zhang ◽  
Dehu Tian ◽  
Bing Zhang
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Wrist Joint ◽  
Statistical Significance ◽  
Functional Results ◽  
Bony Union ◽  
Wrist Flexion ◽  
Significance Level ◽  
Significant Difference ◽  
Fracture Of Distal Radius

Abstract Purpose The aim of this study is to investigate the radiographic and functional results of die-punch fracture of distal radius treated by volar locking plate (VLP) or external fixation (EF). Methods Between January 2015 and June 2018, 87 patients who were treated with EF or VLP were included in this study. At postoperative 6 months and at least 12 months, radiographic and functional outcomes were evaluated, and compared between two groups using SPSS 21.0. Results The follow-up period was 15.6 months in average, and at the mean 8.5 weeks bony union was achieved in all patients. At 6-month visit, patients in VLP group had significantly better wrist flexion (79.2° vs. 71.8°) and pronation (79.5° vs. 75.2°) than those in EF group, but the difference was non-significant at the last visit (> 12 months); as for other parameters, no significant differences were observed. No significant difference was found between both groups in term of volar tilt, radial inclination, radial height, ulnar variance, or Gartland–Werley score and DASH. The articular step-off was significantly greater in EF than VLP group (0.6 mm vs. 0.3 mm, p < 0.001). The overall incidence of complications seemed higher in EF group (25% vs. 14%), but not approaching to the statistical significance level. Conclusions Patients with VLP fixation of die-punch fractures had better wrist flexion and pronation at 6-month visit and more favorable wrist joint congruence at the last visit, but ultimately their outcome was comparable with those treated by EF.

Intramedullary Nail Fixation for Displaced and Unstable Distal Radial Fractures in Patients Aged 65 Years or Older

2016 ◽  
Vol 21 (01) ◽  
pp. 59-63 ◽  
Author(s):  
Takuma Wakasugi ◽  
Ritsuro Shirasaka
Keyword(s):  
Elderly Patients ◽  
Distal Radius ◽  
Functional Results ◽  
Distal Radius Fractures ◽  
Bony Union ◽  
Wrist Flexion ◽  
Radius Fractures ◽  
Articular Fractures ◽  
Intramedullary Implant ◽  
Intramedullary Implants

Background: Distal radius fractures in elderly patients are now commonly treated with a volar locking plate, but flexor pollicis longus dysfunction caused by stripping of the muscle and tendon irritation and rupture caused by prominence of the implant have been reported. Intramedullary implants can stabilize distal radius fractures while minimally affecting the flexor and extensor tendons and muscles around the site, but osteoporosis in elderly patients might affect the radiographic and functional results of distal radius fractures treated by intramedullary implants. We investigated the radiographic and functional results of intramedullary implants for distal radius fractures in patients ≥65 years of age.Methods: We reviewed medical records of 40 patients with extra-articular or simple intra-articular fractures with the sagittal fracture line treated by an intramedullary implant.Results: All fractures achieved bony union, with an average radial inclination of 24.9 degrees, volar tilt of 9.2 degrees, and ulnar variance of 0.7 mm. We encountered one case of postoperative volar displacement of the distal fragment due to the small size of the intramedullary implant. The average range of motion was 69.8 and 59.9 degrees for dorsal and palmar wrist flexion, respectively. Average percentile grip strength of the uninjured side was 97%. The average Mayo modified wrist score at final follow-up was 91.9 points, with 20 patients graded as excellent, 16 as good, and 4 as fair.Conclusions: The findings of this study indicate that intramedullary implants for dorsally displaced extra-articular or simple intraarticular distal radius fractures may offer good radiological and functional outcomes without hardware irritation in elderly patients. Distal radius fractures with an osteoporotic, large medullary canal should be stabilized by implants of an appropriate size.

Multi-Fetal Pregnancy Reduction Does Not Influence Perinatal Results in Twin Pregnancies

Twin Research ◽  
2001 ◽  
Vol 4 (6) ◽  
pp. 422-425 ◽  
Author(s):  
Simona Jirsova ◽  
Tonko Mardesic ◽  
Pavel Muller ◽  
Renata Huttelova ◽  
Jana Zvarova ◽  
...  
Keyword(s):  
Perinatal Death ◽  
Statistical Significance ◽  
Control Group ◽  
Average Weight ◽  
Significance Level ◽  
Time Period ◽  
Significant Difference ◽  
Level Of Significance ◽  
Twin Pregnancies ◽  
Multifetal Pregnancy Reduction

AbstractThe objective of this study was to compare perinatal results in multifetal pregnancies where the reduction to twins was performed with non-reduced twin pregnancies. Perinatal results in 99 sets of twins after transabdominal multifetal pregnancy reduction of triple and higher-order multiple pregnancies performed in a single center were compared with a control group consisting of 151 twin pregnancies conceived in the same time period after infertility treatment, which were not a result of reduction. The main outcome measures were length of pregnancies, weight of the newborns, percentage of miscarriages and the mode of the delivery were analyzed. No significant difference could be found at a 5% level of significance regarding the average duration of pregnancy or average weight of the twins. Fisher test on 5% significance level did not ascertain any significant difference in the probability of miscarriage between the group with reduction (5.26%) and the group without reduction (12.84%). At a 5% level of statistical significance, no significant difference in probability of perinatal death of the fetus or delivery of a stillborn fetus was found. The percentage of cesarean sections did not differ significantly in both groups. The analysis of both groups demonstrated that reduction of multifetal pregnancies to twins may not influence perinatal results in comparison to twin pregnancies where reduction was not performed.

A comparative study on treatment outcomes of bandage and casting in non-displaced extra-articular fracture of distal radius: A clinical trial study

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Hamid Reza Arti ◽  
Reza farahnak
Keyword(s):  
Clinical Trial ◽  
Distal Radius ◽  
Dash Score ◽  
Articular Fracture ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Vas Scores ◽  
The Difference ◽  
Fracture Of Distal Radius

Background: There are some therapeutic choices in non-displaced extra-articular fracture of distal radius that confront with some controversy in their selection. We tried to study these two methods in this article. Methods: This was a prospective randomized clinical trial conducted on the patients (n=62) with NDEA fracture of distal radius, during 2015. The patients were randomly assigned to casting (n-32) or bandage (n=30) group to receive the respective fracture healing procedure. The patients were followed-up at the first, second, third, and sixth weeks after the treatment. The Disabilities of the DASH and the VAS questionnaire were completed. All patients underwent an X-ray radiographic assessment to evaluate any potential complication. Results: At the end of the study, in the bandage and casting group 30 and 32 patients finished the study. The statistical analyses showed that the bandage group showed significantly higher mean DASH score than the casting group at the first week, but for the second week the difference decreased so that for the third week, the casting group showed significantly higher value than the bandage group. Finally, at the sixth week the two groups showed no significant difference in the DASH value. The two groups showed no significant differences in the VAS scores for all follow up assessments. The returning time to work was shorter in the bandage group and the treatment cost was also lower in this group. Conclusion: Bandage is more appropriate treatment option for the NDEA fractures of distal radius.

scholarly journals INFLUÊNCIA DA MODIFICAÇÃO DA BASE DE COLAGEM E DA CONTAMINAÇÃO SALIVAR NA RESISTÊNCIA DE UNIÃO DE TUBOS ORTODÔNTICOS COLADOS AO ESMALTE HUMANO

2021 ◽  
Vol 58 (1) ◽  
pp. eUJ3657
Author(s):  
Germano Brandão ◽  
◽  
Liliana Ávila Maltagliati ◽  
Ana Carla Raphaelli Nahás-Scocate ◽  
Murilo Matias ◽  
...  
Keyword(s):  
Bond Strength ◽  
Shear Bond Strength ◽  
Statistical Significance ◽  
Testing Machine ◽  
In Vitro Study ◽  
Metal Mesh ◽  
Human Teeth ◽  
Significance Level ◽  
Significant Difference

The objective of this in vitro study was to assess and compare the shear bond strength of conventional and modified orthodontic tubes bonded to the surface of dry and saliva-contaminated enamel. The sample consisted of 40 human teeth, which were randomly divided into four groups according to attachment base and presence or absence of saliva contamination as follows: Group CB, conventional orthodontic tubes without salivary contamination; Group CB-S, conventional orthodontic tubes with salivary contamination; Groups BM, orthodontic tubes modified by welding a metal mesh to their base without salivary contamination; and Group BM-S, modified orthodontic tubes with salivary contamination. Shear bond strength test was performed in a universal testing machine and analysis of the adhesive remnant index (ARI) by optical microscopy. Two-way ANOVA was used, followed by Tukey’s test at a statistical significance level of 5%. The ARI results were analysed descriptively. There was statistically significant difference between the groups regarding the shear bond strength values, with conventional tubes presenting significantly higher values (P < 0.05). In addition, the presence of salivary contamination interfered negatively with the behaviour of conventional tubes only (P < 0.05). Shear bond strength was not improved by increasing the area of the orthodontic tubes. Moreover, salivary contamination influenced negatively the SBS values, but only when conventional tubes were used.

scholarly journals External fixator by Mitkovic in the treatment of comminuted intraarticular fractures of the distal radius

2004 ◽  
Vol 57 (9-10) ◽  
pp. 473-479 ◽  
Author(s):  
Ivan Micic ◽  
Milorad Mitkovic ◽  
Desimir Mladenovic ◽  
Sasa Karalejic ◽  
Sasa Milenkovic ◽  
...  
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Wrist Joint ◽  
Functional Results ◽  
Kirschner Wires ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Anatomic Reduction ◽  
Joint Incongruity ◽  
The Moment

Introduction Comminuted intraarticular fractures of the distal radius metaphysis are a major challenge for orthopedic surgeons. The aim of this study was to present results of the survey on treatment of these fractures using an external fixator. Material and methods 73 patients (30 females and 43 males) with closed comminuted intraarticular fractures of the distal radius, type C AO/ASIF (based on radiography at the moment of injury) were treated by a Mitkovic external fixator and followed-up for at least 2 years. An external fixator and Kirschner wires were used in 43 patients. An external fixator without Kirschner wires was used in 30 patients. Results At the end of treatment, functional results and outcomes were excellent in 39 (53.4%), good in 19 (26%), fair in 10 (13.7%), and poor in 5 (6.8%) patients according to Jakim score. Lesser degree of limitation of the movement of the wrist joint was established in 19 patients (26%). Joint incongruity of the distal radius, 0-2 mm, was observed in 22 patients (30%) and over 2 mm in 3 patients. A minimal degree of posttraumatic osteoarthrosis was recorded in 21 patients (28.7%) and moderate ostheoarthrosis in 5 patients (6.8%). Conclusion The anatomic reduction of the articular surfaces and healing of the fracture in a proper functional position are prerequisites for adequate function of the wrist and hand. It appears that an external fixator, with or without Kirschner wires, can be a method of choice in treatment of these complex articular fractures.

Effect of Wrist Joint Angle on the Examination of Hoffmann's Sign

2021 ◽  
Author(s):  
Guan Shi ◽  
Hai Tang ◽  
Jianlin Shan
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Joint Angle ◽  
Wrist Joint ◽  
Control Group ◽  
Wrist Flexion ◽  
Significant Difference ◽  
Palmar Flexion ◽  
Flexion And Extension

Abstract Objective To study the effect of different wrist flexion and extension angles on the results of Hoffmann’s sign.Methods Thirty-seven patients with cervical spondylotic myelopathy and fifty objectives as control group were examinated at 15° palmar flexion, 0° neutral, 30° back extension, and 60° back extension of the wrist joint to observe Hoffmann's sign.ResultsThe patients with cervical spondylotic myelopathy did not present significantly different results of Hoffmann’s sign at 0° neutral, 30° back extension, and 60° back extension, but significantly different at 15° palmar flexion (P<0.05). In control group, there is no significant difference at 15° palmar flexion, 0° neutral, 30° back extension, but significantly different at 60° back extension (p<0.05).ConclusionThe different angles of wrist flexion and extension present a significant impact on the results of Hoffmann’s sign examination. For the patients with cervical spondylotic myelopathy, it is reliable to test Hoffmann’s sign at 30° wrist back extension.

scholarly journals Dorsal Bridge Plating versus External Fixation for Distal Radius Fractures

2019 ◽  
Vol 09 (02) ◽  
pp. 177-184
Author(s):  
William L. Wang ◽  
Asif M. Ilyas
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Hardware Failure ◽  
Pubmed Database ◽  
Significant Difference ◽  
Bridge Plating

Abstract Background External fixation and dorsal bridge plating are wrist spanning fixation options for distal radius fractures; however, their comparative effectiveness is not well understood. A meta-analysis was conducted to compare the clinical outcomes between these two techniques. Materials and Methods A PubMed database query of all distal radius fracture cases managed with spanning external fixation or dorsal bridge plating was performed. A total of 28 articles met inclusion criteria, yielding 895 patients for data extraction and comparative analysis. Results Dorsal bridge plating demonstrated lower rates of infection (2 vs. 10%, p = 0.05) and complex regional pain syndrome (1 vs. 4%, p = 0.04) but higher rates of hardware failure (4 vs. 1%, p = 0.026). Bridge plating also demonstrated higher rates of excellent/good ratings under the Gartland and Werley outcome score (91 vs. 83%, p = 0.016). There was no significant difference in DASH (Disability of the Arm, Shoulder, and Wrist) scores, radiographic parameters, or unplanned reoperations between the two spanning fixation options. Conclusion Bridge plating and external fixation both appear to be comparable for spanning fixation constructs for distal radius fractures, but with bridge plating having a potentially lower complication profile.

Complex Articular Fractures of the Distal Radius: The Role of Closed Reduction and External Fixation

2008 ◽  
Vol 33 (3) ◽  
pp. 305-310 ◽  
Author(s):  
A. BINI ◽  
M. F. SURACE ◽  
G. PILATO
Keyword(s):  
Retrospective Study ◽  
External Fixation ◽  
Distal Radius ◽  
Functional Results ◽  
Ao Classification ◽  
Radial Inclination ◽  
Articular Fractures ◽  
Acceptability Criteria

Twenty-two patients underwent surgery for 23 complex articular fractures of the distal radius of C.3 type, according to the AO classification. The surgical treatment consisted, in all cases, of a closed, or limited-open, reduction and external fixation. The functional and radiographic results were analysed at a mean follow-up of 40 months. This retrospective study confirms that satisfactory functional results where obtained in 12 out of the 15 wrists where all the intra and extra-articular parameters of the Fernandez’ criteria where respected. For those wrists where keeping with Fernandez’ criteria for intra-articular parameters and ulnar variance was not possible, four of eight had satisfactory results. As far as the acceptability criteria for radial inclination and dorsal tilt are concerned, the functional results seem to suggest that a little wider tolerance than proposed in the literature could be accepted.

Intra-Articular Fractures of the Distal Radius: A Prospective Randomised Controlled Trial Comparing Static Bridging and Dynamic Non-Bridging External Fixation

2003 ◽  
Vol 28 (5) ◽  
pp. 417-421 ◽  
Author(s):  
J. KRISHNAN ◽  
A. E. R. WIGG ◽  
R. W. WALKER ◽  
J. SLAVOTINEK
Keyword(s):  
Randomised Controlled Trial ◽  
Randomized Trial ◽  
External Fixation ◽  
Clinical Outcomes ◽  
Distal Radius ◽  
External Fixator ◽  
Controlled Trial ◽  
Articular Fractures ◽  
Significant Difference ◽  
Randomised Controlled

This prospective randomized trial compared a non-bridging external fixator with a bridging external fixator system for the treatment of severe comminuted intra-articular fractures of the distal radius. The results did not demonstrate a statistically significant difference in the radiological and clinical outcomes achieved with these two treatments.

scholarly journals A Prospective Observational Study on Efficacy of Ilizarov External Fixation in Infected Non-Union Tibial Fractures

2021 ◽  
Vol 8 (15) ◽  
pp. 932-938
Author(s):  
Avinash Gundavarapu ◽  
Vishal Singh ◽  
Prashant Kumar Mishra ◽  
Santhosh Kumar M
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Functional Results ◽  
High Energy ◽  
Tibial Fractures ◽  
Bony Union ◽  
Ilizarov External Fixator ◽  
Non Union ◽  
Ring Fixator ◽  
Study Results

BACKGROUND Open fractures and fractures caused by high-energy trauma are likely to get infected and result in non-union. Infected non-union of long bones is a problem in developing countries like India. Ilizarov external fixator was employed to correct all the complications associated with non-union such as bone gap, infection, shortening, and deformities. Stable fixation, corticotomy and bone transport was employed to reduce or eliminate infection at the same time achieving bone union and correction of limb length discrepancy. Our study assesses the efficacy and safety of Ilizarov external fixation in patients with infected non-union tibial fractures. METHODS A series of 30 patients with infected non-union of tibia were treated with Ilizarov external fixation in Yashoda super speciality hospital and regularly followed-up between May 2014 and April 2016 (2 years). Bony and functional results were estimated and correlated with existing studies. RESULTS Out of thirty patients treated, bony results were excellent in 17 patients, good in 8 patients, fair in 4 patients and poor in 1 patient. Functional results were excellent in 17 patients, good in 5 patients, fair in 5 patients, and poor in 3 patients. Average duration of the fixator period was 8.1 months (min - 3 months, max - 14 months). Average length of regenerate was 3.64 cm (min - 2 cm, max - 6 cm). Average lengthening index in the study was 2.09 months / cm. Our study in all 4 categories of Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria had approached Dror Paley’s Bony results and functional results. CONCLUSIONS In our study results have been encouraging in addressing all the complex problems by Ilizarov principle. Ilizarov external fixator system is the best device to treat infected non-union of tibia. Distal third of tibia is more prone for infection and non-union. Corticotomy or bone grafting is required for augmentation of the healing process. Almost all patients had varying degrees of oedema and pin track infections. Infection was controlled in all the cases and bony union was achieved, no patient had persistence of non-union and infection at the end of 2 years. KEYWORDS Ilizarov External Ring Fixator, Infected Non-Union, ASAMI Criteria, Bony Results, Functional Results, Bony Union

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