Intra Focal K-Wiring for Distal End Radius (Kapandji Technique): Surgical Technique

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Vijay A. Malshikare
Keyword(s):  
Surgical Technique ◽  
Standard Form ◽  
Fracture Site ◽  
Proximal Fragment ◽  
Distal Fragment ◽  
Radius Fractures ◽  
Secondary Displacement ◽  
Osteoporosis Fracture ◽  
Type Of Fracture ◽  
Inferior Edge

Many years distal end radius fractures (DRF) are the most encountered type of fracture. In standard form, extra-articular distal end radius fractures were fixed after manual reduction and then pinned extra-articular by drilling distal cortex and passing fracture site to fix proximal fragment (Figure 1). But after 2 to 3 weeks depending upon osteoporosis fracture collapse(cancellous bone heal by collapse) and flexibility of the K wire distal fragment moves back until the K wire abut the inferior edge of the proximal fragment and does not avoid secondary displacement (Figure 2) [1].

Secondary displacement of distal radius fractures treated by bridging external fixation

2013 ◽  
Vol 39 (4) ◽  
pp. 423-428 ◽  
Author(s):  
N. Farah ◽  
L. Nassar ◽  
Z. Farah ◽  
F. Schuind
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Loss Of Reduction ◽  
Ulnar Fracture ◽  
Secondary Displacement ◽  
Type Of Fracture ◽  
Gender Type

Loss of reduction remains an important problem after treatment of distal radius fractures, whatever the type of bone fixation. We assessed retrospectively the rate of secondary displacement after external fixation of distal radius fractures in order to identify possible risk factors for instability. We reviewed the pre-operative and serial post-operative radiographs of a retrospective series of 35 distal radius fractures treated by bridging external fixation. When classified according to the Société Française d’Orthopédie et Traumatologie (SOFCOT) criteria, the rate of secondary displacement was 48.5%. At final follow up, the reduction was anatomical in 12% and acceptable in 83%. There was malunion in 5%. The loss of reduction concerned primarily the distal radius palmar tilt and was moderate. No correlation was found with age, gender, type of fracture, degree of initial displacement, associated ulnar fracture, or seniority of the treating surgeon.

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

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

Sagittal Rotational Malunions of the Distal Radius: The Role of Pure Derotational Osteotomy

2009 ◽  
Vol 34 (2) ◽  
pp. 160-165 ◽  
Author(s):  
F. DEL PIÑAL ◽  
F. J. GARCÍA-BERNAL ◽  
A. STUDER ◽  
J. REGALADO ◽  
H. AYALA ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Distal Fragment ◽  
Radius Fractures ◽  
Hinge Point ◽  
Derotational Osteotomy ◽  
Sagittal Tilt ◽  
Dorsal Defect ◽  
Posterior Anterior

Sagittal rotational malunion after distal radius fractures was identified in eight patients by the presence of a “hinge” point on the volar cortex on the lateral radiograph, and the ulnar head being shorter than the anterior lip of the radius on the posterior–anterior radiograph. The surgical correction consisted of preplating the distal fragment with a volar locking plate before an osteotomy through the “hinge” point, and correcting the dorsal tilt of the distal fragment. Any dorsal defect was filled with cancellous bone graft from the olecranon. Pain, range of motion and grip all improved. Disabilities of arm, shoulder and hand score changed from 54 to six. Dorsal sagittal tilt improved by 26°, from −23°to +3°. Ulnar variance improved by 3 mm, from +1.5 to −1.5 mm, becoming identical to the opposite side. A pure derotational osteotomy corrected the apparent shortening of the radius and restored the volar tilt.

Rupture of the Extensor Pollicis Longus Tendon in Undisplaced Colles’ Type of Fracture

HAND ◽  
1982 ◽  
Vol os-14 (1) ◽  
pp. 41-47 ◽  
Author(s):  
B. Helal ◽  
S. C. Chen ◽  
G. Iwegbu
Keyword(s):  
Fracture Site ◽  
Extensor Retinaculum ◽  
Fracture Callus ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Colles Fracture ◽  
Type Of Fracture ◽  
Extensor Pollicis Longus Tendon

There is a higher risk that the tendon of extensor pollicis longus will rupture in undisplaced Colles’ type of fracture than in those which are displaced. This difference in incidence is due to the integrity of the extensor retinaculum in undisplaced Colles’ type of fracture causing the tendon to be held tight against the fracture callus in the floor of the tunnel which may result in an attrition rupture. In the displaced Colles’ fracture the extensor retinaculum is torn from the bone and thus permits the tendon to escape from contact with the fracture site.

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

2018 ◽  
Vol 46 (11) ◽  
pp. 4535-4538 ◽  
Author(s):  
Hagay Orbach ◽  
Nimrod Rozen ◽  
Barak Rinat ◽  
Guy Rubin
Keyword(s):  
Distal Radius ◽  
Analgesic Efficacy ◽  
Fracture Site ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Vas Score ◽  
Significant Difference ◽  
Group A ◽  
Vas Scores ◽  
Group B

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.

scholarly journals Does the location of short-arm cast univalve effect pressure of the three-point mould?

2020 ◽  
Vol 14 (3) ◽  
pp. 236-240
Author(s):  
Blake K. Montgomery ◽  
Kenneth H. Perrone ◽  
Su Yang ◽  
Nicole A. Segovia ◽  
Lawrence Rinsky ◽  
...  
Keyword(s):  
Distal Radius ◽  
Sagittal Plane ◽  
Fracture Site ◽  
Radius Fractures ◽  
Sensory Inputs ◽  
Fractures In Children ◽  
Modifiable Factors ◽  
Loss Of Reduction ◽  
Ulnar Aspect ◽  
Volar Surface

Purpose Forearm and distal radius fractures are among the most common fractures in children. Many fractures are definitively treated with closed reduction and casting, however, the risk for re-displacement is high (7% to 39%). Proper cast application and the three-point moulding technique are modifiable factors that improve the ability of a cast to maintain the fracture reduction. Many providers univalve the cast to accommodate swelling. This study describes how the location of the univalve cut impacts the pressure at three-point mould sites for a typical dorsally displaced distal radius fracture. Methods We placed nine force-sensing resistors on an arm model to collect pressure data at the three-point mould sites. Sensory inputs were sampled at 15 Hz. Cast padding and a three-point moulded short arm fibreglass cast was applied. The cast was then univalved on the dorsal, volar, radial or ulnar aspect. Pressure recordings were obtained throughout the procedure. Results A total of 24 casts were analyzed. Casts univalved in the sagittal plane (dorsal or volar surface) retained up to 16% more pressure across the three moulding sites compared with casts univalved in the coronal plane (radial or ulnar border). Conclusion Maintaining pressure at the three-point mould prevents loss of reduction at the fracture site. This study shows that univalving the cast dorsally or volarly results in less pressure loss at moulding sites. This should improve the chances of maintaining fracture reductions when compared with radial or ulnar cuts in the cast. Sagittal plane univalving of forearm casts is recommended.

Position of the Distal Fibular Fragment in Pronation and Supination Ankle Fractures: A CT Evaluation

2003 ◽  
Vol 24 (7) ◽  
pp. 561-566 ◽  
Author(s):  
Chris W. Tang ◽  
Nikolaos Roidis ◽  
Suketu Vaishnav ◽  
Anand Patel ◽  
David B. Thordarson
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Fracture Site ◽  
Ankle Fractures ◽  
Qualitative Assessment ◽  
Ct Scans ◽  
Proximal Fragment ◽  
Fracture Fragment ◽  
Normal Side ◽  
Fibular Fracture

Background: Although classically the fibula has been reported to be in external rotation after supination-external rotation (SER) or pronation-external rotation (PER) ankle fractures, a previous CT study demonstrated that what had traditionally been interpreted as external rotation of the distal fibular fracture fragment is actually internal rotation of the proximal fibular fragment. The purpose of this study was to evaluate a series of CT scans in patients who have suffered type IV SER or PER ankle fractures to assess the rotational deformity of the fibular fragment. Materials and Methods: CT scans of the injured and uninjured extremities were performed on 30 extremities which had sustained either SER (21) or PER (9) injuries. The rotational relationship between the tibia and fibula was determined by a measured rotational ratio. A qualitative assessment of the rotational relationship between the tibia and fibula above, at, and below the fracture site at the level of the mortise was also performed. The difference in the ratio (calculated by subtracting the rotation ratio of the normal side from the fracture side) demonstrated whether the fractured fibula is externally or internally rotated compared to the uninjured side. Results: The average rotational ratio difference above the fracture compared to below the fracture for the SER group demonstrated significant external rotation ( p < .001). The PER fracture also demonstrated external rotation of the distal fragment compared to the proximal fragment ( p = .002). Additionally, qualitative assessment of the relationship demonstrated no obvious change in the rotational relationship in any patient above the fracture site except one where mild internal rotation of the proximal fragment was noted. However, at the level of the mortise, all had a normal talofibular rotational relationship while 24 of 30 had widening of the medial clear space with external rotation clearly evident on 15 of these 24 scans. Conclusion: Our study demonstrated that the distal fibular fragment in both SER and PER fractures is externally rotated relative to both the contralateral normal side and compared to the proximal fibular fragment.

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