scholarly journals Midterm surgical treatment outcomes of unstable distal radius fractures

2019 ◽  
Vol 26 (1) ◽  
pp. 17-26
Author(s):  
K. A Yeghiazaryan ◽  
A. P Ratiev ◽  
A. V Grigoriev ◽  
A. V Germanov ◽  
M. A Danilov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
External Fixation ◽  
Distal Radius ◽  
Conflict Of Interest ◽  
Open Reduction ◽  
Wrist Joint ◽  
Plate Fixation ◽  
Young Patients ◽  
Second Stage ◽  
Radiocarpal Joint

Background. Fracture of the distal radius is the most common injures bones of the forearm. Multifragmentary articular injures have occupied a special place among all fractures of the distal radius This factor due to the severity of the injury wrist joint, young patients and difficult rehabilitation. Purpose of study: Improvement results surgical treatment unstable fractures of the distal radius. Patients and methods. All patients were depended into two groups: The first group consisted of 34 patients. The first stage of treatment include close reduction and external fixations. If after external fixation we have persisting fractures dislocation, we take conversion external fixation, open reduction and plate fixation. The second group were included 30 person. In this group we take open reduction and plate fixation. Results. 6 or 12 month after surgery in 1 group we have receiver 87% excellent results. In the the second group we have received 77% excellent results. In the first group 2 cases have slow fractures consolidation, infection complication not found. In the second group we have 2 complication: CRPS and infection. Conclusion. Results in two groups of patients are assessed as good and excellent. The results of the study showed that external fixation in first stage of treatment allows to achieved better restoration radiocarpal joint anatomy (except for type B fractures), and without secondaly displacement tendency. The last fact is very important for patient with delayed the second stage of treatment. This patients with multiple injuries, open fractures and presence of an infected wound and etc. The second stage of treatment consisted of open reduction and plate fixation. Achieved full anatomy restoration radiocarpal joint with possible early rehabilitation. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

Open reduction and plate fixation of dorsally displaced fractures of the distal radius: surgical technique, clinical and radiological outcome

2009 ◽  
Vol 35 (1) ◽  
pp. 56-60 ◽  
Author(s):  
T. E. J. Hems ◽  
B. Rooney
Keyword(s):  
Distal Radius ◽  
Open Reduction ◽  
Articular Surface ◽  
Plate Fixation ◽  
Young Patients ◽  
Extensor Tendon ◽  
Articular Fractures ◽  
Clinical And Radiological Outcome ◽  
Evaluation Measure

Thirty-five unstable dorsally displaced fractures of the distal radius in 34 patients (mean age 39) were studied; 28 fractures were intra-articular. All fractures had open reduction and fixation, through a dorsal approach, with mini-fragment plates placed between the first and second dorsal tendon compartments and deep to the fourth compartment. A congruous reduction of the articular surface was obtained in all cases. Twenty-four patients were available for follow-up (median 38 months). The Modified Mayo wrist score was excellent in 12 cases, good in four, and fair in eight. The median Patient Evaluation Measure score was 23.5. There were no cases of extensor tendon rupture. Radiographic assessment at follow-up showed a mean palmar angle of 6°. There was evidence of osteoarthritis in six patients who had had intra-articular fractures. Open reduction and plating gives satisfactory medium term results for treatment of displaced intra-articular fractures of the distal radius in young patients.

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 External fixation-assisted reduction for the treatment of neglected hip dislocations with limb length discrepancy: a retrospective study of 13 cases

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Pengyu Li ◽  
Fulin Tao ◽  
Wenhao Song ◽  
Jinlei Dong ◽  
Daodi Qiu ◽  
...  
Keyword(s):  
External Fixation ◽  
Open Reduction ◽  
Hip Dislocation ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Acetabular Fractures ◽  
External Fixators ◽  
Residual Limb ◽  
Second Stage ◽  
Length Discrepancy

Abstract Background The purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction. Methods Thirteen patients admitted between January 2010 to February 2018 with a mean duration from injury to surgery of 5.0 ± 2.1 months and an average preoperative leg-length discrepancy of 7.7 ± 2.3 cm were enrolled in this study. The dislocation and associated acetabular fracture type, clinical outcomes and residual limb length discrepancy were evaluated. Results All patients had posterior dislocations, and nine patients presented with acetabular fractures and were followed-up for at least 12 months. The average traction duration of external fixators was 28.8 ± 8.0 days and all patients received second-stage open reduction and internal fixation. Six patients showed residual limb length discrepancy within 2 cm. Patients showed significant improvement in hip function and pain relief. Complications including avascular femoral head necrosis and osteoarthritis occurred in three patients. Conclusion Effective correction of limb length discrepancy and improved function were observed in patients with neglected hip dislocations and limb equality using traction by external fixation combined with second-stage open reduction. Further follow-up is required to determine long-term outcomes.

Trends in the management of fractures of the distal radius in Ireland

2019 ◽  
Vol 101-B (12) ◽  
pp. 1550-1556 ◽  
Author(s):  
R. Mc Colgan ◽  
David M. Dalton ◽  
Adrian J. Cassar-Gheiti ◽  
Ciara M. Fox ◽  
Michael E. O’Sullivan
Keyword(s):  
Distal Radius ◽  
Fracture Fixation ◽  
Emergency Surgery ◽  
Open Reduction ◽  
Plate Fixation ◽  
Kirschner Wire ◽  
Acute Fracture ◽  
Wire Fixation ◽  
Increasing Trend ◽  
Adult Inpatient

Aims The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT). Patients and Methods Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were included Results In 2008 Kirschner-wire (K-wire) fixation accounted for 59% of operations for fractures of the distal radius, and plate fixation for 21%. In 2017, the rate of K-wire fixation had fallen to 30%, and the proportion of patients who underwent plate fixation had risen to 62%. Conclusion There is an increasing trend towards open reduction and internal fixation for fractures of the distal radius in Ireland. This has been accompanied by a decrease in popularity for K-wire fixation. DRAFFT did not appear to influence trends in the management of fractures of the distal radius in Ireland. Cite this article: Bone Joint J 2019;101-B:1550–1556

scholarly journals SURGICAL TREATMENT OF CLAVICULAR FRACTURES IN SPORT

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
E Gastaldi Orquin ◽  
GM Gastaldi Llorens
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Platelet Rich Plasma ◽  
Plate Fixation ◽  
Activity Level ◽  
Contact Sports ◽  
Sport Practice ◽  
Shoulder Range Of Motion

Clavicular fractures are common in sport practice, they are easily diagnosed and have a relative good forecast. Nevertheless there is no consensus among orthopedic surgeons regarding treatment for displaced midle-third clavicular fractures (Robinson’s classification 2B2) and lateral-third fractures. The tendency toward operative treatment is increasing due to the earlier sport recovery. Objectives: The aim of the paper is to present the results of treatment of 98 clavicular fractures in the Clinic Gastaldi of Traumatology during the period from 1997 to 2016, analyzing the radiologic and clinical results. Methods: The serie consists of 89 patients, 80 males and 9 females, average age 32.2 years. From them, 89 were agude fractures and 9 nonunion (after conservative treatment). According to the Thomsom classification there were 82 middle-third and 16 lateral-third. Motorbike sport trauma was the cause of 49 patients (55%), bike trauma in 18 (20%), 18 (20%) fractures occurred due to contact sports and 3 other causes. All patients were surgically treated. We used an antero-superior approach, open reduction and internal fixation with antero-superior plate osteosynthesis. In case of nonunion we decorticated the fracture callus, adding intramedullary reaming and graft bone. PRP (Platelet Rich-Plasma) was used in 8/9 patients. Postoperatively, the patients were placed in a sling. After that they began a rehabilitation program that consists of isometrics, pendular and active movements until 45° during 3 weeks. From 4th to 6th week, active movements until 90°. The patients began free movements after the 6th week. Results: Fracture healing mean was 10 weeks. Bikes and motorbikes were able to ride again between 10 to 21 days after surgery (once removed stitches). All patients retrieved full shoulder range of motion and returned to their previous activity level. Complications: we had no nonunion rates after surgical treatment, neither infections. 1 case of insufficient plate fixation and 4 re-fractures which required surgical treatment. Conclusion: We suggest surgical treatment for clavicular fractures in adult patients, contact sports with IIB and IIIB fractures, re-fractures and painful nonunion. Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third clavicular fractures achieved shorter time to complete return to sport and earlier bone union.

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