scholarly journals Comparative study on the functional outcome of ligamentotaxis in comminuted fractures of the distal end of radius and with that of conservative means of closed reduction and casting

2017 ◽  
Vol 3 (3) ◽  
pp. 614
Author(s):  
Urampath Sudheer ◽  
Chundarathil Jayaprakash
Keyword(s):  
External Fixator ◽  
Closed Reduction ◽  
Functional Results ◽  
Plaster Cast ◽  
X Rays ◽  
Cast Immobilization ◽  
Score System ◽  
Articular Fractures ◽  
Comminuted Fractures ◽  
Group 2

<p><strong>Background</strong>: Comminuted fractures of lower end of radius most often bring out unsatisfactory outcome, if treated by conservative means of closed reduction and casting. This study was aimed to compare the results of ligamentotaxis in comminuted fractures of the distal end of radius and with that of closed manipulative reduction and plaster cast immobilization.</p><p><strong>Methods</strong>: Patients with comminuted fracture lower end of radius treated by ligamentotaxis or the conservative methods were included in the prospective study. Patients in group l treated by external fixator and in group 2 treated by conservative line of management. Postoperative check X-rays were taken. All the patients were evaluated on 3rd, 6th, 12th and 18th months after surgery. Functional results were assessed by Gartlands point score system and subjected to statistical analysis.</p><p><strong>Results: </strong>Total fifty patients were included in the study. Twenty five were treated by external fixator and the remaining was treated by conservative line of management. Patients underwent ligamentotaxis had 88% excellent results whereas 52% of patients on conservative care had similar results. When the conservative methods gave poor results for severely comminuted fractures, ligamentotaxis could bring out excellent re-orientation of fragments back to near normal alignment.</p><p><strong>Conclusions</strong>: Ligamentotaxis using a distracter is a better method to treat comminuted fractures of lower end of radius. Even though the initial reductions were excellent in a plaster cast, re-displacement rates are very high in a plaster cast. Fractures without intra articular extension always yielded far better results than intra articular fractures.</p>

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

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.

Subtalar Joint Dislocations

1995 ◽  
Vol 16 (12) ◽  
pp. 803-808 ◽  
Author(s):  
Donald R. Bohay ◽  
Arthur Manoli
Keyword(s):  
Current Literature ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Joint Stiffness ◽  
Cast Immobilization ◽  
Joint Dislocation ◽  
Posttraumatic Arthrosis ◽  
Articular Fractures ◽  
Joint Dislocations ◽  
Short Period

Dislocations of the subtalar joint are rare injuries. The anatomy, pathophysiology, treatment, and prognosis of subtalar joint dislocations have been well described in the literature. The purpose of this paper is to review the current literature on subtalar joint dislocations, as well as outline those aspects of the anatomy, pathomechanics, and treatment pertinent to care of the patient with subtalar joint dislocation. In addition, complications and obstacles to reduction are described. Subtalar joint dislocations, although not common, have increased in frequency over the last decade. Generally, they can be treated successfully with closed reduction and a short period of cast immobilization. The majority of patients will suffer some disability with subtalar joint stiffness the primary complaint. Associated intra-articular fractures increase the risk of posttraumatic arthrosis.

scholarly journals Management of Comminuited Intra/Juxta Articular Fracture of Distal Radius Using Bridging External Fixator

2022 ◽  
Vol 8 (1) ◽  
pp. 24-30
Author(s):  
Rakesh Sharma ◽  
Dharam Singh ◽  
Jagsir Singh ◽  
Rajesh Kapila
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Road Traffic ◽  
Single Case ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Cost Effective ◽  
Functional Results ◽  
Young Males ◽  
Articular Fractures

Background: Distal radius fractures are the third most common osteoporotic fractures and are frequently treated in emergency department. They have a trimodal peak of occurrence and there has been a significant increase in incidence of involvement in elderly females and young males. Management of these fractures comes with lots of treatment options and challenges to provide good functional outcome. This prospective study was done for the management of communited intra/juxta articular fractures of distal end radius using a bridging external fixator on 25 patients. The principle of ligamentotaxis was used for alignment of fracture fragments and wrist spanning external fixator was used to maintain the fracture reduction.Methods:25 patients of either sex with age group 16 to 80 years were taken from the orthopedic department. After proper primary care, cases were classified using Fernandez classification, and posted for surgery as soon as investigations and fitness were taken.Results:Patients involved in the study were in range of 16 to 78 years with 16 patients having dominant side with road traffic accident as leading cause.Radiological union was seen at an average of 7.3 weeks, 4 patients had superficial pin tract infection, 3 patients had stiffnes and a single case had malunion. Conclusions:Modified clinical scoring system of Green and O’Brien was used to evaluate the overall functional results which showed excellent to good results in 84% of cases. Hence, properly planned and executed bridging external fixator is an easy, cost-effective and reliable treatment modality through the “Principle of Ligamentotaxis”.

scholarly journals INTRA-ARTICULAR FRACTURES OF DISTAL RADIUS;

2018 ◽  
Vol 21 (04) ◽  
pp. 649-653
Author(s):  
Waqar Alam ◽  
Faaiz Ali Shah ◽  
Khalid Mahmood Qureshi ◽  
Shams Ur Rehman ◽  
Shahid Hussain ◽  
...  
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Functional Results ◽  
Distal Radius Fractures ◽  
Monthly Interval ◽  
Point System ◽  
Functional Evaluation ◽  
Radius Fractures ◽  
Articular Fractures

Objective: To assess the radiological and functional outcome of external fixator inthe treatment of intar-articular fractures of distal radius. Study design: Descriptive case series.Place and duration of study: Orthopaedic unit District Headquarter Hospital Temargarha LowerDir from March 2013 to March 2014. Material and methods: Twenty five patients of intra-articularfracture distal radius fulfilling the inclusion criteria were treated with AO external fixator byligamentotaxis. Preoperative and postoperative radiograph measurements were taken of radialinclination, radial tilt, and radial length, and fractures were classified according to the AO system.The fixator was removed after 6-8 week and functional assessment was done using Gartland andWerely point system at monthly interval for six months. Results: Eighteen male (72%) and 7(28%)females mean age 43.1 years with intra-articular distal radius fractures were treated with externalfixator. Preoperative mean radial inclination(10.5 degree) radial tilt(29 degrees dorsal) and radiallength(6.3 mm) were reported postoperatively as 18.8 degrees,8 degrees volar and 10 mmrespectively at final follow up visit. The functional evaluation by Gartland and Werley's pointsystem reported excellent (60% patients) ,good(20%) and fair(12%) at final follow up visit. One(4%) patient could not achieve union while one (4%) malunion was reported. Conclusions:Bridging external fixator(static) yields excellent radiological and functional results in majority ofintra-articular distal radius fractures.

Intra-Articular Fractures at the Base of the Fifth Metacarpal

1992 ◽  
Vol 17 (2) ◽  
pp. 144-147 ◽  
Author(s):  
K. KJÆR-PETERSEN ◽  
A. G. JURIK ◽  
L. K. PETERSEN
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Plaster Cast ◽  
Percutaneous Pinning ◽  
Articular Fractures ◽  
Grip Power

The treatment of 64 intra-articular fractures at the base of the fifth metacarpal was studied. 11 fractures with minimal displacement had been immobilised in a plaster cast without reduction. The position was improved in five of 25 fractures treated by closed reduction and a plaster cast, six of nine fractures after percutaneous pinning, and 12 of 19 fractures after open reduction and internal fixation. At follow-up after a median of 4.3 years, 19 of 50 patients answering a questionnaire had intermittent pain, especially on firm grip. 43 patients were re-examined clinically and radiographically: 21 (49%) had decreased grip power, and 28 had radiographical signs of osteoarthrosis.

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