scholarly journals Functional outcome of distal radius fractures treated with fixation by percutaneous cannulated screw

2019 ◽  
Vol 5 (5) ◽  
pp. 904
Author(s):  
Prakash Kumar ◽  
Ashok Desai ◽  
Harshal Patkar ◽  
Deepak Phalgune
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Closed Reduction ◽  
Ulnar Variance ◽  
Distal Radial Fracture ◽  
Percutaneous Fixation ◽  
Continuous Variables ◽  
Radial Inclination ◽  
Mayo Wrist Score

<p class="abstract"><strong>Background:</strong> In the present study primary objectives were to evaluate the clinical and functional outcome and union rates, whereas secondary objective was to study complications associated with closed reduction percutaneous fixation of displaced unstable fractures of distal radius in adults by using cannulated cancellous (CC) screw.</p><p class="abstract"><strong>Methods:</strong> Thirty two patients aged more than 18 years, with unstable displaced distal radial fracture were included in this prospective observational study. Patients were treated by closed reduction and percutaneous fixation by CC screw. Radiological parameters like radial inclination, radial height, ulnar variance, volar tilt were measured. Mayo wrist score and range of motion were noted. Patients were followed up for six months. Continuous variables were compared by using paired and unpaired ‘t’ test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean Mayo wrist score at six months post-operative follow-up (82.8) was significantly higher compared to six weeks post-operative follow-up (64.4). Mean early post-operative radial height, mean radial inclination, and mean volar tilt were significantly higher compared to mean six months post-operatively. Mean early post-operative ulnar variance was significantly lower compared to mean six months post-operatively. Mean flexion, mean extension, mean supination, mean pronation, mean radial deviation, and mean ulnar deviation was significantly higher six months post-operative follow-up compared to six week post-operative follow-up. Mean grip strength was significantly higher six months post-operative follow-up compared to six week post-operative follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Clinical and functional outcomes associated with closed reduction and percutaneous fixation by cannulated cancellous screw was excellent. Mayo wrist score was increased over six months follow up period.</p>

DORSAL PLATING FOR COMMINUTED INTRA-ARTICULAR FRACTURES OF THE DISTAL END OF THE RADIUS

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 181-190 ◽  
Author(s):  
D. Osada ◽  
K. Tamai ◽  
A. Iwamoto ◽  
S. Fujita ◽  
K. Saotome
Keyword(s):  
Distal Radius ◽  
Open Reduction ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Articular Fractures ◽  
Radial Length ◽  
Comminuted Fractures ◽  
Dorsal Plating

Forty-one dorsally displaced intra-articular fractures of the distal radius were treated by open reduction and internal fixation with the dorsal Symmetry® plates. The average age at the time of the injury was 49 years. An average follow-up period was 15 months. The final radial length averaged 11 mm, radial inclination 23°, volar tilt 7°, ulnar variance 1.5 mm, and articular incongruity 0.3 mm. According to the Gartland and Werly scales, 36 fractures were excellent and five were good. However, ulnar variance increased more than 3 mm during follow-up in eight patients, and volar tilt increased more than 5° during follow-up in ten patients. Use of dorsal Symmetry® plate is effective for unstable comminuted intra-articular distal radius fractures, but severely comminuted fractures may possibly undergo re-displacement post-operatively.

Arthroscopically-Assisted Reduction of Intra-Articular Fractures of the Distal Radius

1998 ◽  
Vol 23 (3) ◽  
pp. 391-395 ◽  
Author(s):  
L. ADOLFSSON ◽  
P. JÖRGSHOLM
Keyword(s):  
Distal Radius ◽  
Closed Reduction ◽  
Joint Surface ◽  
Percutaneous Fixation ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Arthroscopically Assisted ◽  
Arthroscopically Assisted Reduction

Twenty-seven patients with intraarticular fractures of the distal radius with a step of more than 1 mm in the joint surface after attempted closed reduction, were treated by reduction under arthroscopic control and percutaneous fixation. All fractures healed without measurable incongruity of the joint surface and at follow-up 3 to 38 months after surgery 19 patients had excellent and eight patients good results according to the Mayo modified wrist score.

Dual Plating Technique for Volar Rim Fracture of the Distal Radius Using DePuy-Synthes 2.0 m and 2.4 mm Locking Plates

2017 ◽  
Vol 22 (04) ◽  
pp. 423-428 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiro Suzuki ◽  
Hiromasa Wakita
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Locking Plates ◽  
Radius Fractures ◽  
Radial Inclination ◽  
The Mean

Background: To assess the surgical results of distal radius fractures with the involvement of a volar rim fragment using the DePuy-Synthes 2.0 mm and 2.4 mm locking plates.Methods: Subjects were six women and one man of average age 57 years (range, 31–83 y) and a mean follow-up period of 9 months (range, 5–19 mo) with AO B3 (volar shearing) distal radius fractures. Time of the procedure, physical examination of wrist range of motion, grip strength compared with the contralateral healthy wrist, and radiographic evaluation (volar tilt, radial inclination, and ulnar variance) were evaluated. The Visual Analog Scale (VAS: 0 points represents no pain, 100 points represents the worst pain possible) and the Quick Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH, 0 = no disability, 100 = extreme disability) were completed by patients at the final follow-up.Results: The average time of the procedure was 74 min. There were no perioperative complications. Average radiographic measures were: volar tilt, 8°; radial inclination, 23°, and ulnar variance, 0 mm. Wrist range of motion averaged 63° in wrist extension (range, 55–80°) and 55° in wrist flexion (range, 45–65°). Grip strength averaged 81% of the contralateral side at final evaluation (range, 67–100%). The mean QuickDASH score was 3.0 points (range, 0–9.1 points) and the mean VAS for pain was 9.3 at final follow-up.Conclusions: Open reduction internal fixation with the DePuy-Synthes 2.0 mm and 2.4 mm locking plates is an effective means of fixing a distal radius fracture that includes a volar rim fragment without interfering with flexor tendon gliding.

scholarly journals COMPARATIVE STUDY OF RADIOLOGICAL AND FUNCTIONAL OUTCOME OF EXTRA ARTICULAR DISTALRADIUS FRACTURE TREATED CONSERVATIVELY WITH RESPECT TO ITS POSITION OF IMMOBILIZATION

2018 ◽  
Vol 6 (1) ◽  
pp. 46-51
Author(s):  
Gopal Prasad Gnawali
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Closed Reduction ◽  
Functional Results ◽  
Plaster Cast ◽  
Radius Fracture ◽  
Chi Square ◽  
Radiological Parameters

INTRODUCTION: Distal radius fracture is one of the common injury in orthopedic trauma. Traditionally,this fracture is being treated with closed reduction and immobilization in palmer flexion and ulnar deviation. This position of immobilization has been shown with poor functional result. So the aim of our study is to compare the radiological and functional outcome of distal radius fracture treated conservatively with respect to position of immobilization. MATERIAL AND METHODS: Hundred patients, all above 20 years of age with distal radius fracturewhere treated with closed reduction and below elbow cast application. Patients were randomly allocated to dorsal and palmer flexed plaster cast application, fifty in dorsiflexion group and fifty in palmer flexion group. All patients were followed up at 2nd week, 4th week, 6th week and 12th weeks. Radiological parameters measured in every follow-up and functional parameters measured after removal of cast in last two follow up. The results were scored and compared by Demerit Scoring System of Saito. For comparison, t test and Chi square test were used as necessary.RESULTS: All fractures united. All individual movements of wrist were significantly better in the dorsiflexed immobilized group as compared with  the  palmerflexed immobilized  group. Radiological parameters  were  also markedly better  in the dorsiflexed group.CONCLUSION: Both radiological and functional results of the extra articular distal radius fracture are better if the fracture immobilized in the dorsiflexed position after reduction rather than traditional palmer flexion position. Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, page: 46-51

scholarly journals Cast immobilization in fracture distal radius with wrist in dorsiflexion

2019 ◽  
Vol 5 (3) ◽  
pp. 412
Author(s):  
Pradeep K. Verma ◽  
Rajesh Singh ◽  
Abhishek Thakur
Keyword(s):  
Cohort Study ◽  
Functional Outcome ◽  
Distal Radius ◽  
Prospective Cohort Study ◽  
Study Design ◽  
Prospective Cohort ◽  
Study Group ◽  
Cast Immobilization ◽  
Radial Inclination

<p class="abstract"><strong>Background:</strong> The purpose of this study was to evaluate the anatomical and functional outcome of cast immobilization in fracture distal radius with wrist in dorsiflexion. Study design selected was prospective cohort study.</p><p class="abstract"><strong>Methods:</strong> The study group comprised 60 patients, with a mean follow-up of 3 month. Patients were evaluated for radial height, radial inclination and volar tilt according to Lindstrom criteria. Functional outcome were assessed with PRWE score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean loss of radial height was 4.11 mm. Mean loss of radial inclination was 6.85 degree and mean loss of volar tilt was 7.06 degree at the end of 3 month follow up. As per Lindstrom criteria 88% were excellent to fair and 93% were excellent to fair functional outcome as per PRWE score.</p><p class="abstract"><strong>Conclusions:</strong> Cast immobilization in fracture distal radius with wrist in dorsiflexion produces better anatomical and functional outcome.</p><p> </p>

scholarly journals Solitary ulnar shortening osteotomy for malunion of distal radius fractures: experience of a centre in the UK and review of the literature

2019 ◽  
Vol 101 (3) ◽  
pp. 203-207
Author(s):  
S Hassan ◽  
R Shafafy ◽  
A Mohan ◽  
P Magnussen
Keyword(s):  
Distal Radius ◽  
Simple Procedure ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Ulnar Shortening Osteotomy ◽  
Shortening Osteotomy ◽  
The Uk

Introduction Isolated ulnar shortening osteotomies can be used to treat ulnocarpal abutment secondary to radial shortening following distal radius fractures. Given the increase of fragility distal radius fractures awareness of treating the sequelae of distal radius fractures is important. We present the largest reported case series in the UK of ulnar shortening osteotomies for this indication. Materials and methods Twenty patients with previous distal radial fractures were included, who presented with wrist pain and radiologically evident positive ulnar variance secondary to malunion of the distal radius with no significant intercalated instability. Patients were treated with a short oblique ulnar shortening osteotomy, using a Stanley jig and small AO compression plate system. Pre- and postoperative radiographical measurements of inclination, dorsal/volar angulation and ulnar variance were made. Patients were scored pre- and postoperatively using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient-Rated Wrist Evaluation scores by two orthopaedic surgeons. Mean follow-up was 24 months after surgery. Results Radiographical analysis revealed a change in the ulnar variance with an average reduction of 5.74 mm. Mean preoperative scores were 61.1 (range 25–95.5) for QuickDASH and 70.4 (range 33–92) for Patient-Rated Wrist Evaluation. At the latest follow-up, mean postoperative QuickDASH scores were 10.6 (range 0–43.2) and 17.2 (range 0–44) for Patient-Rated Wrist Evaluation. Differences in scores after surgery for both QuickDASH and Patient-Rated Wrist Evaluation were statistically significant (P < 0.01). Conclusions The ulnar shortening osteotomy is a relatively simple procedure compared with corrective radial osteotomy, with a lower complication profile. In our series, patients showed significant improvement in pain and function by correcting the ulnar variance thus preventing ulna–carpal impaction.

ARTHROSCOPIC WAFER PROCEDURE

Hand Surgery ◽  
1998 ◽  
Vol 03 (02) ◽  
pp. 225-235
Author(s):  
Toshihiko Imaeda ◽  
Ryogo Nakamura ◽  
Kenji Tsunoda ◽  
Kentaro Watanabe
Keyword(s):  
Minimally Invasive ◽  
Invasive Procedure ◽  
Triangular Fibrocartilage Complex ◽  
Ulnar Variance ◽  
Minimally Invasive Procedure ◽  
Ulnar Head ◽  
Mayo Wrist Score ◽  
Triangular Fibrocartilage

Thirteen of 15 patients with ulnocarpal abutment syndrome who underwent an arthroscopic wafer procedure since 1991 were seen in follow-up at least six months postoperatively. An arthroscopic wafer procedure was performed during which the triangular fibrocartilage complex (TFCC) was partially removed with a blade and a basket punch was made through the 4–5 arthroscopic portal. The ulnar head was then partially removed with a motorized burr through the 4–5 or 6R portal. The modified Mayo wrist score was used to evaluate the results. Four wrists produced excellent results; six wrists, good; two wrists, fair; and one wrist, poor. The wrists with a null or negative ulnar variance after the procedure achieved a better result than those with a remaining positive ulnar variance at the most prominent as well as at the deepest level of the resected ulna. The arthroscopic wafer procedure offers the benefits of a minimally invasive procedure; however, it is technically demanding to remove the ulnar head with a negative ulnar variance at the most prominent level as well as at the deepest level of the resected ulnar head.

scholarly journals Closed reduction and percutaneous k-wire fixation for distal end radius fractures

2020 ◽  
Vol 8 (7) ◽  
pp. 2400
Author(s):  
Tanveer Ali ◽  
Mohmmad Sikander Baketh ◽  
Maneer Ahmad Mir
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Kirschner Wire ◽  
Mayo Score ◽  
Kirschner Wire Fixation ◽  
Anatomic Reduction ◽  
Wire Fixation ◽  
Inexpensive Procedure ◽  
Anatomical Restoration

Background: To evaluate radiological and functional outcome in fractures of the distal radius treated by K-wire fixation.Methods: Forty patients (16 males, 24 females) with different types of fractures of distal radius were treated. K-wire fixation was performed under axillary bolock or general anaesthesia. Anatomical  restoration was evaluated by postero-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate Radial Height (RH), Radial Inclination (RI) and Volar Tilt (VT). Functional outcome was evaluated using Mayo scoring system.Results: According to Mayo score 72.5% (n=29) of our patients had excellent to good outcome while as 17.5% (n=7) had fair outcome and 10% (n=4) patients had poor outcome.Conclusions: Kirschner wire fixation is an inexpensive procedure that  provides anatomic  reduction,  fracture  fixation,  and maintenance  of  reduction  with  an  adequate method of  immobilization.

Radiographic Outcome of Unstable Distal Radial Fracture Treated by Closed Reduction and Pin in Plaster

2009 ◽  
Vol 2 ◽  
pp. CMTIM.S1929
Author(s):  
Ebrahim Ghaiem Hasankhani ◽  
Mohamad Taghi Pivandi ◽  
Ali Birjandi Nejad
Keyword(s):  
Distal Radius ◽  
Closed Reduction ◽  
Low Cost ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Radiographic Outcome ◽  
Satisfactory Outcome ◽  
Appropriate Treatment ◽  
Type C ◽  
Fracture Of Distal Radius

Background There is controversy about the appropriate treatment for severely displaced and unstable comminuted fracture of distal radius (type C of AO or OTA classification). Recently, there has been an increase in the number of predilection for surgical management of this fracture. Aim To determine the radiographic outcome in type C fractures of the distal radius treated with closed reduction and pin in plaster. Materials and Methods Eighty consecutive patients 60 male and 20 female, average age 40 years (22–60 years), with type C fractures of the distal radius seen between February 2001 and July 2003 in Shahid Kamiab Hospital of Mashad University, were treated by closed reduction and pin in plaster, followed up by anteroposterior and lateral radiographs to evaluate radial height, inclination and volar tilt. Results There was significant improvement in the measurements of radial height, inclination and volar tilt after closed reduction and pin in plaster, and at the time the pins and plaster were removed. (P = 0.00). Conclusion Closed reduction and pin in plaster is an effective, simple and low cost method in type C fractures of distal radius with satisfactory outcome.

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