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.

scholarly journals Correlação clínico-radiográfica das fraturas articulares completas do rádio distal tratadas cirurgicamente

2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Thiago Agostini Pereira Albeny ◽  
Breno Alves de Souza Vaz ◽  
Luis Guilherme Rosifini Alves Rezende ◽  
Filipe Jun Shimaoka ◽  
Amanda Favaro Cagnolati ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Outcome Evaluation ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Anatomic Reduction

Introdução: As fraturas da extremidade distal do rádio representam uma das fraturas mais comuns. Diversos fatores descritos na literatura influenciam nos seus resultados após manejo cirúrgico; como a fragmentação articular, a restauração cirúrgica da anatomia do rádio, a reabilitação pós-operatória, entre outros. Objetivo: analisar o resultado funcional dos pacientes operados de fraturas articulares completas da extremidade distal do rádio e correlacionar estes resultados com os parâmetros radiológicos comumente utilizados. Métodos: 18 pacientes entre 18 a 65 anos, submetidos ao tratamento cirúrgico das fraturas do rádio distal do tipo AO 23C, no período de janeiro de 2014 a julho de 2016. Os seguintes parâmetros clínicos e radiográficos foram avaliados e submetidos a análise estatística: ADM (amplitude de movimento) do punho e antebraço, força de pinças e de preensão, PRWE (Patient Rated Wrist Evaluation), classificação AO da fratura e parâmetros radiográficos pós-operatórios. Resultados: A análise de regressão linear mostrou correlação estatisticamente significativa considerando a inclinação radial e o desvio ulnar. Conclusão: Correlação estatisticamente significativa entre os parâmetros radiográficos e resultados funcionais é de difícil determinação. Novos estudos com maior amostragem e que correlacionem os parâmetros radiográficos e idade são necessários para melhor estudo do tema abordado.Descritores: Fraturas do Rádio; Traumatismos do Punho; Fraturas Intra-Articulares.ReferênciasCourt-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37(8):691-97. Wolf WS. Distal Radius Fracture. In: Green’s Operative Hand Surgery 7. ed. Philadelphia, PA: Elsevier.Alluri RK, Hill JR, Ghiassi A. Distal Radius Fractures: Approaches, Indications, and Techniques. J Hand Surg Am. 2016;41(8):845-54.McQueen MM. Fractures oh the distal radius and ulna. In: Rockwood and Green's fractures in adults 8. ed. Philadelphia, PA: Wolters Kluwer Health.Brogren E, Petranek M, Atroshi I. Incidence and characteristics of distal radius fractures in a southern Swedish region. BMC Musculoskelet Disord. 2007;8:48. Flinkkilä T, Sirniö K, Hippi M, Hartonen S, Ruuheia R, Ohtonen P  et al. Epidemiology and seasonal variation of distal radius fractures in Oulu, Finland. Osteoporos Int. 2011;22(8):2307-12.Róbertsson GO, Jónsson GT, Sigurjónsson K. Epidemiology of distal radius fractures in Iceland in 1985. Acta Orthop Scand. 1990;61(5):457-59.Sigurdardottir K, Halldorsson S, Robertsson J. Epidemiology and treatment of distal radius fractures in Reykjavik, Iceland, in 2004. Comparison with an Icelandic study from 1985. Acta Orthop. 2011;82(4):494-98.Meena S, Sharma P, Sambharia AK, Dawar A. Fractures of distal radius: an overview. J Family Med Prim Care. 2014;3(4):325-32.Metz VM, Gilula LA. Imaging techniques for distal radius fractures and related injuries. Orthop Clin North Am. 1993;24(2):217-28.Reis FB, Faloppa F, Saone RP, Boni JR, Corvlo MC. Fraturas do terço distal do rádio: classificação e tratamento. Rev Bras Ortop. 1994;29(5):326-30.Isani A, Melone CP Jr. Classification and management of intra-articular fractures of the distal radius. Hand Clin. 1988;4(3):349-60.AO Surgery Reference. Disponível em: https://surgeryreference.aofoundation.org/. Acesso em: 04 de janeiro de 2020.Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury. 1989;20(4):208-10.Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68(5):647-59.Szabo RM, Weber SC. Comminuted intraarticular fractures of the distal radius. Clin Orthop Relat Res. 1988;(230):39-48.Trumble TE, Culp RW, Hanel DP, Geissler WB, Berger RA. Intra-articular fractures of the distal aspect of the radius. Instr Course Lect. 1999;48:465-80.Lipton HA, Wollstein R. Operative treatment of intraarticular distal radial fractures. Clin Orthop Relat Res. 1996;(327):110-24.Bradway JK, Amadio PC, Cooney WP. Open reduction and internal fixation of displaced, comminuted intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am. 1989;71(6):839-47.Melone CP Jr. Distal radius fractures: patterns of articular fragmentation. Orthop Clin North Am. 1993;24(2):239-53.Xavier CRM, Molin DCD, Santos RMM, Santos RDT, Ferreira Neto JC. Tratamento cirúrgico das fraturas do rádio distal com placa volar bloqueada: correlação dos resultados clínicos e radiográficos. Rev Bras Ortop. 2011;46(5):505-13.Karnezis IA, Panagiotopoulos E, Tyllianakis M, Megas P, Lambiris E. Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius. Injury. 2005;36(12):1435-39.Schneiders W, Biewener A, Rammelt S, Rein S, Zwipp H, Amlang M. Die distale Radiusfraktur. Korrelation zwischen radiologischem und funktionellem Ergebnis [Distal radius fracture. Correlation between radiological and functional results]. Unfallchirurg. 2006;109(10):837-44Trumble TE, Schmitt SR, Vedder NB. Factors affecting functional outcome of displaced intra-articular distal radius fractures. J Hand Surg Am. 1994;19(2):325-40. Fernandez DL. Should anatomic reduction be pursued in distal radial fractures?. J Hand Surg Br. 2000;25(6):523-27.Kasapinova K, Kamiloski V. Outcome evaluation in patients with distal radius fracture. Prilozi. 2011;32(2):231-46.Paranaíba VF, Santos JBG, Raduan Neto J, Moraes VY, Belotti JC, Faloppa F. Aplicação do PRWE na fratura da extremidade distal do rádio: comparação e correlação dos desfechos consagrados.  Rev bras ortop. 2017;52(3):278-83.da Silva Rodrigues EK, de Cássia Registro Fonseca M, MacDermid JC. Brazilian version of the Patient Rated Wrist Evaluation (PRWE-BR): Cross-cultural adaptation, internal consistency, test-retest reliability and construct validity. J Hand Ther. 2015;28(1):69-76.

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.

Intraarticular Fractures of the Distal Radius Treated with Metaphyseal External Fixation

1998 ◽  
Vol 23 (3) ◽  
pp. 396-399 ◽  
Author(s):  
J. KRISHNAN ◽  
L. S. CHIPCHASE ◽  
J. SLAVOTINEK
Keyword(s):  
Range Of Motion ◽  
External Fixation ◽  
Distal Radius ◽  
External Fixator ◽  
Distal Radial Fracture ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Early Return ◽  
Good Range

Twenty-two patients with unstable Frykman grade 7 or 8 intra-articular fractures of the distal radius were treated with an external fixator. The distal pins were inserted into the distal radial fracture fragments, permitting movement of the wrist and hand. Eleven patients were male and 11 female, with a mean age of 50 years. All patients had regained full function with good range of motion at mean final follow-up of 12 months. However function, pain and range of motion had returned to acceptable levels 4 weeks after removal of the external fixator. This method of external fixation provides a reliable method of maintaining fracture reduction whilst allowing early return of function.

Treatment of Intraarticular Fractures of the Distal Radius with Dynamic External Fixator

1995 ◽  
Vol 8 (3) ◽  
pp. 688
Author(s):  
Myung-Ku Kim ◽  
Nam-Hong Choi ◽  
Jun-Seop Jahng ◽  
Hyoung-Kook Ahn
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Intraarticular Fractures

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.

treatment of unstable intra-articular fractures of the distal radius with small external fixator

1992 ◽  
Vol 27 (1) ◽  
pp. 227
Author(s):  
Hyoun Oh Cho ◽  
Kyoung Duck Kwak ◽  
Sung Do Cho ◽  
Cheol Soo Ryoo
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Articular Fractures

Distinctive features of the results of operative treatment of intraarticular and extraarticular fractures in HIV-infected patients

2021 ◽  
Vol 19 (3) ◽  
pp. 103-108
Author(s):  
S. N. KHOROSHKOV ◽  
◽  
N. G. DORONIN ◽  
N. V. YARIGIN ◽  
V. G. BOSYKH ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Rapid Progression ◽  
Treatment Results ◽  
Expected Time ◽  
Soft Tissue Regeneration ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Fracture Consolidation ◽  
Secondary Displacement ◽  
The Moment

The purpose — to evaluate the effectiveness of the developed algorithm for determining the tactics and methods of treating intraarticular fractures in HIV-infected patients. Material and methods. From 2016 to 2020, 56 HIV-infected patients with intra-articular fractures underwent surgical treatment. In the course of treatment, an algorithm developed in the clinic for determining the tactics and method of treating HIV-infected patients was used, which proved effective in treating extra-articular fractures. Results. The results were evaluated in the average expected time of the fracture consolidation of the selected location, as well as 6 and 12 months from the moment of surgery using the algorithm developed by us for determining the tactics and method of treating fractures in HIV-infected patients. Good results (according to the Luboschitz — Mattis scale) were noted in 16 (30,8%), satisfactory — in 27 (51,9%) and unsatisfactory — in 9 (17,3%) cases. For patients of this category, the most typical complications were the rapid progression of deforming arthrosis of the joints, the secondary displacement of bone fragments against the background of bone resorption, and the development of an inflammatory process of predominantly non-infectious etiology. Conclusion. The use of the developed algorithm for determining the tactics and method of treatment in HIV-infected patients with extra-articular fractures, taking into account the effect of HIV infection and antiretroviral therapy on the processes of bone remodeling and soft tissue regeneration, can significantly reduce the number of unsatisfactory treatment results. At the same time, the peculiarities of the effect of HIV infection on the state of cartilage, subchondral bone and synovial fluid determine the nature and risks of postoperative complications in HIV-infected patients. In the future, it is planned to correct the developed algorithm taking into account the data obtained and to carry out a comparative analysis of the treatment results.

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