scholarly journals Outcome of unstable fractures of the distal end of the radius treated with external fixator

2015 ◽  
Vol 10 (2) ◽  
pp. 27-32
Author(s):  
HK Gupta ◽  
R Shrestha ◽  
SK Shrestha
Keyword(s):  
Prospective Study ◽  
Distal Radius ◽  
External Fixator ◽  
Treatment Options ◽  
Cost Effective ◽  
Point System ◽  
Unstable Fracture ◽  
Medical Sciences ◽  
Back Ground ◽  
Lost To Follow Up

BACK GROUND AND OBJECTIVES Fracture of the distal radius is the most common fracture treated by the orthopedic surgeons. Although there are several treatment options available today, the aim always remains to restore the anatomy and bring back the function to near normal condition. In this prospective study we intend to evaluate the functional and radiological outcome of the unstable fracture of the distal radius when treated with external fixator. MATERIALS AND METHODS In this hospital based, Prospective study conducted in department of Orthopedics, College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan, during the period from January 2011 to September 2012, 54 patients, (33 male and 21 female) with unstable fracture of the distal end of radius were included in the study. All the patients were treated with external fixator and followed for a period of 12 weeks. RESULT Among 54 patients, 52 were followed up for 12 weeks and two patients were lost to follow up after six weeks. The final result was assessed in detail on the basis of Modification, by Sarmiento et al., of the Demerit Point system of Gartland and Werley at the end of 12 weeks. The result was excellent in 25 cases, good in 19 cases and fair in eight cases. There were no poor results in this series. CONCLUSION External fixator is not only easy to use, allows re-reduction, has lower rate of complications and can be stiff enough to maintain the alignment but it is also a cost effective, patient compliant method which causes lesser morbidity to the patient as compared to the other options available.DOI: http://dx.doi.org/10.3126/jcmsn.v10i2.12950Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2); 27-32

scholarly journals Correlation between Radiological Parameters and Functional Outcome of Healed Unstable Fracture Distal Radius after External Fixation

2019 ◽  
Vol 15 (2) ◽  
pp. 103-106
Author(s):  
Robin Shrestha ◽  
Hemant Gupta ◽  
Manoj Kandel
Keyword(s):  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius ◽  
External Fixator ◽  
Point System ◽  
Unstable Fracture ◽  
Medical Sciences ◽  
Radiological Parameters ◽  
Clinical And Radiological Outcome ◽  
Early Functional Recovery

Background: Wrist fractures represent about one-sixth of all fractures seen in emergency department. The goal of treating such fractures is no longer only fracture union, but also the restoration of normal anatomy with early functional recovery, as well as full and painless motion of the wrist. In this prospective study we intend to evaluate the correlation between functional outcome and radiological parameters of the unstable fracture of the distal radius when treated with external fixator. Methods: A hospital based, observational study was conducted at department of Orthopedics, College of Medical Sciences Teaching Hospital, Bharat-pur, Chitwan, during the period of January 2011 to November 2013, 54 patients, 33 male and 21 female, with unstable fracture of the distal end of radius were treated with external fixator and followed for a period of 18 weeks. Results: The clinical and radiological outcome were evaluated on the basis of Modification, by Sar-miento et al., of the Demerit Point system of Gartland and Werley and Sarmiento et al’s modification of Lid-strom’s scoring system respectively at the end of 18 weeks. The clinical result was excellent in 25 cases, good in 19 cases and fair in eight cases. There were 8 (15.4%) excellent, 25 (48.1%) good, 15 (28.8%) fair and 4 (7.7%) poor cases according to radiological scoring. Conclusions: In this study we found no correla-tion between clinical outcome and radiological parameters following external fixation in distal radius fractures.

scholarly journals Use of Cobra External Fixator for treatment of Distal Radius Fractures

2018 ◽  
Vol 9 (6) ◽  
pp. 84-89
Author(s):  
Niraj Ranjeet ◽  
Pratyenta Raj Onta ◽  
Krishna Sapkota ◽  
Pabin Thapa ◽  
Krishna Wahegoankar ◽  
...  
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Treatment Options ◽  
Distal Radius Fractures ◽  
Medical Sciences ◽  
Radius Fractures ◽  
Ao Classification ◽  
Functional Activities ◽  
Clavicle Fractures

Background: Distal radius fractures are one of the commonest injuries only after clavicle fractures. These fractures poses challenges to the treating surgeons as a result of which these fractures are sometime treated unacceptably and leads to poor outcome. Among various treatment options for these fractures wrist sparing Cobra external fixator is one of the options with an impressive stability and outstanding functional outcomes.Aims and Objectives: To determine whether this system can achieve adequate reduction of a variety of DRF, is able to maintain reduction despite hand and wrist movements, whether it compromises hand and wrist functions and leads to long term problems.Materials and Methods: From July 1, 2016 - June 30, 2017, all skeletally matured patients with acute distal radius fractures (AO-A2, B1, C1, C2) were adequately reduced and fixed with Cobra ex-fix. Immediately post-op patients were encouraged to start range of motion of the wrist as the pain decreased. The patients were followed up in 2,4 and 8 weeks and were analyzed clinically, radiologically, their functional outcomes and any complications.Results: Twenty-two patients were included in our study. Nine were males and 13 were females. Using the AO classification, 15 were classified as A2, 2 were B1, 3 were C1, and 2 were C2. The mean number of weeks the cobra fixator was maintained was 5.3 weeks. The Cobra ex-fix was able to achieve excellent maintenance of radial height and radial inclination and good maintenance of dorsal tilt. Recovery of functional activities according to Gartland and Werley’s functional scoring system was good to excellent in all patients at 8 weeks follow-up.Conclusion: The Cobra external fixation system is an outstanding device for use in fractures of the distal radius. It achieves superior anatomic correction and is dependable in maintaining fracture reduction even with hand and wrist use.Asian Journal of Medical Sciences Vol.9(6) 2018 84-89

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 Dynamization of external fixator is single stage definitive procedure for open fractures both bone leg

2017 ◽  
Vol 3 (6) ◽  
pp. 1152
Author(s):  
Ajeet Singh ◽  
Rakesh Kumar ◽  
Rajni Ranjan ◽  
Avijit Mahajan
Keyword(s):  
External Fixator ◽  
Road Traffic ◽  
Bone Fractures ◽  
Cost Effective ◽  
Fracture Pattern ◽  
Open Fractures ◽  
Single Stage ◽  
Medical Sciences ◽  
Selection Of

<p class="abstract"><strong>Background:</strong> Open fracture both bone leg is a common fracture present in orthopaedic causality. Treatment consists of I. V. antibiotics, debridement and external fixator. Judicious selection of the patients on basis of Gustilio and Anderson classification leads to external fixator as a definitive and single stage procedure with dynamization. It reduces the risk of infection at time of definitive procedure and number of hospital stay and surgery.</p><p class="abstract"><strong>Methods:</strong> In school of medical sciences and research, We treated 68 patients with open both bone fracture (Gustilio and Anderson type 2 and 3b) with debridement and external fixator. All patients underwent dynamization depending upon fracture pattern. Majority of our cases were road traffic accident involving male. Average duration of union was 22 to 26 weeks. There was no need for any major plastic surgery procedure. Removal of external fixator and Patellar tendon brace (PTB) was given for the period of 4 to 6 weeks at the time of clinical and radiological union.<strong></strong></p><p class="abstract"><strong>Results:</strong> Eighty eight percent of our cases united well. This reduces the burden of secondary definitive procedure, infection and cost of treatment. So careful selection of the patients and dynamization of external fixator hold the place for definitive surgical option for open both bone fractures.</p><p><strong>Conclusions:</strong> External fixator is simple effective surgical procedure for open fractures both bone leg. Staged dynamization of external fixator add in the better union with functional outcome and cost effective. </p>

scholarly journals Comparison of efficacy of mirabegron and darifenacin in overactive bladder- a prospective study

2020 ◽  
Vol 8 (1) ◽  
pp. 196
Author(s):  
Gurpreet Singh Bhangu ◽  
Kamal Preet Kaur ◽  
Darpan Bansal ◽  
Ritansh Bansal
Keyword(s):  
Overactive Bladder ◽  
Drug Treatment ◽  
Comparative Study ◽  
Prospective Study ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Medical Sciences ◽  
Once Daily ◽  
A Prospective Study

Background: Overactive bladder (OAB) is under reported yet distressing symptoms which can be managed effectively by the drugs available. Aim was to study and compare the efficacy of two drugs, mirabegron and darifenacin in controlling the symptoms of overactive bladder.Methods: This prospective study included a total of 120 cases of overactive bladder reported at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar from January 2018 to December 2019. This comparative study was done by giving Mirabegron to first five patients and next five patients were given darifenacin up to 120 patients. The drug treatment with once daily administration of 25 mg mirabegron and 7.5 mg of darifenacin was given for a total of 12 weeks. The signs and symptoms were noted at the beginning of the therapy and then follow up was done at 4, 8, 10 and 12 weeks.Results: Total 54 out of 60 patients (90%) on miragaberon and 59 of 60 patients (98.33%) on darifenacin were relieved of symptom of increased frequency of micturition. 53 of 60 pateints (88.33%) on miragaberon and 59 of 60 patients (98.33%) on darifenacin were relieved of symptom of decreased average voiding volume. 28 of 60 pateints (46.67 %) on miragaberon showed nocturia as compared to 25 of 60 patients (41.67%) on darifenacin.Conclusions: It has been concluded that both mirabegron as well as darifenacin are highly efficacious newer treatment options for the management of OAB. Our study found Darifenacin to be relatively more efficacious in the treatment of OAB at a lesser dose and statistically significant differences were observed between the two drugs. 

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.

scholarly journals Is there a Consensus in the Management of Distal Radial Fractures?

2009 ◽  
Vol 3 (1) ◽  
pp. 96-99 ◽  
Author(s):  
M.A. Nazar ◽  
R. Mansingh ◽  
R.S. Bassi ◽  
M. Waseem
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Treatment Options ◽  
Distal Radius Fractures ◽  
Dominant Hand ◽  
Volar Plating ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Articular Fracture ◽  
First Case

This unique postal survey was setup to assess the agreement on treatment options in displaced distal radius fractures and whether or not there existed a consensus amongst the surgeons contacted. With this in view we contacted 244 surgeons and 166 completed answers were received. We chose two common examples of displaced distal radius fractures. Case one was a 38 year old teacher with a closed, displaced extra-articular fracture (Frykman type II) of her left non-dominant hand and case two was a 42 year old carer, with a closed, displaced intra-articular fracture (Frykman type VII) of her right dominant wrist. There was a questionnaire included with these radiographs. In the first case, 82 (49%) surgeons favoured MUA + K-wiring, 47 (28%) favoured volar plating and 14 (8%) an external fixator. In the second case, 28 (17%) surgeons favoured MUA + K-wiring, 53 (32%) advocated volar plating and 33 (20%) an external fixator. Furthermore surgeons with specialist Upper limb interest were more likely to apply a volar plate (63% in either case) whilst the surgeons with general or other areas of expertise (18% in first case and 23% for second case). In conclusion there is no consensus among the Orthopaedic surgeons in treating displaced distal radial fractures. A multicentered randomized clinical trial would help elucidate the best treatment options.

scholarly journals Functional outcome of external fixator application vs volar plating for intrarticular distal radius fractures: A long term prospective study

2019 ◽  
Vol 5 (4) ◽  
pp. 753-756
Author(s):  
Dr. Vivekananda BR ◽  
Dr. Suhas BD ◽  
Dr. Shivraj B ◽  
Dr. Yogananda Gali Hanumaih ◽  
Dr. Anil Kumar SN
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Distal Radius ◽  
External Fixator ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures

scholarly journals Soft bandage versus casting in the treatment of torus fracture of distal radius in children; a prospective randomized study

2016 ◽  
Vol 11 (4) ◽  
pp. 3-8 ◽  
Author(s):  
Prakash Bahadur Thapa ◽  
Rudra Prasad Marasini ◽  
Shrawan Kumar Thapa ◽  
Nabeesman Singh Pradhan ◽  
Shreekrishna Giri
Keyword(s):  
Distal Radius ◽  
Randomized Study ◽  
Cost Effective ◽  
Plaster Cast ◽  
Medical Sciences ◽  
Significant Difference ◽  
Provide Pain Relief ◽  
The Mean ◽  
Cast Group ◽  
Fracture Of Distal Radius

Background & Objectives: Various methods of immobilization have been recommended for the treatment of torus fracture of distal radius in children. The purpose of this study is to determine if soft bandage is as effective and safe as below elbow circumferential casts in the treatment of torus fracture of the distal radius in the children.Materials & Methods: Children from 4 to 14 years of age, who presented to emergency and outpatient department of orthopaedics and trauma at National Academy of Medical Sciences with an isolated torus fracture of distal radius, were randomized and treated with either soft bandage or below-elbow plaster cast by the same investigators. Patients with associated neurovascular injuries, bilateral torus fractures, concomitant physeal injuries and associated musculoskeletal injuries were excluded. The patients were followed up at weekly interval for 4 weeks and analyzed with VAS, ROM and outcome questionnaire and data were analyzed by using SPSS 18.Results: Among the 114 patients analyzed, 57 patients were kept in soft bandage group and 57 in below-elbow cast group. The mean age in soft bandage group was 8.29 year and the mean age in below-elbow cast group was 8.55 years. There was no significant difference between the two groups with regard to patient demographics, initial fracture characteristics and mechanism of injury.Conclusion: Treatment of distal radius torus fracture with soft bandage is a cost-effective and safe in the children below 14 years of age. These minor fractures are stable and not subject to the risks of late displacement which can be very effectively treated symptomatically to provide pain relief by using soft bandage only and educating the parents about the nature of this paediatrics fracture.Journal of College of Medical Sciences-Nepal, Vol.11(4) 2015: 3-8

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