scholarly journals Functional and radiological outcome of Colles fracture treated conservatively with plaster and cast

2019 ◽  
Vol 7 (1) ◽  
pp. 47-52
Author(s):  
Sandeep Sharma ◽  
R. Sharma ◽  
S. Neupane ◽  
A.K. Pariyar ◽  
R. Singh

Background and Objectives: Fractures of distal radius are commonly encountered in orthopedic emergency. Various treatment methods are available including closed reduction and immobilization in cast, percutaneous pinning, pins and plaster, external fixation, open reduction and internal fixation with or without bone graft or substitute. There are no clear guidelines to follow. The aim of this study is to compare the radiological and functional outcome of distal radius fracture treated conservatively with cast alone. Material and Methods: Sixty patients suffering from extra articular distal radius fracture were recruited for study. They were all treated conservatively with cast alone. They were followed up for 6 months. The radiological outcome in terms of dorsal angulation, radial length, radial angulation and ulnar variance and functional outcome in terms of Mayo wrist score was assessed. Results: At 6 months follow up dorsal angulation, radial length, radial angulation and ulnar variance were - 5±3.20 degrees, 7.80±0.77mm, 20.47±2.29 degrees and 1.27±0.77 respectively. Functionally 20 patients had good outcome, 32 patients had satisfactory outcome and 8 patients had poor outcome in terms of Mayo wrist scores. Conclusion: Conservative management with cast is an effective treatment modality for Frykmans type I and II Colles fracture with satisfactory functional and radiological outcome.

2009 ◽  
Vol 58 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Shoichi Kuba ◽  
Itaru Furuichi ◽  
Masakazu Murata ◽  
Takeshi Miyaji ◽  
Noriaki Miyata ◽  
...  

1998 ◽  
Vol 23 (5) ◽  
pp. 920-925 ◽  
Author(s):  
Satoshi Kawaguchi ◽  
Kazuzi Sawada ◽  
Yuki Nabeta ◽  
Mitsuru Hayakawa ◽  
Mitsuhiro Aoki

2021 ◽  
Vol 8 (32) ◽  
pp. 3006-3011
Author(s):  
George Allen John ◽  
Dennis Antony

BACKGROUND Distal radius fractures are one of the most common injuries that orthopaedic surgeons will face during their trauma practice. Despite this, many aspects in distal radius fracture management like the definition of what constitutes an acceptable reduction and when or even whether to operate a patient with a distal radius fracture remain a poignant subject of debate even to this day. We wanted to evaluate the functional outcome of fractures of distal end of radius managed with buttress plate. The importance of anatomical reduction in attaining a good functional outcome and post-operative complications of the procedure are also studied. METHODS A prospective study of cases of distal end of radius fractures meeting the inclusion criteria who were admitted in Thrissur Government Medical College, Kerala between 1 – 01 - 2016 to 1 – 06 - 2017 was carried out. Fractures were classified according to Frykman system and anatomical reduction of fragments attempted using buttress plate and screws. After a minimum follow up period of 3 months, the anatomical and functional outcomes were standardised using Lindstorms anatomical and functional scoring system. RESULTS A series of 32 cases with distal end of radius fracture were studied comprising of 24 males and 8 females. Majority were in the age group of 20 to 29 years (50 %). Road Traffic Accidents was the commonest cause of injury (62.5 %). Type III Frykman made the largest contribution with 11 (34 %) cases. A total of 7 cases were found to develop complications including blisters, joint stiffness, infection and paraesthesia. Postoperatively, excellent anatomical reduction was achieved in 75 % of cases and good results in 12.5 % cases. Functionally 68.75 % cases had an excellent outcome and 18.75 % had a good result. CONCLUSIONS Good to excellent results were seen in majority of patients after buttress plate fixation of the distal radius, with outcomes and complications comparable to other studies in literature. This study supports the finding that precise identification of unstable lower radial fractures, and satisfactory anatomical restoration results in improved functional outcome. KEYWORDS Distal End Radius Fracture, Buttress Plating, Functional Outcome, Frykman Classification, Lindstorm Scoring System


Author(s):  
Siu Cheong Jeffrey Justin Koo ◽  
Kam Yiu Adrian Leung ◽  
Wai Wang Chau ◽  
Pak Cheong Ho

Abstract Background Distal radius fracture is one of the most common injuries. Poor functional result with restricted wrist motion can be developed when there is intra-articular fibrous tissue development arising from articular step-off and gapping. Objectives The aim of this study is to compare the functional and radiological outcome between arthroscopic-assisted reduction and fluoroscopic reduction in treating unstable intra-articular distal radius fracture. Methods We retrospectively analyzed 12 patients with intraarticular AO type C distal radius fracture treated with arthroscopic-assisted fracture reduction and internal fixation and compared them with another group of 12 patients in which fracture reduction is assessed by fluoroscopy alone (15 males and 9 females, mean age 57.3, range 27–73). The two cohorts were analyzed for differences in radiological parameters including articular stepping and gapping, palmar tilt, radial inclination, ulnar variance as well as functional outcome in range of motion, grip strength, modified mayo wrist score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score at an average of 12.5 months (range 5–26) after surgery. Results Arthroscopic-assisted fracture reduction group has statistically better restoration of articular stepping and gapping, volar tilt and ulnar variance. Range of motion, grip strength, modified mayo wrist score and Quick DASH score also had statistically significant improvement in arthroscopic group. Conclusion Our study showed arthroscopic-assisted technique can precisely restore radiological parameters in highly comminuted distal radius fracture with good functional outcome. Also, associated intra-articular soft tissue injury can be detected and treated simultaneously. Level of Evidence This is a level III, retrospective cohort study.


Hand Therapy ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 123-130 ◽  
Author(s):  
Sharon Gillespie ◽  
Fiona Cowell ◽  
Graham Cheung ◽  
Daniel Brown

Introduction Complex regional pain syndrome is a multifaceted condition, which is relatively common after distal radius fracture. Method A series of audits and service evaluations were conducted from 2004 to 2013 to investigate the incidence of complex regional pain syndrome type I and any correlation to tight, restrictive, over-flexed casts. Simple subsequent clinical and patient management changes were implemented and impact re-evaluated. Results These audits have contributed to organisational learning and a subsequent reduction in the incidence of complex regional pain syndrome type I in non-operatively managed distal radius fracture from 25%, in keeping with expected incidence in the relevant literature, to a rare event (<1%). Conclusion The authors suggest that careful attention to the prevention of complex regional pain syndrome through staff and patient awareness, vigilance for warning signs and minor modifications to the traditional management of distal radius fractures can significantly reduce the incidence of complex regional pain syndrome type I after distal radius fracture.


2021 ◽  
pp. 204946372110419
Author(s):  
Tjitske D Groenveld ◽  
Emily Z Boersma ◽  
Taco J Blokhuis ◽  
Frank W Bloemers ◽  
Jan Paul M Frölke

Background: Complex regional pain syndrome type I (CRPS) is a symptom-based diagnosis of which the reported incidence varies widely. In daily practice, there appears to be a decrease in incidence of CRPS after a distal radius fracture and in general. Questions/purposes: The aim of this study was to assess the trend in the incidence of CRPS after a distal radius fracture and in general in the Netherlands from 2014 to 2018. Methods: The incidence of CRPS after a distal radius fracture was calculated by dividing the number of confirmed cases of CRPS after distal radius fracture by the total number of patients diagnosed with a distal radius fracture. Medical records of these patients were reviewed. Hospital-based data were used to establish a trend in incidence of CRPS in general. A Dutch national database was used to measure the trend in the incidence of CRPS in the Netherlands by calculating annual incidence rates: the number of new CRPS cases, collected from the national database, divided by the Dutch mid-year population. Results: The incidence of CRPS after distal radius fracture over the whole study period was 0.36%. Hospital data showed an absolute decrease in CRPS cases from 520 in 2014 to 223 in 2018. National data confirmed this with a decrease in annual incidence from 23.2 (95% CI: 22.5–23.9) per 100,000 person years in 2014 to 16.1 (95% CI: 15.5–16.7) per 100,000 person years in 2018. Conclusion: A decreasing trend of CRPS is shown in this study. We hypothesize this to be the result of the changing approach towards CRPS and fracture management, with more focus on prevention and the psychological aspects of disproportionate posttraumatic pain. Level of Evidence: level 3 (retrospective cohort study).


2021 ◽  
Author(s):  
Feng Gang ◽  
Xiangfeng Zhang ◽  
Edem Prince Ghamor-Amegavi ◽  
Hejia Hu

Abstract Background: To study the functional outcome of AO type C3 distal radius fracture using external fixation and modified radial flexor carpi approach with contoured phalangeal plate as “hook plate” to treat small comminuted and unstable fracture fragments.Method: Between June 2016 and October 2017, seven patients presenting with AO type C3 distal radius fracture were treated using modified radial flexor approach and external fixation. Radiographic assessment were based on preoperative and postoperative X-ray and CT imaging during follow-up visits. The grip strength, range of active motion and pain were recorded. Mayo writs score and Gartland and Werley score were obtained to evaluated functional outcome.Results: The mean follow-up was 2 years. All patients achieved articular congruity and bone healing. The average Gartland and Werley score was 2.86 which indicated excellent outcome with minimal impairment to daily life. The average Mayo score was 87.5 which overall was a good score, 3 patients (42.9%) had excellent score and 4 patients (57.1%) had good score. No complications such as radioulnar instability and implant failure occurred.Conclusion: Our results suggest rapid functional outcome and range of motion at the wrist with minimal complications. This technique is effective and addresses the challenges in treating unstable AO type C3 distal radius fracture. Installing the external fixator first provides adequate reduction and enhances stability while the bent phalangeal plate serves as a buttress to grab and fix small fracture fragments.


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