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 Correlation Between Radiological Parameters and Functional Outcomes in Patients Older Than 60 Years of Age With Distal Radius Fracture

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 770-775 ◽  
Author(s):  
Rodrigo Gutiérrez-Monclus ◽  
Héctor Gutiérrez-Espinoza ◽  
Jonathan Zavala-González ◽  
Cristian Olguín-Huerta ◽  
David Rubio-Oyarzún ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Outcome Measures ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Correlation Study ◽  
Radius Fracture ◽  
Radiological Parameters ◽  
Functional Outcome Measures

Background: The relationship between radiographic and functional outcomes is controversial in the elderly. The objective of this study is to determine whether there is a correlation between functional outcome and acceptable distal radius fracture (DRF) alignment in patients older than 60 years of age. Methods: This correlation study was carried out at the Central Metropolitan Health Service of Chile. A total of 180 patients diagnosed with extra-articular DRF, according to the AO classification, were prospectively recruited. Radiological parameters, including radial inclination, residual dorsal angulation, ulnar variance, and articular step-off, were evaluated to assess the results of orthopedic reduction. Functional outcome was assessed immediately following cast removal and again at the 6-month follow-up. The Disabilities of the Arm, Shoulder and Hand (DASH) and Patient-Rated Wrist Evaluation (PRWE) questionnaires were administered to assess upper extremity function, and the visual analog scale (VAS) was used to assess pain intensity. Results: Only 68 patients (37.8%) showed acceptable DRF alignment. After cast removal, the correlations between alignment and the functional outcome measures were as follows: DASH 0.071 ( P = .546), PRWE 0.03 ( P = .823), and VAS 0.12 ( P = .631). At the 6-month follow-up, the correlations between alignment and the functional outcome measures were as follows: DASH 0.029 ( P = .768), PRWE 0.014 ( P = .895), and VAS 0.09 ( P = .614). Conclusions: There was no significant correlation between acceptable alignment according to radiological parameters and short- or medium-term functional outcome in patients older than 60 years with extra-articular DRF treated conservatively.

scholarly journals The Use of Phalangeal Plate as “Hook Plate” to Treat Unstable Distal Radius Fracture Fragments with External Fixation

2021 ◽  
Author(s):  
Feng Gang ◽  
Xiangfeng Zhang ◽  
Edem Prince Ghamor-Amegavi ◽  
Hejia Hu
Keyword(s):  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Hook Plate ◽  
Radius Fracture ◽  
Active Motion ◽  
Excellent Outcome ◽  
Good Score

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.

scholarly journals Functional Outcome of Distal Radius Fracture Treated by Closed Reduction and K Wiring in Elderly Population

2020 ◽  
Vol 9 (48) ◽  
pp. 3660-3664
Author(s):  
Aravind Shanbhag ◽  
Ramdas Shenoy B. ◽  
Visakh Pandikasalayil ◽  
Aditya H. Kumar ◽  
Praveen J.
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Closed Reduction ◽  
Elderly Population ◽  
Radius Fracture

scholarly journals A Rare Combination of Posterior Elbow Dislocation with Ipsilateral Intra-Articular Distal Radius Fracture with Radiocarpal Dislocation: Case Report and Literature Review

2021 ◽  
pp. 93-99
Author(s):  
Dany K. Aouad ◽  
Ramzi Musharrafieh ◽  
Fouad Jabbour ◽  
Nabil Dib ◽  
Alexandre H. Nehme
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Closed Reduction ◽  
Elbow Dislocation ◽  
Daily Activities ◽  
Radius Fracture ◽  
Forearm Fractures

Separate elbow dislocation and forearm fractures are common injuries, with both injuries occurring concomitantly and ipsilaterally being rare. We report a case of a 70-year-old female patient who had a posterior elbow dislocation with ipsilateral comminuted distal radius fracture with anterior radiocarpal dislocation. Closed reduction of the elbow was done with open reduction and internal fixation of the distal radius fracture. At 6-month follow-up, the patient had no pain, with satisfactory range of motion of both joints, resuming her previous daily activities.

Distal Radius Fracture Treatment Outcomes in Patients With Ipsilateral Hemiplegia or Hemiparesis

Hand ◽  
2021 ◽  
pp. 155894472199973
Author(s):  
Nicholas Munaretto ◽  
Adam Tagliero ◽  
Raahil Patel ◽  
Peter C. Rhee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Functional Classification ◽  
Radius Fractures ◽  
Radiographic Outcomes ◽  
Ipsilateral Hemiparesis

Background Little information exists to guide decision-making with regard to distal radius fractures in the setting of ipsilateral hemiparesis or hemiplegia. Methods Patients who sustained a distal radius fracture in the setting of ipsilateral hemiparesis or hemiplegia secondary to brain injury were evaluated. Investigated variables included perioperative pain, preinjury House functional classification score, length of immobilization, radiographic outcome measurements, and time to union. Results There were 15 patients with distal radius fractures with a mean age of 65.9 years. The mean clinical and radiographic follow-up was 2.8 and 2.9 years, respectively. Wrists were placed into the nonoperative group (NOG, n = 10) and operative group (OG, n = 5). Pain significantly decreased at final follow-up for both groups. Baseline House functional classification scores averaged 1.3 and 1.6 for the NOG and OG, respectively, and were maintained at final follow-up. Length of immobilization for the NOG was 46 days and OG was 37 days, P = .15. Radiographic outcomes at final follow-up in the NOG and OG, respectively, were a mean radial height of 9.3 versus. 11.6 mm, radial inclination of 18.3° versus 22.3°, 4.2° dorsal tilt versus 5.3° volar tilt, and tear drop angle of 45.6° versus 44.5°. There were no significant differences in these measurements. Time to radiographic union averaged 58 days for the NOG and 67 days for the OG, P = .42. There were no revision surgeries. Conclusions Based on this small case series, patients with distal radius fracture and ipsilateral hemiparesis or hemiplegia may have similar clinical, functional, and radiographic outcomes, regardless of nonoperative or operative treatment.

scholarly journals Clinical and Functional Outcome of Volar Locking Plate Fixation for Distal Radius Fracture

2009 ◽  
Vol 58 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Shoichi Kuba ◽  
Itaru Furuichi ◽  
Masakazu Murata ◽  
Takeshi Miyaji ◽  
Noriaki Miyata ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Locking Plate Fixation

Is a short arm cast appropriate for stable distal radius fractures in patients older than 55 years? A randomized prospective multicentre study

2017 ◽  
Vol 42 (5) ◽  
pp. 487-492 ◽  
Author(s):  
M. J. Park ◽  
J. P. Kim ◽  
H. I. Lee ◽  
T. K. Lim ◽  
H. S. Jung ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
The Elderly ◽  
Plaster Cast ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Cast Immobilization ◽  
Level Of Evidence

We conducted a prospective randomized, multicentre study to compare short arm and long arm plaster casts for the treatment of stable distal radius fracture in patients older than 55 years. We randomly assigned patients over the age of 55 years who had stable distal radius fracture to either a short arm or long arm plaster cast at the first review 1 week after their injury. Radiographic and clinical follow-up was conducted at 1, 3, 5, 12 and 24 weeks following their injury. Also, degree of disability caused by each cast immobilization was evaluated at the patient’s visit to remove the cast. There were no significant differences in radiological parameters between the groups except for volar tilt. Despite these differences in volar tilt, neither functional status as measured by the Disabilities of the Arm, Shoulder and Hand, nor visual analogue scale was significantly different between the groups. However, the mean score of disability caused by plaster cast immobilization and the incidence rate of shoulder pain were significantly higher in patients who had a long plaster cast. Our findings suggest that a short arm cast is as effective as a long arm cast for stable distal radius fractures in the elderly. Furthermore, it is more comfortable and introduces less restriction on daily activities. Level of evidence: II

scholarly journals Radius distraction could contribute to long-term stability for treating distal radioulnar joint instability during volar plating of distal radius fracture: a retrospective case series study

2021 ◽  
Author(s):  
Cheng-Yu Yin ◽  
Hui-Kuang Huang ◽  
Duretti Fufa ◽  
Jung-Pan Wang
Keyword(s):  
Surgical Technique ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Druj Instability

Abstract BackgroundThe surgical technique of radius distraction for stabilization of distal radioulnar joint (DRUJ) if intraoperative DRUJ instability was found after the fixation of distal radius fracture has been previously described, but this surgical technique lacks clinical and radiographic effect in minimal 3 years follow-up. We therefore evaluated the clinical outcome and radiographic results of radius distraction in minimal 3 years follow-up.MethodsWe reviewed the case series of distal radius fracture with concomitant DRUJ instability receiving radius distraction from the senior author over a 5-year period (January 1st, 2013 to June 30th, 2017) retrospectively, and the evaluation of clinical and radiographic outcomes was performed at clinic as long-term follow-up; a total 34 patients had been evaluated.ResultsAt minimal post-operative 36 months follow-up, all cases demonstrated acceptable wrist range of motion with stable DRUJs and low NRS of wrist pain (0.6, SD 0.7) and DASH score (mean 9.1, SD 6.2), and there were no cases suffering from nonunion of distal radius. The mean ulnar variance of injured wrist and uninjured wrist were − 1.2 mm and 0.2mm, respectively (SD 1.0 and 0.6) with significant statistical difference.ConclusionsRadius distraction during volar fixation of distal radius fracture should be consider if DRUJ instability was found by the radioulnar stress test intraoperatively, and the long-term DRUJ stability could be achieved by maintenance of normal-to-negative ulnar variance, with decreased wrist pain and satisfactory function outcome.Level of EvidenceTherapeutic Level IV

Functional Outcome of Distal End of Radius Fractures Treated with Buttress Plating at a Tertiary Care Centre in Central Kerala, India

2021 ◽  
Vol 8 (32) ◽  
pp. 3006-3011
Author(s):  
George Allen John ◽  
Dennis Antony
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Scoring System ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Anatomical Reduction ◽  
Excellent Outcome ◽  
Fracture Management ◽  
Buttress Plate

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

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