scholarly journals The Outcome of Distal Radius Fractures with Concomitant Injuries Is Similar to those of Isolated Distal Radius Fractures Provided that an Arthroscopically Supported Treatment Is Performed

2020 ◽  
Vol 9 (4) ◽  
pp. 974
Author(s):  
Francesca von Matthey ◽  
Karola Schmid ◽  
Michael Zyskowski ◽  
Stephan Deiler ◽  
Peter Biberthaler ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Wrist Arthroscopy ◽  
Radius Fractures ◽  
Self Assessment ◽  
Concomitant Injuries ◽  
Complex Procedure ◽  
Arthroscopically Assisted Fracture Treatment ◽  
Arthroscopically Assisted ◽  
Type C

Background: Concomitant injuries of distal radius fractures (DRF) can have a fatal impact on the patients’ outcome. However, wrist arthroscopy is a costly and complex procedure. It remains elusive whether patients benefit from an additional arthroscopy. Methods: Patients with a DRF who were treated arthroscopically were enrolled. Fifty-six wrists were evaluated regarding their function by self-assessment with the Munich Wrist Questionnaire (MWQ). Thirty-nine patients were examined for postoperative strength and motion. Concomitant injuries were detected. Results: A total of 75% of the DRF were type C injuries (AO classification). Twenty-four cases (43%) were triangular fibrocartilaginous complex (TFCC) lesion, eight cases (14%) of scapholunate ligament (SL) injuries and seven cases (12%) were a combination of TFCC and SL ligament lesion. No difference in function could be detected between DRF with surgically addressed concomitant lesions and isolated DRF. Dorsalextension, palmarflexion and grip strength were significantly reduced in patients with DRF and concomitant injuries compared to the healthy wrist. However, patients with DRF and arthroscopically treated concomitant injuries had similar results to those suffering only from an isolated DRF. Conclusion: The increased occurrence of concomitant injuries is to be expected in intraarticular DRF. Patients with concomitant injuries benefit from an arthroscopically assisted fracture treatment and show similar results compared to isolated DRF.

The correlation of initial radiographic characteristics of distal radius fractures and injuries of the triangular fibrocartilage complex

2016 ◽  
Vol 41 (5) ◽  
pp. 516-520 ◽  
Author(s):  
K. Kasapinova ◽  
V. Kamiloski
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Triangular Fibrocartilage Complex ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Wrist Arthroscopy ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Triangular Fibrocartilage ◽  
A Prospective Study

Our purpose was to determine the correlation of initial radiographic parameters of a distal radius fracture with an injury of the triangular fibrocartilage complex. In a prospective study, 85 patients with surgically treated distal radius fractures were included. Wrist arthroscopy was used to identify and classify triangular fibrocartilage complex lesions. The initial radial length and angulation, dorsal angulation, ulnar variance and distal radioulnar distance were measured. Wrist arthroscopy identified a triangular fibrocartilage complex lesion in 45 patients. Statistical analysis did not identify a correlation with any single radiographic parameter of the distal radius fractures with the associated triangular fibrocartilage complex injuries. The initial radiograph of a distal radius fracture does not predict a triangular fibrocartilage complex injury. Level of evidence: III

Early Outcomes of Scapholunate Injuries With Concomitant Distal Radius Fractures

Hand ◽  
2019 ◽  
pp. 155894471989003
Author(s):  
Nicholas C. Duethman ◽  
William R. Aibinder ◽  
Nathaniel L. Robinson ◽  
Steven L. Moran ◽  
Sanjeev Kakar
Keyword(s):  
Surgical Treatment ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Adult Patients ◽  
Wrist Arthroscopy ◽  
Scapholunate Ligament ◽  
Radius Fractures ◽  
Treatment Groups ◽  
Functional Differences

Background: There is limited literature regarding the treatment of concomitant scapholunate ligament (SL) injuries in acute distal radius fractures (DRFs). We hypothesized that surgical treatment of SL injuries in adult patients with DRFs leads to improved functional outcomes. Methods: A retrospective review was made of 42 adult patients who underwent surgical treatment of a DRF with a SL injury between 2005 and 2013. In all, 39 of the 42 patients sustained an intra-articular DRF (AO B or C). SL injury was diagnosed by SL diastasis > 3 mm on posteroanterior (PA) radiographs, magnetic resonance imaging, or with wrist arthroscopy. Patients were divided into 3 groups: 23 had a SL repair and were treated within 21 days of injury (acute), 8 underwent SL repair greater than 21 days from injury (subacute/chronic), and 11 did not undergo repair (non-operative). Median overall time to clinical follow-up was 5.1 years. Mayo Wrist Scores (MWS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores were used to evaluate functional outcome. Results: Clinical outcomes measured by the MWS at final follow-up (6 months-12 years) showed no significant differences between the 3 groups. Of patients treated acutely, 17.3% had good to excellent MWS. MWS at 1-year follow-up was 68.4, 70, and 64 in the acute, subacute/chronic, and non-operative groups, respectively. DASH scores were 16.7, 14.3, and 11.8 in the acute, subacute/chronic, and nonoperative groups, respectively, at a mean of 7.8 years. Conclusions: At mid-term follow-up, all 3 treatment groups had similar DASH scores to the general population. There were no statistical functional differences between any of the groups based upon MWS or DASH scores.

COMPARISON OF RADIOLOGICAL AND CLINICAL OUTCOMES OF INTERNAL FIXATION USING TWO DIFFERENT VOLAR PLATES FOR DISTAL RADIUS FRACTURES

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 357-362 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Si-Wook Lee ◽  
Gu-Hee Jung
Keyword(s):  
Clinical Outcomes ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Implant Design ◽  
Radius Fractures ◽  
Radial Length ◽  
Type C ◽  
The Mean ◽  
The Difference

The purpose of this study was to compare the outcomes of volar plating using two different implants for distal radius fractures. Fifty-two patients with AO type C fractures were placed in either of two groups: the AO LDRS group (26 patients) or the Acu-Loc group (26 patients). Radiological parameters including radial length, radial inclination, volar tilt, and intra-articular step-off were significantly improved after surgery. The mean Mayo Wrist Performance Score was 84.6 in the AO LDRS group and 81.1 in the Acu-Loc group. The mean Subjective Wrist Value was 86.7% in the AO LDRS group and 86.3% in the Acu-Loc group. There were no significant differences between the two groups with respect to both radiological and clinical outcomes at the final follow-up evaluation. Volar fixed-angle plating for unstable distal radius fractures had satisfactory radiological and clinical outcomes. The difference of implant design did not influence overall final outcomes.

Distal Radius Fractures - Arthroscopically Assisted Management

2002 ◽  
Vol 10 (3) ◽  
pp. 130-136 ◽  
Author(s):  
G. Peicha ◽  
F.-J. Seibert ◽  
W. Grechenig ◽  
H. G. Clement ◽  
O. Leithgöb ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Arthroscopically Assisted ◽  
Assisted Management ◽  
Arthroscopically Assisted Management

scholarly journals Wrist arthroscopy in the management of articular distal radius fractures

2016 ◽  
Vol 119 (1) ◽  
pp. 157-165 ◽  
Author(s):  
Francesco Smeraglia ◽  
Angelo Del Buono ◽  
Nicola Maffulli
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Wrist Arthroscopy ◽  
Radius Fractures

A Comparison of the Long-Term Outcome of Partial Articular (AO Type B) and Complete Articular (AO Type C) Distal Radius Fractures

2013 ◽  
Vol 38 (4) ◽  
pp. 753-759 ◽  
Author(s):  
Annelies Bolmers ◽  
Willem E. Luiten ◽  
Job N. Doornberg ◽  
Kim M. Brouwer ◽  
J. Carel Goslings ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Type B ◽  
Radius Fractures ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Type C

scholarly journals The rate and associated risk factors for acute carpal tunnel syndrome complicating a fracture of the distal radius

2021 ◽  
Author(s):  
Jun Min Leow ◽  
Nicholas D. Clement ◽  
Margaret M. McQueen ◽  
Andrew D. Duckworth
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Distal Radius ◽  
Carpal Tunnel ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Articular Fractures ◽  
Tunnel Syndrome ◽  
Type C ◽  
Acute Carpal Tunnel Syndrome

Abstract Background Acute carpal tunnel syndrome (ACTS) is a known complication of distal radius fractures. This study aimed to document the demographics, range of presenting symptoms and risk factors of patients who develop ACTS following a fracture of the distal radius. Methods A retrospective review of 1189 patients with an acute distal radius fracture treated in the study centre over a one-year period were identified. Demographic and clinical variables were collected and compared between controls (did not develop ACTS) and those patients who did develop ACTS to identify factors associated with developing ACS. Results There were 51 (4.3%) distal radius fractures complicated by ACTS. The mean age of patients who developed ACTS was 56 years (range, 16–89) and 73% were female. The median time of onset post-injury was one week (range, 1–12). There was no association between patient background and comorbidities with the development of ACTS. AO-OTA Type C fractures had significantly increased rates of developing ACTS. Conclusion Four percent of distal radius fractures were complicated by ACTS. There was no association between patient background and comorbidities with the development of ACTS. AO-OTA type C complete articular fractures had a significantly higher rate of ACTS. A suggested treatment algorithm for patients presenting with ACTS has been presented. Level of evidence: III.

scholarly journals Arthroscopic Management of Intra-articular Ligament Lesions on Distal Radius Fractures

2021 ◽  
Vol 49 (01) ◽  
pp. 024-036
Author(s):  
Marcio Aurelio Aita ◽  
Ricardo Kaempf ◽  
Bruno Gianordoli Biondi ◽  
Gary Alan Montano ◽  
Fernando Towata ◽  
...  
Keyword(s):  
Return To Work ◽  
Distal Radius ◽  
Patient Reported Outcomes ◽  
Distal Radius Fractures ◽  
Joint Surface ◽  
Wrist Arthroscopy ◽  
X Rays ◽  
Radius Fractures ◽  
Patient Reported ◽  
The Mean

AbstractArticular distal radius fractures (DRFs) have increased in incidence in recent years, especially among the economically active population. Most of the treatment approaches are based on plain X- rays, and do not give us any information on how to treat these fractures. In the search for solutions with greater precision in diagnosis, in reducing the joint surface of the fracture, and envolving minimally-invasive techniques, we found arthroscopy as the main tool for these patients. Therefore, an enhanced understanding of the biomechanics of the different types of fracture associated with ligamentous lesions should facilitate the right decision regarding the treatment. The present paper aims at providing a management-oriented concept to diagnose and treat ligamentous lesions associated with intra-articular DRFs based on a arthroscopy-assisted procedure, and showing the objective and patient-reported outcomes and a new classification. The objective and patient-reported outcomes were: the mean range of motion (ROM) was of 94.80% on the non-affected side; the mean score on the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) was of 3.6 (range: 1 to 12). The score on the Visual Analog Scale (VAS) was of 1.66 (range: 1 to 3). Complications were observed in 2 (13.33%) patients: extensor tendon synovitis in 1 patient, and a limitation (stiffness) in ROM in 1 patient, both treated with wrist arthroscopy release. The mean time until the return to work was of 6.4 weeks. In patients with unstable intra-articular DRFs associated with ligamentous lesions, the fixation of specific osseous-ligamentous fragments and ligamentous repair/reconstruction by wrist arthroscopy prove to be a safe and reliable treatment. The clinical and functional results predict that the patients can return to work more quickly.

Distal Radius Fractures and Concomitant Injuries: Experimental Studies Concerning Pathomechanisms

2003 ◽  
Vol 28 (6) ◽  
pp. 609-616 ◽  
Author(s):  
S. PECHLANER ◽  
A. KATHREIN ◽  
M. GABL ◽  
M. LUTZ ◽  
P. ANGERMANN ◽  
...  
Keyword(s):  
Distal Radius ◽  
Testing Machine ◽  
Experimental Studies ◽  
Compression Fracture ◽  
Distal Radius Fractures ◽  
Materials Testing ◽  
Radius Fractures ◽  
Concomitant Injuries ◽  
Bony Avulsion ◽  
Accompanying Injuries

Since Colles’ description of the distal radius fracture (1814) and the publication by Dupuytren (1834), the frequency of this fracture, and the problems associated with it, have been increasingly recognized. Not only the treatment but also the mechanism of injury of the different types of fracture have been analysed repeatedly. The various theories concerning the pathomechanism have led to names such as “sprain fracture”, “bent fracture”, “thrust fracture”, “compression fracture”, “snap fracture” and others. In our experimental studies, we attempted to simulate the pathomechanics of distal radius fractures, and to represent it illustratively. With the aid of a materials testing machine, 63 prepared cadaver parts were hyperextended at the wrist joint until distal radial fracture occurred. Accompanying injuries were identified radiologically and by dissection. Furthermore, the cadaver parts were deep-frozen and examined by means of computer tomography and cryo-section, using Kathrein’s method. Through experimental hyperextension, it was possible to generate dorsal, central and palmar types of fracture. We produced 42 dorsal, 14 central and seven palmar fractures. The extent to which the carpal bones of the proximal row were pressed against the dorsal or palmar edge; or the centre of the distal radial articular surface, was fundamental. Subsequent dissection showed multiple concomitant injuries in 40 cases (63%), and none in 23 cases (37%). One reason for the occurrence of such concomitant injuries may be the relative strengths of the bone and ligaments. Most frequently (27 cases, or 43%), we found a destabilization of the triangular fibrocartilage, with or without a bony avulsion fragment (fracture of the ulnar styloid process), followed by ruptures of the interosseous ligaments between the scaphoid and the lunate (20 cases, or 32%) and between the lunate and triquetrum (11 cases, or 18%). The application of knowledge gained from experimental studies carried out on fixed cadaver parts to clinical cases is problematic. This holds true for both concomitant injuries and fracture types. The lack of physiological defence reflexes as well as the deliberately slowed experimental procedure must be taken into account. On the other hand, in this series of experiments it was possible to generate experimentally many of the radius fractures found in clinical practice, together with their concomitant injuries.

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