RADIOLOGICAL ASSESSMENTS OF INJECTED CALCIUM SULFATE BONE CEMENTS IN THE TREATMENT OF DISTAL RADIAL FRACTURE

2013 ◽  
Vol 25 (05) ◽  
pp. 1340006 ◽  
Author(s):  
Li-Ho Hsu ◽  
Chih-Yung Chiang ◽  
Kai-Chiang Yang ◽  
Chang-Chin Wu
Keyword(s):  
Calcium Sulfate ◽  
Soft Tissues ◽  
Wrist Joint ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Percutaneous Injection ◽  
Negative Results ◽  
Cement Block ◽  
Post Operation

It has been reported in many literatures that different kinds of bone graft augmentations have been applied in the treatment of distal radial fractures with favorable results. The authors applied calcium sulfate cement in the treatment of distal radial fractures and evaluated the radiological outcomes of 33 patients. The radiological changes of cement statuses, implants, and radiological parameter of distal radius were analyzed. After closed reduction of the displacement, fractures were fixed by Kirschner pins and stabilized by percutaneous injection of premixed calcium sulfate bone cement. Periodic X-ray evaluations were obtained at immediate post-operation and at every month. A total of 28 patients completed the follow-up and the cement extravasations into wrist joint or into soft tissues had been seen in almost every patient. The gradual settling and losses of radial height, radial inclination angle, and volar tilting angles were significant even after removal of Kirschner pins after 8 weeks. Gradual absorptions of cured cement block inside and outside distal radial cortices were observed in every case and complete absorptions of intraosseous cements after 8 weeks happened in 53.6% (15/28) of patients. The extravasated cements took longer time to fade away. The radiological results of current study revealed negative results of calcium sulfate applied in the treatment of distal radial fracture in terms of reduction parameters and cement block longevity.

scholarly journals Volar Fixation of Dorsally Displaced Distal Radial Fracture Using Locking Compression Plate

2005 ◽  
Vol 13 (2) ◽  
pp. 153-157 ◽  
Author(s):  
KK Wong ◽  
KW Chan ◽  
TK Kwok ◽  
KH Mak
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Locking Compression Plate ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Compression Plate ◽  
One Year ◽  
Compression Plating ◽  
Unstable Fractures

Purpose. To evaluate the functional and radiological results of treating unstable fractures of the dorsal distal radius with a volar locking plate. Methods. Dorsally displaced distal radial fractures in 30 patients (11 men and 19 women; mean age, 58.6 years) were fixed by volar locking compression plate and followed up for a minimum of one year. Results. At final functional assessment, 24 patients achieved excellent and 5 achieved good outcomes, with one patient exhibiting fair results. Radiological scores demonstrated 22 excellent and 8 good outcomes. No nonunion or infection occurred. Conclusion. Volar locking compression plating is a safe and effective treatment for unstable fractures of the dorsal distal radius.

The incidence of ulnocarpal complaints after distal radial fracture in relation to the fracture of the ulnar styloid

2012 ◽  
Vol 38 (7) ◽  
pp. 710-717 ◽  
Author(s):  
S. Krämer ◽  
H. Meyer ◽  
P. F. O’Loughlin ◽  
B. Vaske ◽  
C. Krettek ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Grip Strength ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Ulnar Styloid ◽  
Distal Radial Fractures ◽  
Pain Scores ◽  
Ulnar Styloid Fracture ◽  
Loss Of Motion

Two hundred distal radial fractures, with a mean follow up of 20 months (range 6–49), were divided into three groups according to the presence and healing status of an ulnar styloid fracture. The patients underwent both clinical and radiological examination and completed two different questionnaires. One hundred and one, of 200 distal radial fractures, were associated with an ulnar styloid fracture. Forty-six of these developed an ulnar styloid nonunion. The authors encountered significantly higher pain scores (ulnar sided pain p = 0.012), a higher rate of DRUJ instability ( p = 0.032), a greater loss of motion and grip strength ( p = 0.001), and a poorer clinical outcome in cases with an ulnar styloid fracture, but no differences were apparent when those with healed ulnar styloid fractures or ulnar styloid nonunions were compared ( p > 0.05). The investigators propose that the incidence of ulnocarpal complaints following distal radial fracture depends on the presence but not the healing status of an ulnar styloid fracture.

Prospective investigation of the relationship between dorsal tilt, carpal malalignment, and capitate shift in distal radial fractures

2020 ◽  
Vol 102-B (1) ◽  
pp. 137-143
Author(s):  
Rachel Dias ◽  
Nick A. Johnson ◽  
Joseph J. Dias
Keyword(s):  
Operating Characteristic ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Roc Curve Analysis ◽  
Distal Radial Fractures ◽  
Initial Radiograph ◽  
Interval Linear ◽  
Adverse Influence ◽  
The Relationship ◽  
Prospective Investigation

Aims Carpal malalignment after a distal radial fracture occurs due to loss of volar tilt. Several studies have shown that this has an adverse influence on function. We aimed to investigate the magnitude of dorsal tilt that leads to carpal malalignment, whether reduction of dorsal tilt will correct carpal malalignment, and which measure of carpal malalignment is the most useful. Methods Radiographs of patients with a distal radial fracture were prospectively collected and reviewed. Measurements of carpal malalignment were recorded on the initial radiograph, the radiograph following reduction of the fracture, and after a further interval. Linear regression modelling was used to assess the relationship between dorsal tilt and carpal malalignment. Receiver operating characteristic (ROC) analysis was used to identify which values of dorsal tilt led to carpal malalignment. Results A total of 250 consecutive patients with 252 distal radial fractures were identified. All measures of carpal alignment were significantly associated with dorsal tilt at each timepoint. This relationship persisted after adjustment for age, sex, and the position of the wrist. Capitate shift consistently had the strongest relationship with dorsal tilt and was the only parameter that was not influenced by age or the position of the wrist. ROC curve analysis identified that abnormal capitate shift was seen with > 9° of dorsal tilt. Conclusion Carpal malalignment is related to dorsal tilt following a distal radial fracture. Reducing the fracture and improving dorsal tilt will reduce carpal malalignment. Capitate shift is easy to assess visually, unrelated to age and sex, and appears to be the most useful measure of carpal malalignment. The aim during reduction of a distal radial fracture should be to realign the capitate with the axis of the radius and prevent carpal malalignment. Cite this article: Bone Joint J 2020;102-B(1):137–143

A comparison of the accuracy of two sets of diagnostic criteria in the early detection of complex regional pain syndrome following surgical treatment of distal radial fractures

2012 ◽  
Vol 38 (6) ◽  
pp. 609-615 ◽  
Author(s):  
A. Żyluk ◽  
H. Mosiejczuk
Keyword(s):  
Surgical Treatment ◽  
Complex Regional Pain Syndrome ◽  
Severity Score ◽  
International Association ◽  
Pain Syndrome ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Need For Treatment ◽  
Severity Scores

A total of 120 patients were examined for the presence of symptoms of complex regional pain syndrome after surgical treatment of a distal radial fracture. The patients were assessed at six weeks and 71 of them were also assessed at 12 weeks. The International Association for the Study of Pain criteria and the complex regional pain syndrome severity score were used to make the diagnosis. At six weeks, ten patients (8.3%) met the criteria of complex regional pain syndrome in both the International Association for the Study of Pain and complex regional pain syndrome scores. At 12 weeks six patients (8.4%) met International Association for the Study of Pain and two (2.8%) patients the complex regional pain syndrome severity score criteria. Only one of the patients diagnosed with complex regional pain syndrome required treatment for the complex regional pain syndrome. In all the other patients the features of complex regional pain syndrome settled spontaneously. Our results suggest that complex regional pain syndrome after distal radius fractures occurs less frequently than was previously reported. The International Association for the Study of Pain criteria and the complex regional pain syndrome severity scores showed similar sensitivity in early diagnosis of complex regional pain syndrome, but both are poor indicators of the need for treatment.

Buttress Pinning in the Unstable Distal Radial Fracture

1995 ◽  
Vol 20 (1) ◽  
pp. 82-96 ◽  
Author(s):  
L. A. BENOIST ◽  
A. E. FREELAND
Keyword(s):  
Bone Grafting ◽  
Radial Displacement ◽  
Average Score ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Insertion Technique ◽  
Distal Radial Fractures ◽  
X Ray ◽  
Yield Information ◽  
Palmar Instability

Between 1989 and 1993, 20 patients with distal radial fractures were treated with a buttressing technique felt to be safe, effective and simple. Out of the initial 20 patients, 16 have been followed-up and are reported. The technique uses an intramedullary styloid pin and a combined extramedullary–intramedullary dorsal buttress pin. The insertion technique and the use of a medial corner pin are illustrated. Results are evaluated from both final X-ray appearance as well as return of function using the five X-ray parameters of Abbasazadegan et al (1989) and the Mayo modification of the Green and O’Brien wrist score (Cooney et al, 1987). The average score on return of function was 78 (two excellent, eight good, six fair). Final axial shortening averaged –1.4mm (+5 mm– –4 mm), radial displacement averaged 0.68 mm (0 mm–5 mm), radial angle averaged 24.75° (18°–34°), dorsal angle averaged +8.25° (–5°–25°) and dorsal displacement averaged +1.31 (0 mm–+12 mm). From this study we recognize the need for a posterior medial pin, and that routine stress views after pinning can yield information concerning carpal instability, palmar instability and the need for bone grafting.

Nonunion of a Distal Radial Fracture in a Healthy Child

1997 ◽  
Vol 22 (2) ◽  
pp. 175-177 ◽  
Author(s):  
S. KWA ◽  
M. A. TONKIN
Keyword(s):  
Healthy Child ◽  
Closed Reduction ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Fractures In Children ◽  
Plaster Immobilization

Nonunion of distal radial fractures in children are rare. We report a case of a closed distal radial fracture in a healthy child, which developed a nonunion following closed reduction and plaster immobilization.

scholarly journals Mortality after distal radial fractures in the Medicare population

2015 ◽  
Vol 40 (8) ◽  
pp. 805-811 ◽  
Author(s):  
M. J. Shauver ◽  
L. Zhong ◽  
K. C. Chung
Keyword(s):  
Mortality Rate ◽  
Femoral Fracture ◽  
Proximal Femoral Fracture ◽  
Vital Statistics ◽  
Distal Radial Fracture ◽  
Medicare Beneficiaries ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Time From Injury

The occurrence of a low energy fracture of the distal radius increases the risk for another, more serious fracture, such as a proximal femoral fracture. Early mortality after a proximal femoral fracture has been widely studied, but the association between a distal radial fracture and mortality is unknown. The date of death for all Medicare beneficiaries who sustained an isolated distal radial fracture in 2007 was determined using Medicare Vital Statistics files. The adjusted mortality rate for each age–sex group was calculated and compared with published US mortality tables. Distal radial fractures were not associated with an increased mortality rate. In fact, beneficiaries had a significantly lower mortality rate after distal radial fractures than the general population. This may be related to the injured beneficiaries’ involvement in the healthcare system. Mortality rate did not vary significantly based on time from injury. Our results indicate that any mortality is unlikely to be attributable to the distal radial fracture or its treatment. Level of Evidence: III

scholarly journals The Buttazzoni Classification of Distal Radial Fractures in Adults: Interobserver and Intraobserver Reliability

Hand ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 283-288 ◽  
Author(s):  
Mats Å. Wadsten ◽  
Arkan S. Sayed-Noor ◽  
Gùran O. Sjù;dén ◽  
Olle Svensson ◽  
Gunnar G. Buttazzoni
Keyword(s):  
Classification System ◽  
Kappa Coefficient ◽  
Intraobserver Reliability ◽  
Classification Systems ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
New Classification ◽  
Distal Radial Fractures ◽  
Orthopedic Surgeons ◽  
Fracture Types

Despite the fact that distal radial fracture is the commonest fracture, there is a little evidence-based knowledge about the value of its classification to guide management and predict prognosis. The available classification systems are either complicated or weakly applicable in clinical practice. Older's classification is the most reliable, but does not cover all radial fracture types. We evaluated the interobserver and intraobserver reliability of a new classification system which is a modification of Older's classification covering all radial fracture types. Two hundred and thirty-two consecutive adult patients with acute distal radial fractures were blindly evaluated according to the new classification by three orthopedic surgeons twice with 1-year interval. The interobserver reliability was measured using the Fleiss kappa coefficient, and the intraobserver reliability was measured using the Cohen's kappa coefficient. The new classification showed fair to substantial interobserver and intraobserver reliability, i.e., results comparable to the reliability of commonly used classification systems. The reliability was better for younger patients and when evaluation was carried out by hand-surgery-interested orthopedic surgeons. The new classification system is simple, covers all radial fracture types, and has an acceptable reliability. Further studies are needed to judge its ability to direct management and predict prognosis.

Cost minimization analysis of the treatment of distal radial fractures in the elderly

2018 ◽  
Vol 100-B (2) ◽  
pp. 205-211 ◽  
Author(s):  
E. Q. Pang ◽  
J. Truntzer ◽  
L. Baker ◽  
A. H. S. Harris ◽  
M. J. Gardner ◽  
...  
Keyword(s):  
Cost Minimization ◽  
Secondary Analysis ◽  
The Elderly ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Payer Perspective ◽  
Chi Squared ◽  
The Mean ◽  
The Cost

Aims The aim of this study was to test the null hypothesis that there is no difference, from the payer perspective, in the cost of treatment of a distal radial fracture in an elderly patient, aged > 65 years, between open reduction and internal fixation (ORIF) and closed reduction (CR). Materials and Methods Data relating to the treatment of these injuries in the elderly between January 2007 and December 2015 were extracted using the Humana and Medicare Advantage Databases. The primary outcome of interest was the cost associated with treatment. Secondary analysis included the cost of common complications. Statistical analysis was performed using a non-parametric t-test and chi-squared test. Results Our search yielded 8924 patients treated with ORIF and 5629 patients treated with CR. The mean cost of an uncomplicated ORIF was more than a CR ($7749 versus $2161). The mean additional cost of a complication in the ORIF group was greater than in the CR group ($1853 versus $1362). Conclusion These findings show that there are greater payer fees associated with ORIF than CR in patients aged > 65 years with a distal radial fracture. CR may be a higher-value intervention in these patients. Cite this article: Bone Joint J 2018;100-B:205–11.

Simultaneous Scaphoid and Distal Radial Fractures

1994 ◽  
Vol 19 (3) ◽  
pp. 384-388 ◽  
Author(s):  
L. M. HOVE
Keyword(s):  
Scaphoid Fracture ◽  
High Energy ◽  
Fracture Dislocation ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Scaphoid Fractures ◽  
Salter Harris ◽  
Greenstick Fracture

Simultaneous fractures of the distal radius and scaphoid are uncommon. In a prospective 3-year study we registered 2,330 distal radial fractures and 390 scaphoid fractures, and 12 were combined. Ten of these had high energy trauma; six were styloid fractures, four Colles’ fractures, one was a greenstick fracture and one Salter–Harris Type 2 epiphyseal fracture. All but one of the 12 scaphoid fractures were stable and healed without problems, and one was a trans-scaphoid, trans-styloid peri-lunate fracture-dislocation. The study supports the opinion that the distal radial fracture constitutes the principal injury that determines the outcome and hence the treatment. If the scaphoid fracture is unstable or dislocated, we recommend internal fixation of the scaphoid. Only a small proportion of these injuries represent a more serious disruption with carpal instability.

Sign in / Sign up

Export Citation Format

Share Document