Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors

Background: Distal radius fracture is extremely common and represents 16% of fractures treated by orthopaedic surgeons. Near anatomical reduction with restoration of radial length, radial tilt and ulnar variances are important for good functional results. A variety of treatment options have been proposed for distal radius fracture closed reduction and immbolization in cast has been the main stay of treatment, but because it invariably results in malunion, poor functional outcome and cosmetic outcome, other modality of treatment were brought into practice like percutaneous intrafocal pinning, transulnar percutaneous pinning, external fixation, plating etc. This comparative study was to compare the clinical outcomes of closed reduction with cast and closed reduction with Percutaneous Kirschner wiring (PKW)/canullated cancellous screws (CC screws 4 mm)for the management of Colles fractures in patients between 20 and 70 years old. In this study we did an prospective study in 40 patients with extra articular distal radius fracture treated by both closed reduction with cast and closed reduction internal fixation (PKW/CC screws).Methods: There were 20 patients with Colles fractures treated by closed reduction with cast and 20 patients treated with closed reduction internal fixation (PKW/CC screws). We compared both the managements together. All patients were followed up in the orthopaedic department prospectively for at least 12 months between June 2015-June 2016 The functional outcomes and radiological results were compared between the two groups.Results: The study included 40 patients, aged between 20 to 69 yrs. Average follow up was 12 months. Using the demerit scoring system of Gartland and Werley we had excellent to good results of 60% in closed reduction internal fixation compared to closed reduction with casting excellent to good was 10%.Conclusions: The percutaneous pinning/cc screws and immobilization in neutral position for 3 weeks followed by physiotherapy proved to be better and simple procedure for extra articular non comminuted distal radius fractures.

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Isolated Carpal Dislocation of the Pisiform with Distal Radius Fracture in Two Adults: A Rare Entity

Journal of Hand and Microsurgery ◽

10.1055/s-0039-1698355 ◽

2019 ◽

Vol 12 (03) ◽

pp. 215-218

Author(s):

Ajay Lall ◽

Nicholas Shephard ◽

Simon Greenbaum ◽

Teresa Doerre ◽

Sean Wilson ◽

...

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Closed Reduction ◽

Adult Population ◽

Symptomatic Improvement ◽

Distal Radius Fractures ◽

Radius Fracture ◽

Radius Fractures ◽

Rare Injury ◽

Good Pain Relief

Abstract Background Pisiform dislocations are an extremely rare injury. There are reports in the literature of isolated dislocations, but to our knowledge there are no reports of distal radius fractures with associated pisiform dislocations. Methods and Results We present two cases of isolated pisiform dislocation and distal radius fracture in the adult population. Both patients were managed conservatively with closed reduction in both the distal radius and pisiform, and subsequently achieved good pain relief and progressive return of wrist function. Conclusion For adult patients with distal radius fractures and an associated pisiform dislocation, successful closed reduction and immobilization can result in symptomatic improvement and return of function.

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

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2020/803 ◽

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

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The Factors Predicting Secondary Displacement after Closed Reduction of Unstable Distal Radius Fracture

Journal of the Korean Society for Surgery of the Hand ◽

10.12790/jkssh.2017.22.1.13 ◽

2017 ◽

Vol 22 (1) ◽

pp. 13

Author(s):

Jung Suk Lee ◽

Jae Hoon Lee ◽

Young Joon Kim ◽

Jong Hun Back ◽

Wook Jae Song ◽

...

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Closed Reduction ◽

Radius Fracture ◽

Secondary Displacement ◽

Unstable Distal Radius Fracture

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Success Rate and Complications of Comminuted Intra-Articular Distal Radius Fracture Treatment via Closed Reduction and Use of a Mini-External Fixator

Trauma Monthly ◽

10.5812/traumamon.18885 ◽

2015 ◽

Vol 20 (4) ◽

Author(s):

Mohammad Hossein Karimi Nasab ◽

Masoud Shayesteh Azar ◽

Samira Fazel Moghaddam ◽

Mehrdad Taghipour

Keyword(s):

Success Rate ◽

Distal Radius Fracture ◽

Distal Radius ◽

External Fixator ◽

Closed Reduction ◽

Radius Fracture ◽

Fracture Treatment

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Irreducible Volar DRUJ Dislocation with Distal Radius Fracture Dislocation

Journal of Wrist Surgery ◽

10.1055/s-0039-1692476 ◽

2019 ◽

Vol 09 (02) ◽

pp. 156-159

Author(s):

Matthew T. Gulbrandsen ◽

Jill G. Putnam ◽

J. Tracy Watson ◽

Michael D. McKee

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Closed Reduction ◽

Open Reduction ◽

Case Reports ◽

Distal Radioulnar Joint ◽

Fracture Dislocation ◽

Radius Fracture ◽

Level Of Activity ◽

Fracture Dislocations

Abstract Background Volar dislocations of the distal radioulnar joint (DRUJ) are rare and often missed during initial evaluation. Chronic dislocations and disability can occur when DRUJ dislocations are unrecognized and not reduced. DRUJ dislocations often occur with other wrist injuries, which may complicate reduction. Closed reduction can fail to reduce DRUJ dislocations, in which case open reduction is necessary. Case Description This case describes a patient who had a volar dislocation of the DRUJ with an associated dorsal distal radius fracture dislocation. Initial attempts at closed reduction were unsuccessful which prompted surgical intervention. After open reduction and internal fixation of the distal radius fracture dislocation, closed reduction of the DRUJ remained unsuccessful. This prompted an open reduction of the DRUJ. Surgical exposure demonstrated that the extensor carpi ulnaris and the distal radius had prevented closed reduction of the DRUJ. Postoperatively, a splint was placed with the wrist in supination. The patient followed-up at the 2- and 4-month intervals with persistent subluxation. However, the patient also reported minimal pain and the ability to return to work and previous level of activity. Literature Review Current literature regarding irreducible volar DRUJ dislocations with distal radius fracture dislocations includes sparse case reports, which are reviewed in this report. Clinical Relevance This case illustrates successful treatment for an uncommon volar DRUJ dislocation associated with a dorsal distal radius fracture dislocation and can be utilized to help guide future treatment of similar complex cases.

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