Intercarpal Ligament Injuries Associated with Distal Radius Fractures: Relation with the Radiographic Findings and Arthroscopic Treatment

ABSTRACT Background: Emergency department (ED) manipulation of complete minimally angulated distal radius fractures in children may not be necessary, due to the excellent remodeling potential of these fractures. Objectives: The primary objective of this study was to determine the proportion of minimally angulated distal radius fractures managed in the ED with plaster immobilization that subsequently required manipulation. Our secondary objective was to document, at follow-up, changes in angulation for each wrist fracture. Methods: This retrospective cohort study reviewed consecutive records of all children with bi-cortical minimally angulated (≤15° of angulation in the sagittal plane and ≤0.5 cm of displacement) distal metaphyseal radius fractures, alone or in combination with distal ulnar fracture. Details of treatment, radiographic findings, and clinical outcomes during the subsequent orthopedic follow up were recorded. Results: Of 124 patients included in the analysis, none required manipulation after their ED visit. All but 14 (11.3%) fractures were angulated ≤20° within the follow-up period. Two (1.6%) fractures that were initially angulated ≤15° progressed to 30°–35°, but remodeled within 2 years to nearly perfect anatomic alignment. By 6 weeks post-injury, no patients had clinically apparent deformity and all had normal function. Conclusions: Minimally angulated fractures of the distal metaphyseal radius managed in plaster immobilization without reduction in the ED are unlikely to require future surgical intervention.

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Midterm results of arthroscopic treatment of scapholunate ligament lesions associated with intra-articular distal radius fractures

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s001670050172 ◽

1999 ◽

Vol 7 (5) ◽

pp. 327-333 ◽

Cited By ~ 32

Author(s):

G. Peicha ◽

F.-J. Seibert ◽

M. Fellinger ◽

W. Grechenig

Keyword(s):

Distal Radius ◽

Distal Radius Fractures ◽

Arthroscopic Treatment ◽

Scapholunate Ligament ◽

Radius Fractures ◽

Midterm Results

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Fluoroscopic Diagnosis of Scapholunate Interosseous Ligament Injuries in Distal Radius Fractures

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-008-0126-6 ◽

2008 ◽

Vol 466 (4) ◽

pp. 969-976 ◽

Cited By ~ 31

Author(s):

Bong Cheol Kwon ◽

Goo Hyun Baek

Keyword(s):

Distal Radius ◽

Distal Radius Fractures ◽

Ligament Injuries ◽

Radius Fractures ◽

Interosseous Ligament

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859 Follow up of distal radius volar plating – No role for post-operative radiographs

British Journal of Surgery ◽

10.1093/bjs/znab259.1011 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

M S Cheruvu ◽

J J Edakalathur ◽

S J Pickard

Keyword(s):

Distal Radius ◽

Image Intensifier ◽

Distal Radius Fractures ◽

Implant Removal ◽

Volar Plating ◽

Radius Fractures ◽

Radiographic Findings ◽

Operative Care ◽

Operative Indications

Abstract Aim There is no consensus on the follow up for distal radius fractures after fixation. All patients receive intra-operative image intensifier screening to check the adequacy of reduction and implant position. We propose that if a patient is asymptomatic, you do not require post-operative radiographs. Method We conducted a retrospective review of all distal radius fractures operated in our hospital over the last 10 years. Data was collected from electronic records for revision surgery or metalwork removal. Records were assessed for patient symptoms, radiographic findings, and indications for implant removal. Patients had a minimum follow up of 6 months. Results 900 distal radius fixations were performed over a 10-year period, of which 747 were volar plating. 49 patients had volar plates removed. 14 patients had metal work removal and joint release for stiffness. 6 had the plate removal and carpal tunnel neurolysis with release. 11 implant removals for screw prominence. Other operative indications included reduction failure (n = 2), infection (n = 2) and removal in paediatric patients (n = 3). 47 of the 49 patients for implant removal were symptomatic at follow up. Only two patients had implant removal following isolated radiographic evidence of metalwork mal position. Conclusions Intra-operative intensifiers reduce the risk of implant and fixation errors. Routine post-operative radiographs altered the management of only 2 out of 700 (0.3%) patients. We suggest that radiographs have no role in routine post-operative care of distal radius fractures, where patients are asymptomatic with appropriate intra-operative intensifier images.

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Dorsal Plate Osteosynthesis in Simple and Complex Fractures of the Distal Radius: A Radiological Analysis of 166 Cases

Journal of Wrist Surgery ◽

10.1055/s-0041-1735839 ◽

2021 ◽

Author(s):

Haval Ghafoor ◽

Mathias Haefeli ◽

Regula Steiger ◽

Philipp Honigmann

Keyword(s):

Distal Radius ◽

Plate Osteosynthesis ◽

Distal Radius Fractures ◽

Dorsal Plate ◽

Radius Fractures ◽

Radiographic Findings ◽

Radiographic Measurements ◽

Loss Of Reduction ◽

Level Of Experience ◽

Dorsal Plating

Abstract Background To report the radiologic outcome and rate of complications of open reduction and internal fixation (ORIF) using a dorsal plate fixation of simple and complex distal radius fractures in adult patients. Methods Patients treated with dorsal ORIF of simple and complex distal radius fractures between December 2008 and April 2013 were included in this single-center retrospective study. Type of fracture, radiographic measurements, and complications were documented. Results One-hundred and sixty-six patients/fractures were included. Restoration of radial inclination (22° ± 3°) was achieved in 38%. Radial height (14 ± 1 mm) was least likely to be restored to normal values postoperative in 25%. Normal ulnar variance (0.7 ± 1.5 mm) could be observed in 60% and adequate volar tilt (11° ± 5°) was achieved in 50% at final follow-up. We observed one loss of reduction in an AO type C2 fracture and a total of 15 nonimplant-related minor clinical complications. Conclusion Our radiographic findings after dorsal plating are comparable to those published on volar plating. The changes in radial height and volar tilt could be attributed to projection-related differences in the radiographs and did not signify a loss of reduction in all cases. Clinical Relevance Dorsal plating of distal radius fractures is safe and remains an important approach in the treatment of complex distal radius fractures. Complications in our study were even less compared to those reported in the literature. Type of Study/Level of Evidence This is a Type IV study. Level of Experience of Surgeons The level of experience of surgeons is III–V.

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