Distal Radius
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Medicine ◽  
2021 ◽  
Vol 100 (36) ◽  
pp. e27116
Author(s):  
Hongliang Li ◽  
Mingyun Fu ◽  
Junqing Gao ◽  
Jile Fu ◽  
Tuming Li ◽  
...  

Author(s):  
G. Harish

In this study we evaluated the functional outcomes of open reduction and internal fixation of distal radius fractures by plate osteosynthesis in considering the parameters like radiological,clinical, and functional outcome in all types of fractures. There blood loss for volar locked plating cases was around 200ml. the pain after the surgery was present equally in all and responses was good to analegesics. It was observed that the plating distal radius is very effective in maintaining length in all types. Good alignment was observed in allmtype of fractures, in case of communited fractures as well. The early recovery and movement in the patients treated with volar locked plating gives a better outcome and good working capacity.


Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Eva Lundqvist ◽  
Per Fischer ◽  
Per Wretenberg ◽  
Wolfgang Krauss ◽  
Marcus Sagerfors

Background: Volar locking plate fixation is the most common method of operative fixation of distal radius fractures (DRFs). For more complex cases, combined plating is an option for stabilizing intra-articular fragments. The prevalence of posttraumatic arthritis (PA) after an intra-articular DRF, and its relation to patient-reported outcome measures (PROMs), remains unclear. The purpose of this study was to study the prevalence of PA and its correlation to clinical outcome measures. Methods: We evaluated 97 consecutive patients with intra-articular DRF, operated with combined plating, 7 years postoperatively. The primary outcome measure was the prevalence of radiographic PA. Secondary outcome measures included visual analog scale (VAS) pain score, hand grip strength, wrist range of motion (ROM), Patient-Rated Wrist Evaluation (PRWE) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. Radiographic examination was performed between 1 and 7 years postoperatively. Results: The prevalence of PA was 29% at the 7-year follow-up. No correlation was found between PA and ROM, hand grip strength, PRWE, QuickDASH, VAS pain scores, or radiographic reduction. Median wrist ROM and grip strength were significantly inferior compared with the uninjured side. Hardware removal was performed in 51.5% of cases. There were 2 cases of tendon ruptures. Conclusions: Combined plating can yield a good clinical outcome 7 years postoperatively and a low prevalence of PA. The presence of PA did not correlate to clinical outcome measures or to the accuracy of anatomical reduction 1 year postoperatively. The frequency of tendon ruptures was acceptable, but the high frequency of hardware removal is a concern.


2021 ◽  
pp. 204946372110419
Author(s):  
Tjitske D Groenveld ◽  
Emily Z Boersma ◽  
Taco J Blokhuis ◽  
Frank W Bloemers ◽  
Jan Paul M Frölke

Background: Complex regional pain syndrome type I (CRPS) is a symptom-based diagnosis of which the reported incidence varies widely. In daily practice, there appears to be a decrease in incidence of CRPS after a distal radius fracture and in general. Questions/purposes: The aim of this study was to assess the trend in the incidence of CRPS after a distal radius fracture and in general in the Netherlands from 2014 to 2018. Methods: The incidence of CRPS after a distal radius fracture was calculated by dividing the number of confirmed cases of CRPS after distal radius fracture by the total number of patients diagnosed with a distal radius fracture. Medical records of these patients were reviewed. Hospital-based data were used to establish a trend in incidence of CRPS in general. A Dutch national database was used to measure the trend in the incidence of CRPS in the Netherlands by calculating annual incidence rates: the number of new CRPS cases, collected from the national database, divided by the Dutch mid-year population. Results: The incidence of CRPS after distal radius fracture over the whole study period was 0.36%. Hospital data showed an absolute decrease in CRPS cases from 520 in 2014 to 223 in 2018. National data confirmed this with a decrease in annual incidence from 23.2 (95% CI: 22.5–23.9) per 100,000 person years in 2014 to 16.1 (95% CI: 15.5–16.7) per 100,000 person years in 2018. Conclusion: A decreasing trend of CRPS is shown in this study. We hypothesize this to be the result of the changing approach towards CRPS and fracture management, with more focus on prevention and the psychological aspects of disproportionate posttraumatic pain. Level of Evidence: level 3 (retrospective cohort study).


Author(s):  
Pantouvaki Anna ◽  
Kastanis Grigorios

Objectives: The purpose of this study is to evaluate the frequency of unstable distal radius fractures in adult population and the management performed in orthopaedic and physiotherapy department of the General Hospital” Venizeleio” in Heraklion-Crete re-organised due to pandemic period. In pandemic period, due to urgent needs of covid-19 patients, a lot of orthopaedic associations suggested some restrictions concerning the treatment of DRF. The aim of this study is to answer in two hypothetical questions. First, did patients with unstable DRF receive a conservative instead of surgical treatment and second is the protocol of rehabilitation program still the same or do the patients receive a modified rehabilitation program? Methods: Patients admitted in the emergency department of the hospital during pandemic period of 2020 with distal radius fracture surgically treated, were evaluated and data compared with those of pre-pandemic period. (2018-2019). Results: A number of 32, 35 and 42 patients with DRF were treated and hospitalized in 2018, 2019 (pre-pandemic period) and 2020 (pandemic period) respectively. The mean age of patients did not appear with any statistical difference. (p= .93) between periods and causes of DRF did not change dramatically. Additionally, there was a remarkable variation in number of patients between the 1st and 2nd semesters of quarantine period. (p=.68). Conclusion: Adaptations in management of distal radius fracture during lockdown did not affect patient’s surgical and rehabilitation treatment and functional outcomes. The mean age of patients treated, did not vary during pandemic period while the causes of DRF. But it was obligatory to adopt the rehabilitation treatment plan and the number of hospital visits due to Covid-19 precautions.


2021 ◽  
pp. 2150021
Author(s):  
Sina Heydari ◽  
Najmeh Alizadeh ◽  
Milad Rezaiye ◽  
Mohammad Ali Sheikh Beig Goharrizi ◽  
Akbar Mehralizade ◽  
...  

Background: Distal radius fracture is a common type of bone fracture in patients of all ages. Most of the complications of this type of fracture are related to intra-articular fractures. Aim: This study aimed to compare the treatment results of distal radius fracture with two closed pinning and plate plastering methods in young patients admitted to Imam Khomeini Hospital in Jiroft in 2019. Method: The sample size was 176 patients with distal radius fractures admitted to Imam Khomeini Hospital in Jiroft in 2019. The patients were randomly divided into two treatment groups: (1) closed reduction and percutaneous pinning, and (2) plastering with plates. Finally, patients were compared in terms of the mentioned variables immediately after surgery and three months after that. The collected data were coded, entered, and analyzed by using SPSS. Results: The mean age of the selected patients in the closed pinning treatment group was 27.32 years and in the plate plastering group was 27.72 years. The minimum age of patients was four years, and the maximum was 59 years. Patients in the plate plastering treatment group seemed to have a higher mean age than those in the closed pinning treatment group, but this difference is not statistically significant ( [Formula: see text]). There was no statistically significant difference between men’s and women’s ratio in terms of being in the two treatment groups ( [Formula: see text]). There was no statistically significant difference between the right hand and left dominant hand ratio in the two treatment groups ( [Formula: see text]). There was a statistically significant difference between the ability and disability ratio to perform the activity in the two treatment groups ( [Formula: see text]). There was no significant difference between the subjective ratio of no pain, minor pain, and occasional pain in the two treatment groups ( [Formula: see text]). There was a significant difference between the ratio of movement limitation less than 20%, limitation 20–50%, and limitation more than 50% in the two treatment groups ( [Formula: see text]). There was a significant difference between the ratio of normal wrist strength, strength 30–60, and strength 60–90 in the two treatment groups ( [Formula: see text]). There was no statistically significant difference between the uncomplicated ratio and partial crepitation in terms of placement in the two treatment groups ( [Formula: see text]). Finally, there was no statistically significant difference between the total score ratio, closed pinning, and plate plastering treatment groups ( [Formula: see text]). Conclusion: According to this study results, there is no difference between the two treatment methods of closed pinning and plastering with a plate. However, the pinning treatment group had the highest frequency of excellent scores than the plate plastering method.


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