Radius Fractures
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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.


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 ◽  
Vol 103-B (9) ◽  
pp. 1457-1461
Author(s):  
George Philip Esworthy ◽  
Nick A. Johnson ◽  
Pip Divall ◽  
Joseph J. Dias

Aims The aim of this study was to identify the origin and development of the threshold for surgical intervention, highlight the consequences of residual displacement, and justify the importance of accurate measurement. Methods A systematic review of three databases was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. This search identified papers investigating functional outcome, including presence of arthritis, following injury. Orthopaedic textbooks were reviewed to ensure no earlier mention of the threshold was present. Results Knirk and Jupiter (1986) were the first to quantify a threshold, with all their patients developing arthritis with > 2 mm displacement. Some papers have discussed using 1 mm, although 2 mm is most widely reported. Current guidance from the British Society for Surgery of the Hand and a Delphi panel support 2 mm as an appropriate value. Although this paper is still widely cited, the authors published a re-examination of the data showing methodological flaws which is not as widely reported. They claim their conclusions are still relevant today; however, radiological arthritis does not correlate with the clinical presentation. Function following injury has been shown to be equivalent to an uninjured population, with arthritis progressing slowly or not at all. Joint space narrowing has also been shown to often be benign. Conclusion Knirk and Jupiter originated the threshold value of 2 mm. The lack of correlation between the radiological and clinical presentations warrants further modern investigation. Measurement often varies between observers, calling a threshold concept into question and showing the need for further development in this area. The principle of treatment remains restoration of normal anatomical position. Cite this article: Bone Joint J 2021;103-B(9):1457–1461.


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