colles fracture
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2022 ◽  
Author(s):  
Mohammad Taghi Niknejad
Keyword(s):  

2021 ◽  
Vol 15 (8) ◽  
pp. 2519-2521
Author(s):  
Shah Hussain ◽  
Zahid Khan ◽  
Muhammad Habib Khan ◽  
Muhammad Gulzar Khan ◽  
Jamal Bahadar ◽  
...  

Objective: To compare the effectiveness of hematoma block versus intravenous sedation in reduction of colles fractures. Study Design: Randomized control trial Place and Duration: Conducted at the Emergency department of Lady Reading Hospital Peshawar for duration of six months i.e January 2020 to June 2020. Methodology: One hundred and twenty patients of both gender presented with distal radius fracture were enrolled in this study. After taking written informed consent from all the patients’ detailed demographics including age, sex, BMI, site of fracture, cause of fracture and radiographic assessment were recorded. All the patients were equally divided into two groups. Group I (Hematoma Block) consist of 60 patients and group II (Intravenous Sedation) contains 60 patients. Pain was recorded on visual analogue scale VAS at the start and after procedure of reduction. Data was analyzed by SPSS 24.0. Results: Majority were females 40 (66.7%) in group I and 41 (68.3%) in group II and the rest were males 20 (33.3%) and 19 (31.7%). Mean age of the patients in group was 27.48±19.64 years with mean BMI 25.12±9.46 kg/m2 and in group II mean age was 26.72±9.48 years with mean BMI 24.48±17.61 kg/m2. In group I 35 (58.3%) had left side fracture while in group II 32 (53.3%) cases had left hand fracture. Falling was the most common cause of colles fracture found in 45 (75%) patients of group I and 42 (70%) patients in group II followed by accident 13 (21.7%) and 15 (25%) in group I and II. Before reduction means pain score by using VAS among both groups was 8.60±8.23 and 8.03±5.23, during induction mean VAS score reduced to 3.77.±5.42 and 3.09±4.44 and after reduction mean VAS score was lower in hematoma block 1.01.±2.22 as compared to group II 2.06.±4.14. Post-treatment complications were higher in group II as compared to group I. Conclusion: In this research we concluded that hematoma block is a safe and effective as compared to intravenous sedation for the decrease of colles fracture pain in patients. Keywords: Colles Fracture, Hematoma Block, Intravenous sedation, VAS, Pain Reduction


2021 ◽  
pp. 74-76
Author(s):  
Nilabh Kumar ◽  
Laljee Chaudhary ◽  
Debarshi Jana

Background:Colles fracture in adults is a common injury and considering that there is very limited knowledge about the best method of treatment, either conservative or surgical. There is insufcient evidence from comparisons tested within this study to establish the relative effectiveness of the two methods over one another but from a health policy and health care funders' perspective it seems justiable to apply least costly option for managing this common fracture in our country. Aim: To study the functional outcome following treatment of Colles fracture by using closed reduction and plaster cast application versus Kirschner wire xation and to study the effectiveness and complications of both the procedure. Materials and Methods: 50 adult patients with fracture Colles were assigned in to two groups after informed consent. Both groups were investigated in usual manner. Group A: Cases treated with plaster cast application alone (n = 25).Group B: Cases treated with K-wire and plaster cast application (n = 25). The patients were followed up every four weeks till radiological union was seen. The assessment of results were made using the demerit score system of Gartland and Werley based on objective and subjective criteria, residual deformity and complications. Results: At 6 months postoperatively, According to Gartland and Werley Group A we had 5 (10%) excellent results, 12(24%) good results, 06(12%) fair results and 2 (4%) poor results. In group B, 5(10%) excellent results, 13(26%) good results, 07 (14%) fair results and none had poor results. Conclusion: From a health policy and health care funders' perspective it seems justiable to apply least costly option for managing this common fracture in our country.


2021 ◽  
Vol 12 ◽  
Author(s):  
Kazuteru Shiraishi ◽  
Andrew J. Burghardt ◽  
Makoto Osaki ◽  
Sundeep Khosla ◽  
Julio Carballido-Gamio

BackgroundBone parameters derived from HR-pQCT have been investigated on a parameter-by-parameter basis for different clinical conditions. However, little is known regarding the interrelationships of bone parameters and the spatial distribution of these interrelationships. In this work: 1) we investigate compartmental interrelationships of bone parameters; 2) assess the spatial distribution of interrelationships of bone parameters; and 3) compare interrelationships of bone parameters between postmenopausal women with and without a recent Colles’ fracture.MethodsImages from the unaffected radius in fracture cases (n=84), and from the non-dominant radius of controls (n=98) were obtained using HR-pQCT. Trabecular voxel-based maps of local bone volume fraction (L.Tb.BV/TV), homogenized volumetric bone mineral density (H.Tb.BMD), homogenized μFEA-derived strain energy density (H.Tb.SED), and homogenized inter-trabecular distances (H.Tb.1/N) were generated; as well as surface-based maps of apparent cortical bone thickness (Surf.app.Ct.Th), porosity-weighted cortical bone thickness (Surf.Ct.SIT), mean cortical BMD (Surf.Ct.BMD), and mean cortical SED (Surf.Ct.SED). Anatomical correspondences across the parametric maps in the study were established via spatial normalization to a common template. Mean values of the parametric maps before spatial normalization were used to assess compartmental Spearman’s rank partial correlations of bone parameters (e.g., between H.Tb.BMD and L.Tb.BV/TV or between Surf.Ct.BMD and Surf.app.Ct.Th). Spearman’s rank partial correlations were also assessed for each voxel and vertex of the spatially normalized parametric maps, thus generating maps of Spearman’s rank partial correlation coefficients. Correlations were performed independently within each group, and compared between groups using the Fisher’s Z transformation.ResultsAll within-group global trabecular and cortical Spearman’s rank partial correlations were significant; and the correlations of H.Tb.BMD–L.Tb.BV/TV, H.Tb.BMD–H.Tb.1/N, L.Tb.BV/TV–H.Tb.1/N, Surf.Ct.BMD–Surf.Ct.SED and Surf.Ct.SIT–Surf.Ct.SED were significantly different between controls and fracture cases. The spatial analyses revealed significant heterogeneous voxel- and surface-based correlation coefficient maps across the distal radius for both groups; and the correlation maps of H.Tb.BMD–L.Tb.BV/TV, H.Tb.BMD–H.Tb.1/N, L.Tb.BV/TV–H.Tb.1/N, H.Tb.1/N–H.Tb.SED and Surf.app.Ct.Th - Surf.Ct.SIT yielded small clusters of significant correlation differences between groups.DiscussionThe heterogeneous spatial distribution of interrelationships of bone parameters assessing density, microstructure, geometry and biomechanics, along with their global and local differences between controls and fracture cases, may help us further understand different bone mechanisms of bone fracture.


Author(s):  
Neetin P. Mahajan ◽  
Prasanna Kumar G. S. ◽  
Kishor Jadhav ◽  
Kartik Pande ◽  
Tushar Patil

<p class="abstract">Malunion of the distal end of radius is a known consequence of the conservative management. The functional impairment depends on the severity of the deformity and it can be associated with distal radioulnar joint (DRUJ) instability. Subsequent radius ulna fracture in an elderly osteoporotic patient is a challenging task to manage. A 60 year old female patient came with radius ulna shaft fracture with DRUJ instability with ipsilateral malunited distal radius fracture. We managed with open reduction and internal fixation using 3.5 mm locking compression plate (LCP) with ulnar shortening and K wires for DRUJ. At one year, follow-up, patient is having good clinical and radiological outcome without any complications. Radius ulna shaft fracture in cases of malunited colles fracture with positive ulnar variance with DRUJ instability can be managed well with open reduction and internal fixation of radius-ulna shaft which provides stable fixation, ulnar shortening at the fracture site to maintain the neutral/negative ulnar variance and DRUJ fixation using K wires. Use of multiple vicryl sutures to tie the plate to the bone gives additional stability in osteoporotic bones till the fracture unites and prevents implant failure. Combination of the above mentioned procedures helps in getting good functional outcome in elderly osteoporotic patients.</p>


2020 ◽  
Vol 10 (3) ◽  
pp. 47-52
Author(s):  
Shriraj Shrestha ◽  
Parash Bhandari ◽  
Saurav Dahal ◽  
Basanta Maharjan ◽  
Suraj Bajracharya

Background: Colles’ fracture is a common injury in the elderly population. Although it can be easily reduced, it is difficult to maintain the reduction in the conventional position of the wrist in palmar flexion with a poor functional outcome. Thus our study aimed to compare the radiological and functional outcome of such fractures with the wrist in two different posi­tions of dorsiflexion and palmar flexion. Methods: A prospective, observational study was conducted from April 2019 to March 2020 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Ne­pal. Sixty-two patients, 31 in each group, all above 45 years with Colles’ fracture underwent close reduction and below elbow cast immobilization under hematoma block. Maintaining palmar flex­ion and ulnar deviation at the fracture site, the wrist was immobilized in dorsiflexion and palmar flexion attitude alternatively. During the respective follow-ups, the Demerit Scoring System of Saito was evaluated. Data collection and entry was done using the statistical package for social science version 16 and analyzed by using descriptive and inferential statistics. Results: All fractures were united. At the end of twelve weeks, Saito Scoring System of good to ex­cellent was markedly better in dorsiflexed group 29(93.5%) patients as compared to palmar flexed group 22(71.0%) patients, similarly grip power was also superior in dorsiflexed group 19(61.3%) patients than in palmar flexed group 11(35.5%) patients. Conclusions: Cast immobilization of Colles’ fracture with the wrist in dorsiflexion prevents re-dis­placement of the fragments resulting in significantly better radiological and functional outcomes.


2020 ◽  
Author(s):  
Saagar Patel ◽  
Alexandra Janda ◽  
Manickam Kumaravel, MD, FRCR
Keyword(s):  

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