Distal Radius Fractures
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Hand ◽  
2021 ◽  
pp. 155894472110289
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 ◽  
Vol 55 (4) ◽  
pp. 349-354
Maximilian Lenz ◽  
Maik Neumann ◽  
Christian K Spies ◽  
Gregor Stein ◽  

Joonha Lee ◽  
Yohan Lee ◽  
Yong Gil Jo ◽  
Sang Yoon Kang ◽  
Kee Jeong Bae

Purpose: In general orthopedic surgery, the use of prophylactic antibiotics to prevent infection is recommended to be administered within 24 hours. However, there was no analysis on the incidence of surgical site infection according to the duration of use of prophylactic antibiotics for upper extremity fractures. This study aims to derive the appropriate prophylactic antibiotic using time by analyzing the incidence of infection according to the time of prophylactic antibiotic use in distal radius fractures.Methods: We retrospectively analyzed patients who used prophylactic antibiotics among patients who underwent open reduction and internal fixation for distal radius fractures from April 2018 to May 2021. The time of use of prophylactic antibiotics was classified into the 1-day group used, from 1 hour before surgery to 24 hours after the first administration, and the long-term group, continuously administered until discharge after surgery. Demographic characteristics, infection rate, C-reactive protein, risk factors for surgical site infection, and bone union were compared between the two groups.Results: A total of 168 patients were included in the study, 73 in the 1-day group and 95 in the long-term group. Superficial infection occurred in seven patients in the 1-day group and nine in the long-term group, and there was no statistically significant difference in the incidence rates of the two groups (p=0.980). Conclusion: The use of prophylactic antibiotics for 24 hours does not show a significant increase in the infection rate compared to the case of continuous use during open reduction and internal fixation of distal radius fractures.

2021 ◽  
Vol 35 (3) ◽  
pp. s33-s36
Ryan J. Lubbe ◽  
Daniel T. Kokmeyer ◽  
Colby P. Young

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