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Results for “RADIUS FRACTURES”

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PubMed2001

[Correction of malunited distal radius fractures by osteotomy and interposition of iliac crest bone spain in the radio-palmar position. A retrospective study of 42 patients].

The retrospective study included 42 patients who have been treated with a palmar opening wedge osteotomy after malunion of distal radius fracture. 31 patients could be reexamined clinically and radiologically. The corrective osteotomy on the distal radius was done only radiopalmar with an insertion of a corticocancellous iliac graft. Radiological and functional findings as well as the subjective judgement of the patient have been commented pre- and after surgically according to the assessment scheme of Pechlaner and were then compared with the contra lateral wrist. The evaluation of the x-ray pictures showed an improvement from 3.7 to 1.9 points, the functional improvement from 3.7 to 2.6 points. The improvement of the subjective complaints results in a diminution of 3.3 to 2.2 points.

Adult↗
PubMed1990

[Special forms of distal radius fractures].

The severity of a fracture of the distal radius is not only determined by the type of the fracture but also by concomitant ligamentous and carpal injuries, which are often underestimated and imply a higher degree of instability than the bony lesion alone. Therefore classifications are valuable, which combine fracture type and associated lesions, thus permitting conclusion about the therapeutic method of choice. The article discusses indication, operative technique and special features of radial fractures in combination with carpal injuries, of radial styloid fractures as well as Barton's and Reverse-Barton's fractures, of bilateral radial fractures and of radial fractures as part of a chain fracture. It is important to perform an early fasciotomy and carpal tunnel release in cases of severe soft tissue damage and threatening compartment syndrome.

Aged↗
PubMed1997

Prospective multicenter trial of a plate for dorsal fixation of distal radius fractures.

A new plate designed specifically to address complex wrist pathology was used for the internal fixation of 22 complex fractures of the distal radius in 22 patients in a prospective multicenter trial. The majority of fractures were group C2- and C3-type fractures according to the Comprehensive Classification of Fractures. No plate failures, loss of reduction, nonunions, or infections occurred. Within the average follow-up time of 14 months, the functional results (including an average motion of 76% and an average grip strength of 56% of the contralateral side) were comparable to those reported for similar fractures in previous investigations. Five patients had irritation of the tendons in the second dorsal compartment. This trial serves both as a verification of the safety and efficacy of this distal radius plate as well as a demonstration of its utility in the treatment of complex fractures of the distal radius.

Adult↗
PubMed2003

Dome-shaped osteotomy for distal radius fracture malunions.

After having hinted to the various component of the malformity caused by malunions of the distal radius fracture, the various possibilities of correcting this deformity are described. The difficulty to correct all the components of the deformity are considered. Then a Dome-shaped osteotomy of the distal radius is described that allows to correct all the deformities in all the directions as the gliding plane of the osteotomy is spherical. The ulnar plus and the DRUJ alterations are corrected by means of an added Sauvé-Kapandji procedure that guarantees against any painful movement of the DRUJ preserving effective prono-supination.

Journal Article↗
PubMed1995

Arthroscopic-assisted reduction of distal radius fractures.

The outcomes of seven patients with severe comminuted intraarticular fractures of the distal radius treated by arthroscopic reduction and percutaneous external fixation (ARPEF) were retrospectively reviewed. All of the fractures were classified as C3 types using the AO classification scheme. Outcomes were evaluated using the Gartland and Werley functional criteria, an objective wrist examination, a radiographic analysis, and a self-assessment outcome form at an average follow-up of 27 months (range, 12 to 45 months). All patients were free of pain and had returned to their prior occupations. No patient had articular incongruency of greater than 1 mm, and there was no evidence of radiocarpal degenerative change. Active range of motion and maximal grip strength averaged 92% and 98%, respectively, of the uninjured wrist. The technique of arthroscope-assisted reduction and percutaneous external fixation yielded excellent results in a small group of patients, with minimal complications.

Adult↗
PubMed1990

[Sequelae and evaluation after distal radius fractures].

The sequela of fractures of the distal radius show the same variety as the fracture models themselves, depending on conservative or operative repositioning. The most frequent disadvantages are deviation of the bone axis, depression of the basis of the radius, steps in the cartilage plain and rough deformity. Most important are the arthrotic changes in the joint, such as entrapment and compression neuropathies. The sequela of fractures in children, adults and the aged differ. The purpose of the expert appraisal is not only to assess the damages after fracture but also to give new proposals for further therapy.

Diagnostic Imaging↗
PubMed1988

Unusual fragment displacement in a distal radius fracture.

A 25-year-old man sustained a closed comminuted intra-articular fracture of the distal radius. Tomography showed 180 degree rotation of a palmar medial articular fragment. This rare injury is mentioned only once in the literature. When recognized, open reduction and internal fixation are necessary.

Adult↗
PubMed1994

[A comparison of 2 methods of plastic cast fixation in treatment of loco classico radius fracture. A prospective, randomized study].

The purpose of this study was to compare the functional and radiological result of two different positions of the wrist in a plaster cast following Colles' fracture. For this prospective study, each of 50 patients with type A 2.2, A 3.3, C 1.2 or C 2.2 (AO classification) fractures of the radius was randomly assigned to one of two groups. Both groups were treated in the same way as far as anaesthesia and reduction were concerned. The only difference in treatment lay in the position of fixation in plaster. In group 1 the wrist was immobilized in neutral flexion-extension. In group 2 the wrist was dorsiflexed 20 degrees, while the carpus was pushed in a volar direction by an impression in the plaster cast. At review 2-7 years after the accidents, the two groups were compared with reference to symptoms, range of motion at the wrist, power of first closure and radiographic appearance. In group 1 there were 5 patients with significant disability, compared with only 1 in group 2. A significant difference was found in the range of movement between the two groups for flexion and ulnar abduction (p < 0.01). The loss of power of first clenching (difference between injured and healthy hand) was 6.2 mmHg for group 1 and 3.8 mmHg for group 2 (not significant). The radiographic examination showed significant differences both in sagittal inclination (p < 0.001) and in radial shortening (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Comparison of forearm and conventional Bier's blocks for manipulation and reduction of distal radius fractures.

Forearm-based Bier's block has been advocated as a useful anaesthesic technique in hand surgery. However, there is limited data comparing forearm blocks with the conventional Bier's block. We conducted a randomised controlled trial (n=30) comparing the two techniques of anaesthesia for manipulation and reduction of closed distal radius fractures in an emergency room setting. Pain scores measured using the Visual Analogue Scale during the procedure were used as the primary outcome assessment. There was no significant difference in pain scores between the forearm and conventional Bier's block (mean VAS 18.4 SD 22.10 versus 33.7 SD 29.6). No major complications were observed in either group. The forearm-based Bier block is an effective alternative to the conventional block.

Adult↗
PubMed2004

Corrective osteotomy of malunited distal radius fractures using carbonated hydroxyapatite as an alternative to autogenous bone grafting.

PURPOSE: The purpose of the present study was to report on the author's experience using carbonated hydroxyapatite as a bony substitute in distal radius corrective osteotomies. METHODS: Six patients had a corrective osteotomy for a malunited distal radius fracture using carbonated hydroxyapatite as an alternative to an autogenous bone graft. Internal fixation of the osteotomy was achieved by using 2 or 3 K-wires. RESULTS: At an average follow-up evaluation of 33 months (range, 22-45 mo) all the osteotomies united. Wrist flexion-extension motion improved from 75 degrees to 110 degrees , forearm rotation increased from 116 degrees to 157 degrees , and grip strength had an average increase of 140% at the time of the final follow-up evaluation. All patients were satisfied and there were no reports of persistent pain. Radiographic evaluation showed an average volar tilt improvement from a preoperative dorsal angulation shifting into a neutral position in the sagittal plane; radial lengthening improved from an average of 4 mm (range, 2-6 mm) before surgery to 7 mm (range, 5-9 mm) after surgery, ulnar plus deformity improved by 5 mm. Radiographically the carbonated hydroxyapatite material was integrated completely into the bone tissue with evidence of progressive re-absorption and bony calcification over time. The Mayo wrist score system, according to Cooney and Krimmer modifications, improved by an average of 88 and 98 points (0-100 points), respectively. CONCLUSIONS: On the basis of this preliminary experience it is reasonable to consider carbonated hydroxyapatite as a viable alternative to bone grafting in conjunction with surgical correction of a distal radius malunion. It must be augmented, however, with internal fixation.

Adult↗
PubMed1957

Radius fracture.

Explore the source record for details and available documents.

Humans↗
PubMed1991

Augmented external fixation of unstable distal radius fractures.

The technique of "augmentation" of external fixation employs the use of percutaneous Kirschner wires to secure the radial styloid fragment as a lateral buttress, elevate and fix in place the depressed lunate fossa fragment, and, when necessary, add support to the elevated articular surface by means of subarticular bone grafting. A series of 51 cases of comminuted, unstable intraarticular distal radius fractures has been managed using this technique. Detailed evaluation has demonstrated precise articular reconstitution with an overall satisfactory result rate of 92%.

Adolescent↗
PubMed2005

Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures.

INTRODUCTION: This study investigates the clinical and radiological results of open reduction and internal fixation of unstable distal radial fractures using a palmar placed interlocking plate system with no substitutes for treatment of the dorsal metaphyseal fracture void. MATERIALS AND METHODS: Nineteen patients with a mean age of 61 years (range 49-78 years) and a dorsally displaced distal radial fracture were treated using a palmar placed 2.4 mm interlocking plate system. All 17 women and 2 men were followed up according to the study protocol. Standardised radiographs in anteroposterior and lateral projection were performed before reduction and at 2, 6, 12 and 24 weeks after surgery. Radiological measurements included palmar tilt, radial inclination and radial shortening as defined by ulnar variance and intra-articular steps. Clinical assessment included active range of motion (ARM) of the wrist, pain according to a visual analogue scale (VAS), grip power, working ability, Disability of Arm, Shoulder and Hand-Score (DASH Score) and Mayo Wrist Score. RESULTS: At final follow-up after a minimum of 11 months, the palmar tilt was +1 degrees , radial inclination 19.8 degrees and ulnar variance 1.0 mm. Mean loss of palmar tilt measured 1.9 degrees , radial inclination 1.3 degrees and ulnar variance 0.4 mm. Mean wrist extension measured 58 degrees , wrist flexion 41 degrees , pronation 83 degrees and supination 84 degrees . The Mayo Wrist Score showed 21% excellent, 58% good, 16% fair and 5% poor results. CONCLUSION: The treatment of unstable, dorsally dislocated, distal radius fractures AO types A3, C1 and C2, with a palmar placed 2.4 mm interlocking plate system and without additional treatment of the metaphyseal defects showed good radiological and functional results with minimal loss of reduction.

Aged↗
PubMed1988

[Distal radius fracture--indications for conservative, partial surgical and surgical therapy].

460 fractures of the distal radius including 91 which are treated surgically are investigated in a retrospective study. There were 260 fractures of the left and only 200 of the right radius. 66% of the patients were female, especially striking is the superior number of women older than 45 years. The evaluation of the final radiological results referring to anatomical joint angles and normal radius length shows a high correlation to the evaluation of the final functional results. 70% of the latter are valued as excellent or good, 19% as tolerable and 11% as poor. The classification according to Frykman shows a significantly better result for cases without violation of the distal ulna. The comparison between operative and non-operative treatment of dislocated fractures without infraction of the radiocarpal joint demonstrates good results of percutaneous wire fixation in those cases. The therapy of fractures with infraction of radiocarpal and radioulnar joint is difficult. In this group we could not find a superiority of operative against conservative treatment. Wire fixation lead to 19% poor results and cannot be recommended for all cases. Six patients treated by external fixation and five treated by osteosynthesis using metal plates had good or tolerable results. The indication for using these methods has to be considered.

Adult↗
PubMed2005

[Micro-CT analysis of cancellous bone fragments from the distal radius fracture zone in osteoporosis].

The incidence and prevalence of osteoporosis must be considered to continue to increase significantly due to the expected demographic development and environmental changes. In the diagnosis and staging of osteoporosis the three-dimensional bone structure should be as important as the bone mass or the mineral content of the bone. In this study, microfragments were taken from distal radius fracture zones and investigated in Micro-CT scans. Patients in which osteodensitometry of the lumbal spine had revealed osteoporosis in were found to have significantly reduced bone mass, bone density and trabecular thickness. Trabecular fractures which were found in non-osteoporotic patients even in robust trabeculae were detected by the two-dimensional analysis in thin locations and arborizations. Despite some trabeculae turned out to be very small the differences in the histomorphometry and the quality of trabecular fractures in osteoporotic as well as non-osteoporotic patients could be visualized very good in the Micro-CT analysis.

Absorptiometry, Photon↗
PubMed1986

[Results of conservative treatment of distal radius fractures].

The results of conservative treatment of fractures of the distal radius in 303 patients over a period of two years are demonstrated. 226 patients could be followed-up. The healing of the fracture was satisfactory in 78%, while the results regarding the various age groups showed considerable differences. Along with the demonstration of the functional and anatomical results in relation to age, sex, and localization the technique of fracture treatment as well as follow-up treatment are discussed.

Adolescent↗
PubMed1987

[Wrist para-articular radius fractures in winter sports].

Winter sport is of great importance in the Alpine countries. In 1980 3600 persons (10.24%) of all new admittances hospitalized in our hospital were injured when practicing winter sports. In 1983 they lessened to 2597 (7.73%) and in 1985 2999 (5.74%). Analysis of all injuries caused by winter sport activities shows that the number of injured persons is decreasing, severity of the injuries however, increasing. A comparison of the distal radius fractures in 1980, 1983 and 1985 indicates that extraarticular metaphyseal fracture types have decreased, intraarticular fracture with multiple fragments however, have increased. Mainly younger patient suffer from severe fractures. We regard the high pace-risk of the age group as the main course of this fact.

Adolescent↗