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At least 811 records · Page 45Linked to original sources
PubMedDate not supplied

Use of an ipsilateral vascularized ulnar transposition autograft for limb-sparing surgery of the distal radius in dogs: an anatomic and clinical study.

OBJECTIVE: To develop a surgical technique for using the distal aspect of the ulna as a transposition autograft in a distal radial defect and to assess patency of vascular supply and viability of the distal ulna in a heterotopic position. STUDY DESIGN: Cadaveric study and clinical cases. ANIMALS: Twenty-two normal canine thoracic limbs; 3 dogs with distal radial osteosarcoma. METHODS: The arteries and veins of 12 limbs were injected with latex. Barium sulfate suspension was injected into the brachial artery of 10 other limbs after removal of the distal radius only (n = 2), ulna transposition (UT) (n = 6), or no procedure (n = 2). The distal ulna grafts were then harvested and decalcified in formic acid. The grafts were cut into 3-5 mm transverse sections and radiographed with a nonscreen film system to determine filling of intramedullary vessels with barium suspension. UT was performed in 3 dogs with distal radial osteosarcoma. Bone scintigraphy was performed 2-7 days after surgery to assess viability of the transposed ulna graft. RESULTS: Angiography confirmed patency of the caudal interosseous artery in all but 2 limbs in which the UT technique was performed; however, barium-filled vessels were identified in the medullary cavity of all ulnar grafts. Scintigraphy confirmed graft viability in the 3 dogs, all of which had good to excellent limb function. CONCLUSIONS: The distal aspect of the canine ulna can be used as a vascularized transposition autograft to replace distal radial defects, and viability can be maintained. CLINICAL RELEVANCE: The UT technique appears to be an acceptable limb-sparing technique for dogs with tumors of the distal aspect of the radius.

Animals↗
PubMed1999

Dynamic traction for unstable fractures of the distal radius.

We have designed a flexible distracter through which dynamic traction is applied to fractures of the distal radius. The distraction is maintained during flexion and extension as well as radial and ulnar deviation. The results in 30 patients showed that the majority of the fractures maintained reduction during the period of dynamic traction. In several patients the radiological variables even improved during dynamic traction. The median radial shortening was 0 mm, the palmar angulation 7 degrees, and the radial inclination 23 degrees. Continuous dynamic traction applied to fractures of the distal radius did not lead to redisplacement of the fracture, and the overall functional results were good.

Adult↗
PubMed1999

Nonunion of the distal radius.

We report five cases of nonunion of the distal radius. There were three women and two men. The mean age was 44 years (range, 34-56). All five patients were heavy tobacco smokers and three had a history of alcohol abuse. In three patients, union of the distal radius was obtained. Two had a persistent nonunion which was salvaged with a total wrist fusion.

Adult↗
PubMed2000

T incision for exposure of the distal radius and wrist.

A retrospective review of 66 T-shaped incisions for exposure of the dorsal distal radius and wrist was performed. The incision provided excellent exposure in all cases and no additional incisions were required. Cosmesis was considered acceptable by all patients. Complications occurred in 6% and were more likely in patients undergoing fixation of acute distal radius fractures using Kirschner wires which protruded through the skin flaps.

Adolescent↗
PubMed2001

[Carpal injuries associated with distal radius fractures. Diagnosis and therapy].

The frequency of carpal injuries associated with distal radius fractures is often underestimated. Diagnosis of such lesions can be difficult. Important diagnostic steps include conventional X-rays, cinematography of the wrist, MRI, and arthroscopy. Different procedures such as wrist arthrography and CT are of secondary value. An early diagnosis of ligament injuries and instabilities can be obtained through cinematographic examination, whereas injuries to the TFCC are mainly diagnosed by MRI. Arthroscopy provides exact diagnosis as well as therapy, including arthroscopically controlled reposition of centrally depressed fragments of the articular surface of the radius and even treatment of TFCC lesions.

Arthroscopy↗
PubMed2002

[Narrowing of the third extensor tendon compartment in minimal displaced distal radius fractures with impending rupture of the EPL tendon].

Delayed ruptures of the extensor pollicis longus tendon (EPL) occur in about 0.7 percent following undisplaced distal radius fractures. Two possible mechanisms are mainly discussed in the literature: A mechanical irritation of the tendon caused by a sharp edge of the fractured bone and a direct microvascular compromise of the poorly vascularized tendon. In undisplaced fractures, however, a mechanical irritation seems less likely. In the cases here described we were able to demonstrate a fragment displacement in the area of Lister's tubercle suspected by the native X-ray and further evaluated by a CT scan. The use of CT scans even in minor displaced distal radius fractures involving Lister's tubercle may demonstrate a direct contact of the EPL tendon with a sharp edge of this fractured bone and make adequate surgery possible.

Bone Screws↗
PubMed2003

[Dislocation of the Ulnar Head following Malunion of Distal Radius Fracture in Childhood].

Four children between the age of 10 and 13 years with distal radius fractures healed with dorsal angulation presented to us in our out-patient department. All had been treated conservatively with an upper-arm cast, all fractures had healed with an average dorsal angulation of 10 degrees. Despite this dorsal angulation, the patients were pain free. Subsequent minor injury resulting in pain to the wrist was now the reason for their presentation. On examination we found a spontaneous palmar dislocation of the ulnar head during supination. This proved to be resistant to conservative therapy. In all cases corrective osteotomy of the radius at the level of angulation was performed. Redislocation of the ulnar head was prevented by this method in all cases.

Adolescent↗
PubMedDate not supplied

[Results following percutaneous intramedullary pin fixation in distal radius fractures].

42 distal radius fractures have been submitted to further examination after percutaneous intramedullary pin fixation. The outcome were 95.3% of very good to good anatomic results and 90.5% of satisfying functional results. This showed the close link between the radiological-anatomical and functional results. The success of the treatment was very acceptable, although the Morbus Sudeck as the major complication--with 7.2%--was still relatively frequently observed. It could be seen that particularly fractures at the risk of dislocation with smash zone constituted an indication for the percutaneous intramedullary pin fixation, that is to say all fractures for which a retention is primarily difficult. It constitutes a supplement, as well as an extension to the therapy of the distal radius fractures.

Adult↗
PubMed1982

[Thoughts on the so-called "radius-capitellum axis" (author's transl)].

We have studied 438 patients radiologically in order to observe the so-called "radius-capitellum axis". In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull.

Arthritis↗
PubMed2003

Fractures of the distal radius in low-demand elderly patients: closed reduction of no value in 53 of 60 wrists.

To determine the value of reduction of fractures of the distal radius in the very elderly and low-demand or demented patient, we assessed 60 fractures in 59 patients for the reduction achieved and maintained. The mean patient age was 82 (65-93) years. All fractures were initially reduced under regional or general anaesthesia. In 44 dorsally displaced fractures, reduction failed in 7 cases initially, and 37 lost reduction during the following weeks of immobilisation in plaster. In 9 wrists with volarly displaced fractures, reduction was achieved in 6; all malunited. A total of 53/60 fractures healed in a malunited position. We found no correlation between fracture classification, initial displacement, and final radiographical outcome. On the basis of these observations we conclude that reduction of fractures of the distal radius is of minimal value in the very old and frail, dependent or demented patient.

Aged↗
PubMed2004

Elevated plasma beta-endorphin/beta-lipotropin concentration following a radius fracture.

Plasma beta-endorphin/beta-lipotropin concentration was assessed soon after a fracture. Blood samples from 14 patients with radius fractures were obtained from both arms soon after admission to the hospital (mean 245 min) after the accident. Follow-up samples were taken after healing of the fractures. Higher plasma beta-endorphin/beta-lipotropin concentrations were found in blood samples taken soon after a fracture in both arms compared with the concentrations after healing of the fracture. At admission, mean beta-endorphin/beta-lipotropin concentrations in the fractured and the contralateral arms were 12.7 pmol/L and 13.2 pmol/L, and after recovery 11.1 pmol/L and 11.5 pmol/L (p = 0.012 and p = 0.041), respectively. The pain decreased according to the visual analogue scale (VAS) (0-10) from 4.64 at admission to 0.58 after healing (p < 0.001). In conclusion, this study showed that beta-endorphin/beta-lipotropin concentrations are increased in both arms following a radius fracture compared to the level after the fracture has healed.

Adult↗
PubMed2002

Ruptures of flexor tendons at the wrist as a complication of fracture of the distal radius.

We report two cases of rupture of flexor tendons after fracture of the distal radius. The first case was a rupture of the flexor digitorum profundus and superficialis tendon to the index finger that happened 20 years after the fracture. The second was a rupture of the flexor pollicis longus tendon that occurred two years after, and the flexor profundus tendon to the index finger that occurred four years after the fracture. In the first case, the ruptures were caused by the bony protuberance of the radius after long interval without interference of the ulnar head.

Aged↗
PubMed2004

Experience with the AO Pi-plate for displaced intra-articular fractures of the distal radius.

We have used open reduction and internal fixation (ORIF) with the AO pi-plate in 32 displaced, intra-articular fractures of the distal radius. The indication was a displaced intra-articular fracture with a step-off of more than 1 mm and a gap between fragments of more than 3 mm, judged from the primary computed tomograms (CT). All fractures were classified as AO type C3. Twenty-nine patients were followed-up after a mean of 23 (9-46) months. The dorsal tilt, the radial length, the radial inclination, the articular step-off, and the intra-articular gap between fragments were substantially improved postoperatively. All the patients had excellent or good extra-articular and intra-articular alignment. Two patients had reduced extension power of the first finger. Seventeen patients had Disability of the arm, shoulder, and hand (DASH) scores of less than 10 points, five had scores between 11 and 20, three between 21 and 30, three between 31 and 40, and one patient had a score of 65 points. Complications occurred in two patients: one had a painful amputation neuroma of the superficial radial nerve, and one developed adhesions of the flexor tendons of the second and third fingers because the screws were too long and had penetrated the tendon sheaths. We conclude that the AO pi-plate is an excellent option for the most comminuted fractures of the distal radius.

Adult↗
PubMed2004

Anterior interosseous nerve palsy after reduction and percutaneous pinning of open fractures of the radius and ulna.

We report a case of an anterior interosseous nerve palsy after closed reduction and percutaneous pinning of open fractures of the radius and ulna in an adult. Operative findings showed that the anterior interosseous nerve was trapped between the distal and proximal part of the fractured radius. Treatment by neurorrhaphy gave a satisfactory result.

Fracture Fixation, Intramedullary↗
PubMed1999

Carpal tunnel syndrome after epiphysiolysis of the distal radius in a 5-year-old child. Case report.

Carpal tunnel syndrome after fracture of the distal radius is a well known complication in adults, but in small children carpal tunnel syndrome is extremely rare. A case of carpal tunnel syndrome in a 5-year-old girl is presented. She had a distal epiphysiolysis of the radius, which was treated conservatively. Eight weeks after removal of the plaster of Paris she had clinical signs of carpal tunnel syndrome after exercise but without new injuries. Conservative treatment with a dorsal splint was effective, and all her symptoms disappeared. So conservative treatment seems worth considering before operation in similar cases.

Carpal Tunnel Syndrome↗
PubMed2003

Simultaneous distal radius and hip fractures in elderly patients--implications to rehabilitation.

PURPOSE: The reasons for fractures in the elderly patients are multifactorial. Osteoporosis is considered to be the main pathology. Other reasons are the increase in fall frequency and the protective response to trauma. The most common sites at which these fractures occur are the hip, vertebra and distal radius. A combination of these is uncommon. METHODS: All patients who were treated between January 1990 and December 2000 with a combination of distal radius and hip fractures and were older than 65-years were retrospectively evaluated. The following parameters were evaluated: age; sex; pre fall function; use of drugs; chronic and acute comorbidity; circumstance of the fall; hospitalization length of stay; treatment procedure; complications; and post-hospitalization rehabilitation. RESULTS: Forty-six patients met the study's criteria. Group I consisted of 16 patients between 65-80 years, and group II consisted of the remaining 30 patients older than 80 years. All patients suffered low energy trauma. Ten out of the 16 patients in group I, and eight out of the 30 patients in group II were totally independent, while the remaining patients needed some help with activity of daily living (ADL). In all patients the simultaneous fractures were ipsilaterally. For 45 patients hospital stay ranged from 5-23 days. Twenty-eight patients were transferred to a geriatric rehabilitation centre. Twenty-six of them returned to their previous ADL after a period of 60 days on average. Among the 18 remaining patients, 11 gained full recovery (6 from group I and 5 from group II) and seven patients (5 from group II) had a slight reduction in ADL. CONCLUSIONS: A combination of these fractures is probably more traumatic and occurs in the higher-age group. It is always located in the ipsilateral side. The double trauma represents a better pre-morbid condition relative to patients in the same age group, and thus it may serve as a prognostic indicator for success in rehabilitation.

Activities of Daily Living↗
PubMed2005

Ice and pulsed electromagnetic field to reduce pain and swelling after distal radius fractures.

OBJECTIVE: To examine the relative effectiveness of ice therapy and/or pulsed electromagnetic field in reducing pain and swelling after the immobilization period following a distal radius fracture. METHODS: A total of 83 subjects were randomly allocated to receive 30 minutes of either ice plus pulsed electromagnetic field (group A); ice plus sham pulsed electromagnetic field (group B); pulsed electromagnetic field alone (group C), or sham pulsed electromagnetic field treatment for 5 consecutive days (group D). All subjects received a standard home exercise programme. A visual analogue scale was used for recording pain; volumetric displacement for measuring the swelling of the forearm; and a hand-held goniometer for measuring the range of wrist motions before treatment on days 1, 3 and 5. RESULTS: At day 5, a significantly greater cumulative reduction in the visual analogue scores as well as ulnar deviation range of motion was found in group A than the other 3 groups. For volumetric measurement and pronation, participants in group A performed better than subjects in group D but not those in group B. CONCLUSION: The addition of pulsed electromagnetic field to ice therapy produces better overall treatment outcomes than ice alone, or pulsed electromagnetic field alone in pain reduction and range of joint motion in ulnar deviation and flexion for a distal radius fracture after an immobilization period of 6 weeks.

Adolescent↗