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At least 865 records · Page 48Linked to original sources
PubMed2004

Dorsal plating for comminuted intra-articular fractures of the distal end of the radius.

Forty-one dorsally displaced intra-articular fractures of the distal radius were treated by open reduction and internal fixation with the dorsal Symmetry plates. The average age at the time of the injury was 49 years. An average follow-up period was 15 months. The final radial length averaged 11 mm, radial inclination 23 degrees, volar tilt 7 degrees, ulnar variance 1.5 mm, and articular incongruity 0.3 mm. According to the Gartland and Werly scales, 36 fractures were excellent and five were good. However, ulnar variance increased more than 3 mm during follow-up in eight patients, and volar tilt increased more than 5 degrees during follow-up in ten patients. Use of dorsal Symmetry plate is effective for unstable comminuted intra-articular distal radius fractures, but severely comminuted fractures may possibly undergo re-displacement post-operatively.

Adolescent↗
PubMed2005

Superficial radial nerve compression caused by a parosteal lipoma of proximal radius: a case report.

The superficial radial nerve might be compressed or injured at various anatomical sites along its course in the forearm. Most of the superficial radial nerve neuropathy are caused by pathological lesions such as trauma, a mass or tight band at the distal third of the forearm. Wartenberg's syndrome is the most common cause of sensory radial entrapment at the distal forearm. Compression of superficial radial nerve occurring at the proximal third of forearm is unusual. We present a rare case of superficial radial nerve compression due to a parosteal lipoma of proximal radius. Results of complete physical and radiological examinations are also presented. Surgical intervention of the tumour mass was performed for nerve decompression. The patient reported total relief of the neurological symptom post-operatively. This rare case demonstrates the unique characteristics of parosteal lipoma with unusual superficial radial nerve neuropathy at the proximal radius. This report reminds us that there is the possibility of superficial nerve compression caused by tumour mass over the proximal third of forearm.

Bone Neoplasms↗
PubMed1996

Distal radius: in vivo assessment with quantitative MR imaging, peripheral quantitative CT, and dual X-ray absorptiometry.

PURPOSE: To evaluate in vivo the relationship between magnetic resonance (MR) imaging relaxation time and bone mineral density (BMD) at the distal radius. MATERIALS AND METHODS: The 1/T2* MR imaging relaxation rates and dual X-ray absorptiometry (DXA) measurements were evaluated in the trabecular bone of the distal 5 cm of the radius in 14 healthy premenopausal women and 11 healthy postmenopausal women and in 11 women with osteoporosis. Trabecular and total BMD were measured with peripheral quantitative computed tomography (CT). RESULTS: In healthy women, 1/T2* values and trabecular BMD at peripheral quantitative CT were significantly correlated but 1/T2* and total BMD were not. Statistically significant (P = .03) correlations between 1/T2* and DXA were found only in the most distal area covered with DXA. The 1/T2* values were more closely correlated with age and showed higher relative annual decreases (0.47%-0.81%) than peripheral quantitative CT (0.20%-0.59%) or DXA (0.10%-0.39%). Pre- and postmenopausal healthy subjects could be distinguished only with MR imaging, and postmenopausal healthy and osteoporotic subjects only with CT and DXA. CONCLUSION: MR imaging relaxation rates correlate well with trabecular BMD in vivo.

Absorptiometry, Photon↗
PubMed1997

Assessment of osteoporosis: comparison of radiographic absorptiometry of the phalanges and dual X-ray absorptiometry of the radius and lumbar spine.

PURPOSE: To evaluate radiographic absorptiometry (RA) of the phalanges in healthy women and in women with osteoporosis and to compare the results of RA with those of dual x-ray absorptiometry (DXA) of the radius and spine. MATERIALS AND METHODS: Thirty-two healthy premenopausal women, 39 healthy postmenopausal women, and 35 postmenopausal women with osteoporosis underwent RA of the phalanges and DXA of the radius and lumbar spine. Pairwise comparisons, age-related bone losses, and percentage decrements and Student t values for intergroup discrimination were calculated. The ability to identify patients with osteoporotic fractures was evaluated by using receiver operating characteristic and age-adjusted logistic regression analyses. The diagnostic agreement for osteoporosis was assessed with kappa statistics. RESULTS: Findings from RA were correlated with those from spinal DXA (r = .56). The annual bone losses in healthy women, as measured with RA, radial DXA, and spinal DXA, were 0.47%, 0.47%, and 0.32%, respectively. Intergroup percentage decrements and t values obtained with RA were comparable to those obtained with radial and with spinal DXA. Receiver operating characteristic analysis showed no statistically significant differences. The odds ratios for RA, radial DXA, and spinal DXA were 2.1, 1.9, and 2.4, respectively. The kappa scores were 0.44 for both RA versus radial DXA and RA versus spinal DXA, and the score was 0.22 for radial DXA versus spinal DXA. CONCLUSION: RA appears to be a useful technique for assessing age- and menopause-related bone loss and for identifying women with osteoporosis.

Absorptiometry, Photon↗
PubMed1999

Tomographical description of tennis-loaded radius: reciprocal relation between bone size and volumetric BMD.

Effects of long-term tennis loading on volumetric bone mineral density (vBMD) and geometric properties of playing-arm radius were examined. Paired forearms of 16 tennis players (10 women) and 12 healthy controls (7 women), aged 18-24 yr, were scanned at mid and distal site by using peripheral quantitative computerized tomography. Tomographic data at midradius showed that tennis playing led to a slight decrease in cortical vBMD (-0.8% vs. nonplaying arm, P < 0. 05) and increase both in periosteal and endocoritcal bone area (+15. 2% for periosteal bone, P < 0.001; and +18.8% for endocortical bone, P < 0.001). These data suggest that, together with an increase in cortical thickness (+6.4%, P < 0.01), cortical drift toward periosteal direction resulted in improvement of mechanical characteristics of the playing-arm midradius. Enlargement of periosteal bone area was also observed at distal radius (+6.8%, P < 0.01), and the relative side-to-side difference in periosteal bone area was inversely related to that in trabecular vBMD (r = -0.53, P < 0.05). We conclude that an improvement of mechanical properties of young adult bone in response to long-term exercise is related to geometric adaptation but less to changes in vBMD.

Adult↗
PubMed1977

Congenital hypomegakaryocytic thrombocytopenia associated with bilateral absence of the radius - the TAR syndrome.

A case of the TAR syndrome is described which presented bilateral absence of the radius and pronounced thrombocytopenia at birth; when seen at the age of 6, growth and development was within normal limits, except for the upper extremities, and no signs of an haemorrhagic diathesis were seen. A careful family study brought 2 additional cases to light: a female second cousin was found to have bilateral absent radius, but no haematological abnormalities when seen at the age of 10. Her younger brother had died at the age of 3 months with severe thrombocytopenia and heavily malformed, flipper-like upper extremities. The broad clinical variation of the syndrome should be kept in mind in genetic studies and counselling.

Abnormalities, Multiple↗
PubMed2006

Extracorporeal shock wave treatment for defective nonunion of the radius: a rabbit model.

PURPOSE: To investigate the effect of extracorporeal shock wave treatment (ESWT) on bony union using volume analysis of the callus mass by computed tomography and histology. METHODS: Both radii of 13 rabbits were osteotomised and a defective bony nonunion created by placing a polyethylene pad between the osteotomy site for 40 days. Nonunion was confirmed by radiography using Lane-Sandhu criteria. ESWT (14 kW, 0.46 mJ/mm(2), 1000 shock waves) was applied to the right radius of the rabbits. The left radius served as a control. Five rabbits were killed 4 weeks after ESWT (group 1) and 8 after 6 weeks (group 2). Volume analysis of the callus mass was performed using computed tomography and the bone healing process was assessed by histology. RESULTS: In group 1, callus volume on the treated side was invariably greater than that on the control side; the difference being statistically significant (p=0.032). In group 2, the callus volume of the treated side was greater than that of the control side, except in rabbits 4 and 9. Only after excluding the findings from the latter did the difference attain statistical significance (p=0.020). Histology confirmed that the bone-healing process was faster in the treated side. CONCLUSION: ESWT enhanced the bone-healing process by increasing both volume and speed of callus formation.

Animals↗
PubMed2001

Calcification of the intervertebral discs and curvature of the radius and ulna: a radiographic survey of Finnish miniature dachshunds.

The vertebral column of 124 randomly selected miniature dachshunds, representing 4.5% of the population registered by the Finnish Kennel Club during the years 1988 to 1996, were radiographed. The front legs were also radiographed in order to evaluate the curvature of the radius and ulna. Calcified discs were found in 75.9% of the longhaired miniature dachshunds and in 86.7% of the wirehaired ones. The occurrence of signs associated with IDD was 16.5% in longhaired and 15.6% in wirehaired miniature dachshunds. The occurrence of signs of IDD in dogs with calcified discs was 20.0% and 17.9% in longhaired and wirehaired miniature dachshunds, respectively. In dogs without calcifications only one dog showed signs of IDD. The curvature of the radius and the ulna did not differ between the dogs with signs of IDD and the healthy ones, or between the dogs with and without intervertebral calcifications. Our results indicate that radiographic eradication based on the presence of intervertebral calcifications is not suitable for breeding purposes for the Finnish miniature dachshund population because the percentage of dogs without calcifications is small.

Animals↗
PubMedDate not supplied

The relationship between adherence to hand therapy and short-term outcome after distal radius fracture.

This study aimed to examine the relationship between adherence to hand therapy and short-term outcome after fracture of the distal radius. Attendance at hand therapy appointments, therapist-rated adherence during appointments, and home-exercise diaries were used to monitor adherence in 15 people undertaking rehabilitation after a wrist fracture. Outcome measures were change in impairment (wrist extension, grip strength, and pain rating) and change in activity (modified Levine questionnaire, Jebsen Test of Hand Function) from initial assessment (after cast removal) to follow-up (six weeks later). Multiple regression analysis found over 50% of variance in wrist extension change, Levine questionnaire change, and change on the simulated feeding item of the Jebsen Test of Hand Function to be predicted by adherence. Home exercise adherence was the most important predictor of the adherence measures. These results highlight the importance of adherence to home exercises prescribed by a hand therapist after fracture of the distal radius.

Aged↗
PubMed1990

Quantitative gamma-ray computed tomography of the radius in normal subjects and osteoporotic patients.

A new design of gamma-ray computed tomography (CT) scanner was used to measure bone density in 516 normal adults and in 116 female patients with osteoporotic fractures. Trabecular bone density (TBD) was measured for a core of the ultradistal radius; cortical bone mass per unit length (MLS) and mass per unit volume (MVS) were computed for the radius shaft. TBD, MLS and MVS peaked at the age of about 40 in females and fell by 32%, 15% and 24%, respectively, by the age of 65. In males, TBD decreased from the third decade and MLS and MVS peaked in the fourth decade. The corresponding falls by 65 years were 20%, 6% and 7%. In patients with Colles' fracture TBD and MLS were reduced by 13% and 10%, respectively, relative to age matched normal female subjects. For patients with vertebral crush fracture the reductions relative to age matched normal females were 36%, 17% and 16% for TBD, MLS and MVS. In fracture patients the deficit in TBD was significantly greater than that for cortical bone but TBD was no better at discriminating normal and osteoporotic individuals because of its larger normal range. We conclude that gamma-ray CT may best be used for monitoring changes in bone rather than as a diagnostic screening tool.

Adult↗
PubMed1998

The posterior interosseous nerve and the posterolateral approach to the proximal radius.

We dissected 21 cadaver elbows to determine the relationship of the posterior interosseous nerve to the posterolateral approach to the elbow and head of the radius. At the distal end of the exposure the first branches at risk, those to extensor carpi ulnaris, were on average 6.0 +/- 1.0 cm (4.0 to 8.4) from the articular surface of the radial head. When using the posterolateral approach it is important that the interval between extensor carpi ulnaris and anconeus is clearly identified with the forearm fully pronated. The supinator should be released close to its ulnar border. It is safe to expose the proximal radius as far as the distal aspect of the bicipital tuberosity.

Adult↗
PubMed1999

Salvage of the head of the radius after fracture-dislocation of the elbow. A case report.

We describe a patient with a Mason type-III fracture of the head of the radius associated with traumatic dislocation of the elbow. The radial head was intact throughout its circumference despite being completely detached from the shaft and devoid of any soft-tissue attachments. Severe comminution of the radial neck prevented reconstruction by internal fixation and precluded prosthetic replacement of the head. The head was fixed to the shaft with a tricortical iliac-crest bone graft which replaced the neck. Two years later, the patient had a stable elbow with flexion from 10 degrees to 130 degrees. Radiologically, the head of the radius appeared to be viable and the bone graft had incorporated.

Bone Transplantation↗
PubMed2000

The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius.

The capacity for physiotherapy to improve the outcome after fracture of the distal radius is unproven. We carried out a randomised controlled trial on 96 patients, comparing conventional physiotherapy with a regime of home exercises. The function of the upper limb was assessed at the time of removal of the plaster cast and at three and six months after injury. Factors which may predict poor outcome in these patients were sought. Grip strength and hand function did not significantly differ between the two groups. Flexion and extension of the wrist were the only movements to improve with physiotherapy at six months (p = 0.001). Predictors of poor functional outcome were malunion and impaired function before the fracture. These patients presented with pain, decreased rotation of the forearm and low functional scores at six weeks. Our study has shown that home exercises are adequate rehabilitation after uncomplicated fracture of the distal radius, and routine referral for a course of physiotherapy should be discouraged. The role of physiotherapy in patients at high risk of a poor outcome requires further investigation.

Aged↗
PubMed2001

Fractures of the neck of the radius in children. Early experience with intramedullary pinning.

The treatment of fractures of the neck of the radius in children is difficult, particularly if the angulation of the fracture exceeds 60 degrees. Since 1994 we have used closed reduction and stabilisation with an intramedullary Kirschner wire in patients with grade-IV fractures according to the classification of Judet et al. In a retrospective analysis of a two-year period (1994 to 1996), 324 children with fractures of the elbow were treated in our department. Of these, 29 (9%) had a fracture of the neck of the radius; six were grade-IV injuries (1.9%). Five of the latter had an excellent postoperative result with normal movement of the elbow and forearm. One patient with a poor result had a concomitant dislocation of the elbow. Our results suggest that closed reduction and intramedullary pinning of grade-IV fractures allows adequate stabilisation while healing occurs.

Bone Nails↗
PubMed2005

Unstable extra-articular fractures of the distal radius: a prospective, randomised study of immobilisation in a cast versus supplementary percutaneous pinning.

We performed a prospective, randomised study on 57 patients older than 60 years of age with unstable, extra-articular fractures of the distal radius to compare the outcome of immobilisation in a cast alone with that using supplementary, percutaneous pinning. Patients treated by percutaneous wires had a statistically significant improvement in dorsal angulation (mean 7 degrees), radial length (mean 3 mm) and radial inclination (mean 3 mm) at one year. However, there was no significant difference in functional outcome in terms of pain, range of movement, grip strength, activities of daily living and the SF-36 score except for an improved range of movement in ulnar deviation in the percutaneous wire group. One patient developed a pin-track infection which required removal of the wires at two weeks. We conclude that percutaneous pinning of unstable, extra-articular fractures of the distal radius provides only a marginal improvement in the radiological parameters compared with immobilisation in a cast alone. This does not correlate with an improved functional outcome in a low-demand, elderly population.

Activities of Daily Living↗
PubMed2005

Displaced fracture of the distal radius in children: factors responsible for redisplacement after closed reduction.

We retrospectively reviewed 183 children with a simple fracture of the distal radius, with or without fracture of the ulna, treated by closed reduction and cast immobilisation. The fracture redisplaced after an initial, acceptable closed reduction in 46 (25%). Complete initial displacement was identified as the most important factor leading to redisplacement. Other contributing factors were the presence of an ipsilateral distal ulnar fracture, and the reduction of completely displaced fractures under deep sedation or local haematoma block. We recommend that completely displaced fractures of the distal radius in children should be reduced under general anaesthesia, and fixed by primary percutaneous Kirschner wires even when a satisfactory closed reduction has been achieved.

Adolescent↗
PubMed2006

Displaced fractures of the neck of the radius in adults. An excellent long-term outcome.

We have reviewed 20 women and three men aged 22 to 73 years, who had sustained a Mason type-IIb fracture of the neck of the radius 14 to 25 years earlier. There were 19 patients with displacement of the fractures of 2 mm to 4 mm, of whom 13 had been subjected to early mobilisation and six had been treated in plaster for one to four weeks. Of four patients with displacement of 4 mm to 8 mm, three had undergone excision and one an open reduction of the head of radius. A total of 21 patients had no subjective complaints at follow-up, but two had slight impairment and occasional elbow pain. The mean range of movement and strength of the elbow were not impaired. The elbows had a higher prevalence of degenerative changes than the opposite side, but no greater reduction of joint space. Mason type-IIb fractures have an excellent long-term outcome if operation is undertaken when the displacement of the fracture exceeds 4 mm.

Adult↗