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At least 937 records · Page 52Linked to original sources
PubMed1991

[Value of plate osteosynthesis in treatment of radius fractures at a typical site].

In the past, distal radius fractures tended to be treated conservatively. Recently, however, unsatisfactory anatomical and functional results have led to an increase in their surgical treatment. Our preferred method of treatment has been percutaneous pin fixation after closed reduction. In our opinion, open reduction and internal fixation with an A0-plate is indicated for Smith fractures (B3 A0-classification), and for any fractures which cannot be ideally reduced (usually C1 to C3 fractures). From 1972 until 1989, 84 patients with distal radius fractures underwent surgical treatment in the Unfallkrankenhaus Salzburg. The procedure was usually performed under brachial plexus or Bier block, and we preferred a palmarly positioned plate for internal fixation. Follow-up of 42 patients showed good results, the functional and subjective results earning higher marks than the X-ray findings.

Adult↗
PubMed1991

[Comparative study of the treatment of fractures of the head of the radius by resection or by Swanson's silastic implant].

The authors report 62 fractures of the head of the radius treated either by excision or silastic implant arthroplasty. Fifty-two patients were reviewed with a mean follow-up period of 5 years (range 1 to 13). Of 22 prosthetic replacements, 12 were satisfactory while of 30 excisions only 10 were rated good or excellent. Excision usually yielded valgus deformity of the elbow (range 9 to 35 degrees) and with a risk of shortening of the radius. Range of flexion-extension was identical after both procedures but pronation supination was better after prosthesis replacement (78/70) than after radial head excision (65/60) 3 fractures of the implant were found at 6, 9 and 10 years postoperatively; only one of them was associated with pain and required removal of the loose fragments.

Adolescent↗
PubMed1991

[Elbow dislocation with fracture of the coronoid process and comminuted fracture of the radius head].

In fractures of the elbow with an associated fracture of the coronoid process, the size of the coronoid fragment determines the stability of the joint. A diminution of the arch of the incisura semilunaris by about 30 degrees causes instability of the elbow. We present an alternative way of treating the special case of a fracture of the coronoid process combined with comminuted fracture of the proximal end of the radius. A suitable fragment of the head of the radius is used to reconstruct the coronoid process. The stability achieved allows early functional postoperative treatment with a good range of movement at the elbow joint.

Aged↗
PubMed1991

[Fractures of the distal radius. Guidelines for treatment].

Fractures in the distal part of the radius are a common injury in the elderly and in an increasing number of young patients as well. In order to obtain optimal function it is essential, in older and younger patients alike, to secure anatomic length of the radius and anatomic congruency of the joint. Fractures with a tendency to secondary dislocation after primary good reduction should be recognized. Rereduction and fixation with percutaneous K-wires secure the position of the fracture. In some patients primary pinning or primary treatment with an external fixator should be considered, depending on the type of fracture. Guidelines are outlined for the treatment of this very frequent fracture.

Colles' Fracture↗
PubMed1990

[Dynamic treatment of para-articular wrist and articular radius fractures with a new kind of dynamic fixation].

During a period of almost ten years with 280 cases, experience has been gathered in connection with the immobilisation of radius fractures, in the vicinity of the wrist, by means of the fixateur externe. The good x-ray and functional results, overshadowed by the long physiotherapy later, have always aroused the wish for early mobilisation coincidal with the fixateur. The hither to wellknown movable fixateur such as that from Cleyburn have the disadvantage that the mounting of the apparatus can first be carried out after the reduction of the radius-fracture. Jonsson suggested a movable fixateur, that could be attached to the well-known Midifixateur of Hoffmann. In collaboration with the Howmedica company, we further developed this apparatus so that the wrist could remain active even under the necessary traction. The first six patients treated with this type of apparatus stood out from the rest, after removal of the fixateur, due to the instant and satisfactory mobility of the wrist. Needless to say, by using this movable apparatus, the lengths of treatment and line off work can be drastically reduced to a minimum. The movable fixateur will be on the market and obtainable in the near future.

Aged↗
PubMed1990

[Insertion of a radius head prosthesis in the management of fresh injuries].

Authors report on experiences in using radius head prosthesis on the basis of early follow-ups. The operation is performed in cases of closed, comminuted fractures of the radial head if the fracture is irreponable on the basis of X-ray and intraoperative findings. Controls until now have shown excellent functional results. Based on literary data they describe the possibilities of late complications after using silicone prosthesis. The number of patients and the short time elapsed after operations does not allow far-reaching conclusions yet. A description of the use of radius head prosthesis in traumatology was not found in the Hungarian literature.

Fractures, Open↗
PubMed1990

[Treatment of distal radius fracture. Surgical technique: bore wire osteosynthesis].

The Kirschner wire fixation is mainly indicated in unstable types of Colles' and children's fractures of the distal radius. Out of 2760 distal radius fractures (1975-1989) 626 (20.7%) were treated operatively including 326 (11.8%) with K-wires. Primary operation was performed in 53.5% immediately after trauma. Exposing the sensitive radial nerval paths, 3-4 K-wires were inserted from the radial and the dorsoulnar aspect. The K-wire ends were covered subcutaneously. The clinical evaluation of a series of 226 patients according to the score of Lidström presented 79% excellent and good, 16% fair and 5% poor results. The clinical results correlate to the radiocarpal angle and radial shortening. Because of additional injuries to the ulnar complex give worse results in reposition, the ulnar styloid should be fixed.

Bone Plates↗
PubMed1990

[Treatment of distal radius fracture with plate osteosynthesis].

The indications for osteosynthesis of distal radius fractures with a T-plate have been precisely defined. They include Smith's fractures, Barton's fractures, reversed Barton's fractures and the fracture types A3, C1 and C2 according to the A0 classification. The surgical approach is dorsal for the extension type fractures and palmar for those of the flexion type A. Correct diagnosis and accurate operative technique make it possible to achieve favourable results in the treatment of these often compound fractures. Results are presented for 105 patients who underwent osteosynthesis of distal radius fractures with a T-plate.

Bone Plates↗
PubMed1990

[Pediatric fractures of the distal radius].

Fractures near the wrist account 3/4 of all forearm fractures. In most cases both of the forearm bones are fractured. A distal fracture of the radius, comparable to the radius fracture in loco typic of adults, does not occur in children for several reasons. Treatment with preliminary extension has shown benefits only in those cases, in which both forearm bones were fractured. Axis deviation of more than 10 degrees and an ad latus dislocation of more than 1/4 of the bone diameter must not be tolerated. The importance of the distal radioulnar joint as well as possible scar formation of the membrana interossea must be stressed. More than 80% of forearm fractures can be treated conservatively with good results. The other 16.5% must be treated operatively. The applied procedures also yield good and very good results in more than 90% of the cases.

Child↗
PubMed1990

[Treatment of distal radius fracture--diagnosis and therapy of local concomitant injuries].

In a high percentage the accompanying local injuries in Colles' type fractures of the distal radius are related to lesions of the triangular fibrocartilage complex (TFCC) and the distal radioulnar joint (DRUG). Frequency and importance of these local injuries concerning the long-term result after distal radius fractures are described and diagnostic and therapeutical proceedings are presented.

Fracture Fixation, Internal↗
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↗
PubMed1991

Reduction of treatment-related complications in the external fixation of complex distal radius fractures.

Treatment-related complications in the external fixation of complex distal radius fractures may be diminished by the insertion of 4-mm, self-tapping half-pins after predrilling. The pins are placed proximally in the radius and distally through six cortices of the second and third metacarpals. An adaptable fixation device that allows reduction after pin insertion and assembly is recommended. It must allow enough mobility to completely reduce a very unstable fracture after its application. A limited open surgical approach allows direct visualization of the bone where the fixator pins will be placed, as well as central insertion of the pins. It avoids eccentric drill placement, open section defects, redrilling, and damage to soft-tissue structures.

Biomechanical Phenomena↗
PubMed1991

[Results of distraction by way of external metacarporadial fixation in fracture of the distal end of the radius. Apropos of 97 cases].

104 fractures cases were treated over 5 years using this method, which is reserved for the most critical cases (less than one fourth the total number of fractures of the distal end of the radius); 97 of those were reviewed by an impartial observer. The technique consists in distractive reduction, maintained by a small external holding device interconnecting two pins inside the radius and two pins in the 2nd metacarpal bone. Usually, the device is removed after 45 days. Subjective results were rated "very good" in 62.8% of cases, while post-mobilization, radiological and overall findings rated likewise in 61.8%, 40.2% and 63.9% of cases, respectively. Half the patients presented secondary displacement, which although usually minimal, did necessitate in 6 cases a new reduction (using the same device). Algodystrophy occurred in 17 cases and constituted the main source of complications. It increased in frequency proportionally to the degree of distraction applied. At long term, important finger stiffness persisted only in 3 cases. Thus, the quality of results obtained makes external fixator distraction a choice therapeutic method in hard-to-manage fractures.

Follow-Up Studies↗
PubMed1991

Modified transfixation pinning of compound radius and ulna fracture in a heifer.

A 405-kg heifer sustained a compound fracture of the distal portion of the radius and ulna after being hit by a car. The fracture was thoroughly debrided, lavaged, and reduced with the heifer under general anesthesia. The fracture was immobilized with a modified walking cast, using 2 fully threaded 6.4-mm (outside diameter) Steinmann pins placed through the proximal portion of the radius. The pins were incorporated into a full-limb fiberglass cast, and a 0.5-cm X 2.25-cm aluminum walking bar was positioned medially and laterally on the limb. The modified walking cast was removed after 7 weeks, and the fracture healed without complication. The transfixation pins and aluminum walking bar helped reduce the strong compressive and rotational forces at the fracture site. The modified walking cast can potentially be used for fixation of a variety of fractures in large animals.

Animals↗
PubMed1991

[Hypersupination dislocation of the distal radio-ulnar joint after distal radius fracture].

Following an intraarticular distal radius fracture of the scaphoid, scapholunate dissociation and fracture of the ulnar styloid process without dislocation, the distal radius fracture healed with rotational deformity. In the course of conservative treatment, a dislocation of the distal radioulnar joint in locked hypersupination developed. Due to the locked rotational deformity, standard X-rays were difficult to assess. Only with the help of a CAT-scan, were the authors able to visualize the distal radioulnar joint dislocation and later control the postoperative result.

Adult↗
PubMedDate not supplied

Pseudarthrosis of the radius associated with neurofibromatosis: report of a case and review of the literature.

An 11-year-old child with pseudarthrosis of the radius associated with neurofibromatosis was treated by conventional bone graft. Five years after the operation, the pseudarthrosis united, but the grafted bone was slightly sclerotic and bowed. This article describes the clinical findings and postoperative results, and discusses the current surgical approaches in the treatment of pseudarthrosis of the radius.

Bone Transplantation↗
PubMed1989

[Intra-articular fracture of the distal radius: results following osteosynthesis with a support plate].

The treatment of comminuted intra-articular fractures of the distal radius often requires an operative fixation. Beside the recently recommended external fixator, the support plate fixation offers a helpful alternative to treatment. Between 1980 and 1986, 30 wrists in 29 patients with intra-articular fractures of the distal radius were stabilized with a buttress plate an the Kantonsspital Chur, Switzerland. The mean follow-up-time was 15 months. These follow-ups showed that the buttress plate in treatment of complicated intra-articular fractures allows a satisfactory reduction and stabilization with restoration of the articular congruity and the possibility for early active assisted motion. Buttress plate fixation still remains a demanding technique, which in complicated cases, should be reserved for the experienced surgeon.

Adult↗
PubMed1989

[Concomitant carpal injuries in radius fractures. Nature and incidence, analysis of the last 10 years].

Carpal involvement was detected in 47 cases amongst 2828 radius fractures in the last ten years at the St. Gallen Cantonal Hospital. A radiological correlate of this carpal involvement was found retrospectively in 18 cases. The number is likely to be very much higher with increased attention to this injury! The significance of exact diagnosis is underscored by the observation that the concomitant carpal lesion predominates in the further course and determines the fate of the wrist a long time after the radius fracture has healed up.

Carpal Bones↗