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At least 1,009 records · Page 56Linked to original sources
PubMed1993

Unstable articular fractures of the distal radius. Comparative techniques of ligamentotaxis.

Ligamentotaxis employing either pins and plaster or external fixators, frequently in conjunction with supplemental Kirschner wire internal fixation, has proved to be a reliable means of maintaining an accurate reduction of unstable articular fractures of the distal radius. Critical preoperative evaluation and surgical restoration of articular congruity along with attention to key technical details have resulted in a reproducible successful recovery. In our experience, the advantages of the pins and plaster technique are its relatively simple methodology, its comparatively low cost, and its high level of patient acceptance. The distinctive advantages of the external fixator are its superior mechanical efficiency, its capacity for fracture adjustment during the healing period, and the fact that it ensures unimpeded access to wounds. Nonetheless, regardless of the specific method chosen, this study clearly supports the contention that precision in patient selection and pin placement are the prerequisites for successful ligamentotaxis in the management of distal radius fractures.

Adolescent↗
PubMed1993

Intrafocal (Kapandji) pinning of unstable fractures of the distal radius.

Intrafocal pinning of distal radius fractures was described first by Kapandji in 1976. The technique has been used widely in Europe but remains relatively unknown in the United States. It is indicated in unstable distal radius fractures without significant intra-articular displacement. This article provides a review of the European experience, a description of the surgical technique, and an analysis of our own clinical series. Intrafocal pinning works best in patients less than 65 years of age, for the fracture patterns described previously. It provides the surgeon with a simple and effective, minimally invasive method of improving alignment and stability of unstable fractures.

Adolescent↗
PubMed1993

Management and rehabilitation of distal radius fractures.

Distal radius fractures require precise medical treatment, therapeutic intervention during fracture immobilization, and specialized rehabilitation thereafter to ensure an optimal functional result. With an understanding of the mechanics of distal radius fractures, surgical intervention, and bone healing, the therapist can modify the therapy program according to the patient's individual needs. The therapeutic process is begun in the crucial stage of bone healing during fracture immobilization. By addressing edema reduction and early range of motion of the uninvolved joints, most problems can be avoided before cast or fixator removal. Rehabilitation following the immobilization period should focus on regaining wrist movements provided that earlier problems have been addressed properly. During the rehabilitative process, the therapist can incorporate scar management, modalities, joint mobilization, active and passive range of motion, splinting, and strengthening to maximize the patient's functional result.

Carpal Tunnel Syndrome↗
PubMed1993

Comminuted fractures of the proximal radius and ulna.

Forty-three comminuted fractures of the proximal radius and ulna in 34 patients were treated with operative stabilization using AO/ASIF techniques. The patients were divided into three groups, according to the type of injury: Group I, isolated comminuted fractures of the olecranon (18 patients); Group II, isolated fractures of the radial head (eight patients); Group III, combined olecranon and radial head fractures (eight patients). All fractures were followed until union. The average follow-up period was 18 months (range, 12-48 months). At the time of this review, the average limits of elbow motion were 20 degrees extension, 118 degrees flexion, 65 degrees pronation, and 62 degrees supination. Two patients were unable to return for follow-up examination. Using the functional classification of Broberg and Morrey, results were rated as excellent in nine cases, good in 15, fair in five, and poor in three. The complication rate in this series was 19%: Two patients developed nonunion, and one patient lost reduction during rehabilitation. All of these patients required reoperation, with eventual satisfactory outcome. Three patients developed heterotopic ossification, two of which were minor and one of which produced ankylosis of the elbow joint. Each of these patients had delayed (more than 72 hours postinjury) stabilization. A functional elbow was achieved in 29 of the 32 patients who returned for follow-up examination. Operative stabilization of comminuted fractures of the proximal radius and ulna provides a stable painless joint with a functional, but not full, range of motion.

Adolescent↗
PubMed1995

[Treatment of radius fractures with a newly developed dynamic external fixator].

Ligamentotaxis first described by Vidal presented the opportunity to treat wrist fractures near to the joint with external fixation. The first published results with this technique were surprisingly successful. As a result, since 1980 the author began, as one of the first in the German speaking regions, to treat radius fractures with the Hoffmann C-series external fixator. With a newly developed dynamic wrist fixator device 4 clinics have treated 104 fractures in a prospective study. These fractures were followed up 6 months later. Using the Lidström classification, the x-ray results were very good and good for 98% and moderate for 2% of treated fractures. Clinically the results were very good and good for 91% and moderate for 2% of treated fractures. Poor results were not recorded. 92% of the patients had a shortening of the radius of less than 2 mm. The sooner motion was initiated, the better the results were during the follow up. All the parameters such as x-ray evaluation, clinical evaluation, pain, strength, and in particular motion were improved when compared to a static fixator or motion after 14 postoperative days. The treatment time with this new dynamic wrist fixator device was reduced by two weeks compared to a static fixator. Cancellous bone grafting was never necessary.

Equipment Design↗
PubMed1996

Redisplaced unstable fractures of the distal radius: a prospective randomised comparison of four methods of treatment.

We performed a prospective, randomised trial on 120 patients with redisplaced fractures of the distal radius comparing four methods of treatment. The four treatment groups, each containing 30 patients, were remanipulation and plaster, open reduction and bone grafting, and closed external fixation with and without mobilisation of the wrist at three weeks. The radiological results showed improvement in angulation of the distal radius for the open reduction and bone grafting group. Functional results at six weeks, three and six months and at one year, however, showed no difference between any of the four groups. The main influence on final outcome was carpal malalignment which had a statistically significant negative effect on function.

Adolescent↗
PubMed1995

[Scaphoid fracture associated with displaced fracture of the distal end of the radius in children. Apropos of a case].

A child of 13 years, victim of a fall on his wrist at dorsal flexion position; he presented a scaphoid fracture associated with a displaced fracture of the distal end of the radius. The radius fracture was reduced under general anesthesia, by external manoeuvre; the consolidation was obtained after 10 weeks of plaster cast immobilization. The follow-up was of two years, with a good clinical and radiological result in spite of a non union of the Ulnar-styloid. It is important to remember this exceptionnel association in children not to forget the scaphoid fracture.

Adolescent↗
PubMed1996

Distal radius fractures: concepts and complications.

Distal radius fractures are one of the most common types of injuries treated by an orthopedic surgeon. The overall results may not be as favorable as once thought. As a distinct subgroup, the young adult deserves special consideration. Management of distal radius fractures in these patients is difficult due to the higher energy involved, amount of comminution, and associated soft tissue damage. Functional outcome has been best when an anatomical reduction has been achieved. Many surgical options are available: external fixation, percutaneous pin fixation and open reduction are the mainstays. The complications may be minimized with careful attention to and knowledge of the techniques used and early intervention when closed treatment fails.

Adult↗
PubMed1996

[Is the static external fixator a suitable method in the treatment of multi-fragmented fractures of the distal radius?].

We present a retrospective study of 21 patients treated with an external fixator for comminuted fractures of the distal radius from May 1993 until May 1994. Mean follow-up was 14.5 months after operation. The 21 patients were on average 59 years old. The distal radius fractures were classified according to the AO: Type A2 (four times), Type A3 (two times), Type C1 (one time), C2 (nine times), C3 (five times). We mounted the external fixator generally in a static way. After two weeks it was dynamized. The fixator was removed after four to at least six weeks. An additional osteosynthesis with Kirschner wires was performed in twenty cases. Three times we added a primary cancellous bone graft, in one case an implantation of Endobone was used.

Aged↗
PubMed1997

Outcome of distal radius fractures using the short form 36 health survey.

The Short Form 36, a survey designed to accurately study subjective findings, was applied to analyze the outcome of distal radius fractures and its' relation to extrinsic and intrinsic factors. The survey was administered to 50 adults (mean age, 49.6 years) requiring fixation of a distal radius fracture with a mean followup of 2.4 years. Treatment included external fixation and pins in 24 patients, buttress plating in 20 patients, pins alone in four patients, and external fixation alone in two patients. The Short Form 36 scores were correlated with components possibly affecting outcome and compared with those of the general population. There was no correlation with residual radial height, radial tilt, or palmar tilt. No differences were observed between treatment or fracture groups. Intraarticular incongruence of 1 mm or greater correlated with a lower Short Form 36 score and with the development of arthrosis. Those injured while working were more than four times less likely to return to work than those injured while away from work. The Short Form 36 was found an effective and precise tool for measuring subjective patient information.

Adolescent↗
PubMed1997

[Treatment of long tubular bone pseudoarthrosis with revascularized cortical layer of radius].

The method of osteogenesis without resection of the false joint was employed in the treatment of long tubular bone pseudarthrosis. The authors used a free revascularized radial flap, including the corticoperiosteal layer of the radius as a source of osteogenesis. A thin corticoperiosteal graft was taken from the distal third of the radius with or without a skin flap, if necessary. The graft was placed into the slotted bed of the false joint and fixed by two screws. Final fixation was made by using an Ilizarov apparatus or a metal plate. The authors used this procedure in the treatment of 12 patients with long tubular bone pseudarthrosis who had undergone at two operations on the false joint or fracture. Eight patients suffered from chronic osteomyelitis. Eleven patients completely recovered at postoperative month 12. Radiographic and scintigraphic investigations showed signs of bed-graft adhesion at month 3 after surgery and those of false joint ossification at month 6 postoperatively.

Adult↗
PubMed1998

Prenatal diagnosis of an uncommon syndrome: thrombocytopenia absent radius (TAR).

The prenatal diagnosis of the thrombocytopenia absent radius (TAR) syndrome using ultrasound and cordocentesis at the 34th week of gestation is established. Two basic components of the syndrome, bilateral absence of radius and thrombocytopenia at a level 12.000/mm3 were detected. No complication during the cordocentesis and delivery occurred due to thrombocytopenia. This case report, to our knowledge, is one of a limited number of cases emphasized on prenatal diagnosis of TAR syndrome in the world.

Chromosome Aberrations↗
PubMed1997

[Guidelines: treatment of distal radius fracture].

The treatment aim is restoration of adequate length of the radius, adjustment of the distal radioulnar joint, alignment of the distal radius joint surface, and prevention of reflex dystrophy syndrome. Stable fractures are treated by close reduction and a cast for 3-4 weeks, depending on bone stock quality. Instable extra-articular fractures are treated by K-wiring using various methods. In case of a comminuted dorsal or palmar area, K-wiring is unstable, so additional fixation is necessary (autogeneous bone graft + external fixator + plate or cast). The external fixator alone or in combination with K-wires is the appropriate fixation method all intra- or extra-articular comminuted fractures. Palmar or dorsal plate osteosynthesis is highly recommended in palmar or dorsal rim fractures (B 3, B 2 type), whereas in C 2 to C 3 fractures additional autogeneous graft and/or K-wires or screws are necessary should be used in combination with autogeneous graft, according to the fracture pattern. Ligament injuries or luxation in the carpal row must be looked for precisely and treated according to the injury pattern.

Bone Transplantation↗
PubMedDate not supplied

Differential lengthening of the radius and ulna using the Ilizarov method.

Three patients with relative length discrepancy between the radius and ulna and with wrist angular deformity are reported. The Ilizarov apparatus was used for correction of the deformity by differential lengthening of the radius and ulna. The total lengthening percentages ranged from 21 to 52%. All patients obtained a good functional result after surgery with full range of motion of fingers and moderate loss of wrist range of motion in two patients. All patients were able to achieve primary bone healing.

Child↗
PubMed1998

A systematic approach to handling the distal radio-ulnar joint in cases of malunited distal radius fractures.

The distal radio-ulnar joint (DRUJ) is often the site of persistent symptoms after malunion of distal radius fractures. These malunions alter load transfer across the ulnocarpal joint, disturb DRUJ kinematics, and result in joint incongruity at the sigmoid notch. Treatment of distal radius malunions must not only correct position of the radial platform and joint incongruity but also restore anatomic relationship at the DRUJ. A systematic approach to the surgical reconstruction of these multiplanar deformities using clinical and radiographic parameters is outlined.

Algorithms↗
PubMed1998

Agenesis of a radius in a polar bear cub (Ursus maritimus).

A polar bear (Ursus maritimus) cub, delivered by a cesarean section, was diagnosed with congenital agenesis of the radius on the basis of clinical presentation and radiology. A specific etiology could not be ascertained. Agenesis of the radius has not been previously reported in any nondomestic species.

Animals↗
PubMed1997

[Repair of bone defect of distal end of radius and its functional restoration].

The treatment of the bone defect of the distal part of the radius included repair of the bone defect and restoration of the function of the wrist joint. Since 1979, three operative methods were used to treat 13 cases, and they were grafting of the vascularized fibula by anastomrsis fibular vessels, grafting of upper part of fibular with lateral inferior genicular artery and grafting vascularized scapula flap. Follow-up had been carried out from 1 to 10 years. The result was satisfactory. The discussion included the repair of the defect of the middle or distal part of the radius, the operative methods, main attentions and indications. It was considered that it should be based on the length of bone defect while the operative method was considered.

Adolescent↗