Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “RADIUS FRACTURES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMed2003

[Radio-radial external fixation in the treatment of distal radius fractures allows for free wrist motion].

INTRODUCTION: Joint bridging external fixation in the treatment of distal radius fractures restores radial length, whereas anatomic reduction of articular fragments is difficult. Immobilisation of the wrist joint is a further disadvantage. An extraarticular hybrid fixation of distal radius fractures was introduced that facilitates fracture reduction, safe retention and allows for free wrist movement. METHODS: 30 consecutive patients with extra- and intraarticular comminuted fractures of the distal radius were treated with an extraarticular radio-radial external fixation employing a modified Ilizarov hybrid fixation technique. The operative procedure is described in detail. A clinical and radiological evaluation was carried out on the first and seventh day as well as 6 weeks postoperatively after implant removal. RESULTS: Anatomic reduction was achieved in 24 cases (80%). On the first postoperative day dorsiflexion was 30%, palmar flexion was 51% and pronation/supination was 60%/70% of the uninjured side. Six weeks postoperatively all fractures united. Wrist motion of the affected side was more than 80% of the unaffected side. Neither extensor tendinitis nor pin loosening in the distal fragment did occur. CONCLUSION: The technique of extraarticular hybrid fixation is safe and reliable in the treatment of comminuted fractures of the distal radius. It allows for early wrist movement in the immediate postoperative period.

Adult↗
PubMed1999

Intra-focal fixation for treating distal radius fracture: results of 104 cases.

Intra-focal fixation for a displaced distal radius fracture is a surgical option that achieves early functional recovery. We report a retrospective evaluation of the results with various types of distal radius fracture, using various fixation materials in 104 patients (69 women and 35 men; average age, 51.4 years; range, 4-91 years). Fracture types classified according to Frykman were: 14 type I, 15 type II, 6 type III, 16 type IV, 10 type V, 16 type VI, 9 type VII, and 18 type VIII. Fixation materials used were: conventional Kirschner wire in 6 patients, threaded Kirschner wire in 38, arum pins in 38, and conehead wedging screws in 22. The results for patients with Frykman types V-VIII fractures were not as good as those for patients with types I-IV. The arum pin and conehead wedging screw were each superior to either Kirschner wire or threaded Kirschner wire in reducing the fracture and in maintaining fixation. Our evaluation suggested that intra-focal fixation was also suitable for treatment of an intra-articular fracture. In elderly patients, we recommend the arum pin and conehead wedging screw as fixation materials, and suggest short-term postoperative immobilization.

Adolescent↗
PubMed2005

The effects of implant composition on extensor tenosynovitis in a canine distal radius fracture model.

PURPOSE: Dorsal plating of distal radius fractures with titanium plates has resulted in clinically observed tenosynovitis and tendon rupture. The goal of this study was to investigate whether titanium-based implants result in more extensor tendon inflammation than matched stainless-steel implants in a canine fracture model. METHODS: An osteotomy was created in the distal radius of 18 beagles and fixed with 2.7-mm 4-hole plates composed of commercially pure titanium, titanium alloy (Ti-Al6-V4), or 316L stainless steel. Animals were killed at an average of 4 months. Tendon gliding was assessed by applying a force at the extensor musculotendinous junction and noting gliding. Histologic grading (mild, moderate, severe) was based on cellular hypertrophy, hyperplasia, and leukocytic infiltration. RESULTS: Tendons glided freely in 100% stainless-steel specimens, 75% of titanium alloy, and 43% of commercially pure titanium groups. A severe inflammatory reaction was identified in 60% of the titanium alloy (Ti-A16-V4) group, 57% of the pure titanium group, and 0% of the stainless-steel group. CONCLUSIONS: Dorsal plating of the canine radius with commercially pure titanium or titanium alloy implants produced a greater inflammatory peritendinous response than matched stainless-steel implants.

Alloys↗
PubMed2006

A biomechanic comparison of an internal radiocarpal-spanning 2.4-mm locking plate and external fixation in a model of distal radius fractures.

PURPOSE: To compare the biomechanic stability of distal radius fracture fixation with a new internal radiocarpal-spanning 2.4-mm locking plate, which acts as an internal distal radius fixator, versus a standard distal radius external fixator. The number of locking screws necessary for adequate fracture fixation was also assessed. METHODS: Ten cadaveric specimens were mounted in a loading fixture with cables attached to the 2 flexor and 3 extensor wrist tendons. A 1-cm osteotomy was created to simulate an unstable distal radius fracture. The radiocarpal-spanning locking plate was fixed to the radius and index metacarpal with 4 screws proximally and 4 distally. The specimen was incrementally loaded through the tendons. Motion at the fracture site was determined. Screws were sequentially removed from the construct, the specimen was again incrementally loaded, and fracture motion was measured. The fixation was then changed to an external fixator, and the loading tests were repeated. RESULTS: Fracture fixation with the radiocarpal-spanning 2.4-mm locking plate was significantly more stable with 4 screws proximally and 4 screws distally (4 x 4) and with the 3 x 3 configuration than with the external fixator in both flexion and extension. The 4 x 4 screw configuration was not significantly different from the 3 x 3 screw configuration. The 4 x 4 screw configuration was significantly more stable than the 2 x 2 and 1 x 1 screw configurations in both flexion and extension. All internal fixator configurations and the external fixator showed more fracture displacement at increasingly higher loads. CONCLUSIONS: Fracture fixation with the new internal radiocarpal-spanning 2.4-mm locking plate is more stable than with a standard distal radius external fixator. Only three 2.4-mm locking screws proximally and three 2.4-mm locking screws distally are required for adequate fixation of the locking spanning plate.

Aged↗
PubMed1993

[Early results of treatment of distal radius fracture using the Kapandji technique].

The early results of treatment of the distal radius fracture with Kapandji method in 50 patients are presented. K wire fixation of the distal fragment prevents redisplacement and enables early rehabilitation. Anatomical and functional criteria as well as the type of fracture were included in results assessment. The method proved to be useful in the treatment. The method proved to be useful in the treatment of selected types of the distal radius fracture: A2, A3, B1, B2 and C1 (AO classification).

Aged↗
PubMed2007

Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment.

PURPOSE: Outcomes study of distal radius fracture (DRF) treatment has been hampered by an uncertainty regarding the most appropriate outcomes assessment tool to evaluate the effectiveness of treatment. This study aimed to measure the responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) and physical measurements to assess the value of these outcomes tools for DRF studies. METHODS: Forty-seven patients prospectively completed the MHQ and physical testing at 3 months and 6 months (period 1) after open reduction and internal fixation of unstable DRFs. Thirty-seven patients prospectively completed the MHQ and physical testing at 6 months and 1 year after open reduction and internal fixation (period 2). Responsiveness to clinical change within each period was calculated with standardized response means (SRMs). RESULTS: In period 1, all domains of the MHQ except aesthetics significantly improved. The SRMs were large for the overall score and for the work domain. The SRMs were medium for the pain, function, and activities of daily living domains. In period 1, the grip strength, pinch strength, and active wrist range of motion measurements significantly improved and had large SRMs. In period 2, the grip- and pinch-strength tests significantly improved and the SRMs were medium, whereas the active wrist range of motion had a small SRM. CONCLUSIONS: Unlike other conditions such as carpal tunnel syndrome, for which the outcomes questionnaire is the most responsive measure, in DRF treatment both the MHQ and physical tests are responsive in measuring outcomes and should be reported for outcomes studies of DRFs. The MHQ and physical tests can be used for outcomes research related to DRF with the advantage of also being useful for assessing and comparing outcomes for other hand disorders.

Activities of Daily Living↗
PubMedDate not supplied

Distal radius fracture in adults: self-reported physical functioning, role functioning, and meaning of injury.

PURPOSE: To identify physical function, role function, and meaning of injury in adults with a distal radius fracture. SAMPLE: Convenience sample of 60 adults with an isolated distal radius fracture. METHOD: Repeated measures of analysis of variance were used to test the relationship of gender, age, education, hand dominance, preinjury physical health, and treatment modality to physical function, role function, and meaning of illness/injury. The independent variable is time and the dependent variables are physical function, role function, and meaning of illness/injury. FINDINGS: Although improvement occurred with time, older adults had significantly lower physical functioning than younger adults while their wrist was immobilized, and middle-age adults had significantly lower role functioning compared to younger and older adults. Physical function was influenced by age, and role function was influenced by both age and education. CONCLUSION: The identified need for additional guidance and physical and emotional support with the standard treatment of distal radius fractures highlights the need for nursing care during the early recovery period.

Activities of Daily Living↗
PubMed1989

[Distal radius fracture. Fracture stabilization with biodegradable osteosynthesis pins (Biofix). Experimental studies and initial clinical experiences].

K-wire stabilization and casting of unstable or intraarticular fractures of the distal radius has proven to be an effective method of treatment since many years. However the need of implant removal after fracture healing is a disadvantage of this method. For this reason we investigated on the use of biodegradable implants in a fracture model of the distal radius. The biomechanical testing with Polydioxanon-(PDS)-pins (Ethipin) showed too small primary stability for the use in vivo. Osteosyntheses with three Polyglycolacid-(PGA)-rods Biofix compared with three K-wires 1.6 mm on the other hand showed 82% initial stability. From May to September 1988 typical distal radius fractures in 11 patients have been stabilized with Biofix-rods. The result of primary reduction could be obtained in all cases. These first experiences suggested, that stabilization of distal radius fractures with Biofix-rods might alternatively be performed instead of K-wire pinning.

Adult↗
PubMed1997

Fixation of complex elbow fractures, Part II. Proximal ulna and radius fractures.

Complex fractures of the elbow often include significant injury to the proximal ulna and/or proximal radius. Such injuries are often combined with injury to the periarticular soft tissues. Appropriate treatment is dependent on accurate diagnosis, definitive treatment of both the skeletal and ligamentous components of injury, and initiation of rehabilitation programs the stress early motion.

Fracture Fixation↗
PubMed2001

Five-pin external fixation and early range of motion for distal radius fractures.

One of the continuing dilemmas in the treatment of distal radius fractures is how best to reduce residual dorsal angulation and impacted articular fragments. Although external fixation devices may maintain radial length, individual fracture fragments may still heal in a displaced or angulated position. The addition of a dorsal pin in combination with an external fixation device can easily correct the dorsal tilt found in many fractures of the distal radius. Although not necessary in all fractures, this additional pin helped with reduction of those fractures that would not improve with traction and with maintenance of reduction.

Biomechanical Phenomena↗
PubMed1989

Radius fracture after total wrist arthroplasty.

Four cases of radius fracture are presented; each was caused by a fall and happened at least 18 months after total wrist arthroplasty. One patient had bilateral fractures occurring 12 months apart. All injuries were initially treated nonoperatively. Nonunion or healing with deformity occurred in three fractures. Revision arthroplasty was done in two cases with satisfactory results, and is being considered for a third.

Accidental Falls↗
PubMed2005

A randomised clinical trial of activity-focussed physiotherapy on patients with distal radius fractures.

INTRODUCTION: Physiotherapy is considered by some authorities to be an important aspect of management in patients following distal radius fractures. There is evidence of improvement in impairment with physiotherapy; however, there is no evidence to support early return of functional activity. Traditional physiotherapy management has focussed on improving impairment; however, there are no trials with emphasis on skill acquisition via motor re-learning principles. MATERIALS AND METHODS: Forty-one participants with conservatively managed distal radius fractures were studied in a randomised, single-blinded, prospective trial. Two treatment options were compared: exercise and advice versus activity-focussed physiotherapy with measurement periods of 6 weeks after removal of cast and follow-up at 24 weeks. RESULTS: Participants allocated to the exercise and advice group consulted a physiotherapist an average of 0.9 (SD 0.4) times, while the participants allocated to the more intensive activity-focussed group consulted with physiotherapy a mean of 4.4 (SD 2.3) times. At both 6 and 24 weeks there were no significant differences between the groups for change in impairment (as measured by grip strength, range of motion of wrist flexion and extension and pain intensity), activity limitation and participation restriction, as measured by the Patient-Rated Wrist Evaluation (PRWE). Exercise and advice given by a physiotherapist were equally as effective as activity-focussed physiotherapy in recovery both at 6 and 24 weeks. CONCLUSION: The results suggest that after removal of cast from fracture of distal radius, patients may routinely require no more than a single session of advice and exercise provided by a physiotherapist.

Activities of Daily Living↗
PubMed2002

The effects of dorsally angulated distal radius fractures on carpal kinematics.

A cadaver model was used in a biomechanical study of dorsally angulated distal radius fractures to evaluate alterations in carpal kinematics. Distal radius fractures were simulated by dorsal closing-wedge osteotomy and fixed with a custom-designed external fixator. A magnetic tracking device measured the carpal bone motions in several positions of dorsal angulation from neutral tilt to 30 degrees dorsal tilt. Changes in carpal alignment showed different patterns between each specimen consisting of a spectrum from dorsal subluxation of the entire carpus to adaptive dorsal carpal instability (DISI deformity). Components of carpal bone motion were altered markedly at all positions of dorsal angulation of the distal radius. The severity of the DISI deformity and related carpal instability correlated well with the alterations of carpal kinematics during wrist flexion and extension, whereas dorsal subluxation alone had a poor relationship with changes in carpal kinematics. The amount of DISI deformity and the degree of dorsal angulation of the radius may be prognostic factors when considering whether to perform a corrective osteotomy of the distal radius.

Aged↗
PubMed2005

Internal distraction plating of distal radius fractures.

Internal distraction plating can be used for the treatment of highly comminuted distal radius fractures especially in elderly patients. The technique involves the use of 3.5, 2.7, or 2.5 dynamic compression plates. The instrumentation is applied in distraction dorsally from the radial diaphysis, bypassing the comminuted segment, and fixed distally to the long metacarpal. The advantages of this technique are: a) it can be used as an alternative for managing difficult fractures in the elderly population; b) it is indicated in patients with osteoporotic bone; c) complications associated with external pins are avoided; and d) the stability of the plate allows patients to use the extremity for transfer and activities of daily living. On the other hand, possible disadvantages to be considered are: a) the need of a second operation to remove the plate; and b) the prolonged duration of immobilization. Elderly patients with osteoporotic bone who undergo treatment of comminuted distal radius fractures may result in poor outcomes with high rates of complications if external fixation or standard internal fixation is used. The current approach represents an alternative that provides union of the fracture with excellent alignment, functional range of motion, and minimal functional disability.

Bone Plates↗
PubMed2006

Pediatric distal radius fractures and triangular fibrocartilage complex injuries.

Management of distal radius fractures is guided by the pattern and location of injury, degree of deformity, and expectations of bony remodeling based on the amount of remaining skeletal growth.Indications for surgical treatment include unstable or irreducible fractures, open fractures, floating elbow injuries, and neurovascular or soft-tissue compromise precluding cast immobilization. Patients and families should be counseled regarding the potential for post-traumatic distal radial growth arrest following physeal fractures. In these cases, epiphysiodeses, ulnar shortening osteotomies, or corrective radial osteotomies may be performed, depending on the pattern of arrest,degree of deformity, and remaining skeletal growth.TFCC tears may be the source of ulnar-sided wrist pain in children and adolescents, though symptoms and physical examination findings maybe subtle. Patients who have persistent pain and functional limitations despite activity modification and therapy are candidates for surgical treatment. Appropriate repair of peripheral TFCC tears with correction of concomitant wrist pathology restores normal wrist anatomy, alleviates pain, and allows for return to functional activities.

Arthroscopy↗
PubMedDate not supplied

Results of acute arthroscopically repaired triangular fibrocartilage complex injuries associated with intra-articular distal radius fractures.

PURPOSE: This study reviews the results of acute repair of peripheral ulnar-sided triangular fibrocartilage complex (TFCC) detachment associated with intra-articular distal radius fractures. TYPE OF STUDY: Two-year follow-up of patients who had undergone acute TFCC repair. METHODS: Fifty-six patients underwent arthroscopically assisted treatment of intra-articular distal radius fractures using external fixation and adjunctive percutaneous pinning between 1994 and 1998. Thirteen patients with an acute, complete tear of the ulnar attachment of the TFCC were treated using arthroscopic repair of the TFCC in addition to stabilization of the radius fracture. All patients were evaluated at a mean of 24 months (range, 17 to 35 months) with a physical examination, wrist radiographs, and a Disability of Arm, Shoulder, and Hand (DASH) module outcome assessment questionnaire. RESULTS: Average wrist flexion, extension, pronation, and supination were 67.3, 61.8, 79.1, and 86.8, respectively. The average grip strength was 78% of the uninjured side. The results of the Gartland and Werley grading system were good to excellent in 12 patients and fair in 1 patient. The DASH outcome scores revealed a mean functional score of 13 and a mean athletic score of 12. None of the patients reported ulnar-sided pain at follow-up. CONCLUSIONS: Arthroscopically assisted TFCC repair in conjunction with distal radius fixation resulted in a high degree of patient satisfaction and good to excellent clinical outcomes.

Adolescent↗
PubMed2006

Anatomy of the distal brachioradialis and its potential relationship to distal radius fracture.

PURPOSE: To describe the anatomy of the brachioradialis (BR), paying special attention to its insertion in relation to the surrounding structures in cadavers and evaluating and correlating this information with a distal radius fracture pattern in a clinical population. METHODS: Eighteen fresh-frozen cadaver arms were dissected to observe the gross anatomy of the BR. The dimensions of the insertion were measured using a caliper and a 3-dimensional digitizer. The radiographs of 34 patients with 35 distal radius fractures were reviewed and the fracture pattern was compared with the normalized location of the BR insertion based on the cadaver measurements. RESULTS: On average the BR tendon inserted onto the proximal base of the first dorsal compartment 17 mm from the radial styloid tip and extended 15 mm proximally; the insertion was 11 mm wide. The BR insertion was bordered consistently by both septa of the first dorsal compartment, forming a tunnel-like structure of thick fibrous tissue on the radial aspect of the distal radius. The whole length of the tendon attached firmly to the underlying antebrachial fascia, which limited excursion. In 18 of the fractures the fracture line deviated from transverse to proximal at the radial side, forming a radial beak. The proximal tip of the beak correlated with the expected location of the proximal end of the BR tendon insertion. CONCLUSIONS: The BR distal tendon insertion is a consistent, distinct insertion at the base of the first dorsal compartment, which correlates with the radial-beak fracture pattern in approximately 50% of distal radius fractures. Cutting the BR tendon disconnects the distal fragment from the BR muscle and the forearm fascia, which may facilitate reduction of the distal radial fragments during open reduction of the distal radius fracture.

Adult↗