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At least 595 records · Page 33Linked to original sources
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↗
PubMed1998

[Distal, metaphyseal compression fractures of the radius. Results of open reposition, stable defect replacement with cortico-cancellous iliac crest bone and plate osteosynthesis].

Conservative treated distal radius fractures with extended metaphyseal void and missing cortical support resulted in loss of reduction. From 1988 till 1994 117 fractures of the distal radius were treated by open reduction, filling the metaphyseal void with a corticocancellous iliac bone graft and plate fixation. In this retrospective study results after surgical reconstruction were evaluated radiologically and clinically and were discussed to conservative treatment. 30 patients suffering from extraarticular metaphyseal distal radius fracture were evaluated after a mean of 42 months (minimum 20, maximum 68 months) after surgery. Ulnar variance was restored in 70% to the uninvolved side. Ulnar minus variance up to 2 mm persisted in 30%. Radial joint angles were restored to normal in 53%. In 40% of the patients a loss of reduction up to 10 degrees and in 7% up to 25 degrees occured. Active range of motion in the sagittal and frontal plane was equivalent to the non involved side in 30%. 70% of the patients showed reduced range of motion up to 20%. Rotation was unlimited in 77%, reduced up to 10% in 23%. Subjective results were excellent in 90%, good in 10%. Compared to conservative therapie, surgery showed superior results.

Adolescent↗
PubMed1984

Articular fractures of the distal radius.

Fractures of the distal radius are frequently biarticular injuries and comprise four basic components. Displacement of the key medial fragments and their strong ligamentous attachments (termed the medial complex) is the basis for a useful classification into four fracture types. Optimal management requires precise correlation of articular disruption and prompt recognition and repair of any concomitant soft tissue or skeletal injury.

Colles' Fracture↗
PubMed1988

Open reduction and internal fixation of volar lip fractures of the distal radius.

Fractures of the volar lip of the distal radius are relatively uncommon injuries. However, controversy exists concerning the treatment of these fractures. We reviewed our experience with open reduction and internal fixation through a volar approach using buttress plates. Sixteen patients with 17 fractures were treated by this method. Their ages ranged from 16 to 65 years (average 38 years). Eight fractures occurred secondary to motor vehicle accidents, while the remaining patients sustained falls. Mean follow-up time was 19.5 months. All fractures healed with no infections. Sixteen of the fractures were treated primarily with open reduction and internal fixation, while one patient was treated 6 weeks after injury for a malunion. Ranges of motion averaged 71 degrees dorsiflexion, 60 degrees palmar flexion, 79 degrees pronation, 78 degrees supination, 22 degrees radial deviation, and 32 degrees ulnar deviation. Analysis of results demonstrated 12 excellent, 2 good, and 3 fair results. Two patients with fair results had nonanatomic restoration of the joint surface at surgery, while the other patient with a fair result was treated late. We recommend early open reduction and internal fixation of displaced or unstable volar lip fractures of the distal radius. Accurate anatomic alignment and stable fixation are achieved with the volar buttress plate. Motion can begin 2-3 days after surgery to aid in obtaining excellent functional results.

Adult↗
PubMedDate not supplied

A comparison of immediate postreduction splinting constructs for controlling initial displacement of fractures of the distal radius: a prospective randomized study of long-arm versus short-arm splinting.

PURPOSE: To compare, in a prospective, randomized manner, the sugar tong splint with a short-arm radial gutter splint in terms of patient satisfaction and the ability to maintain reduction of distal radius fractures. METHODS: A total of 118 patients with displaced distal radius fractures were enrolled; 85 patients (85 fractures) were available for follow-up evaluation and were included in the study population. There were 26 men and 59 women with a mean age of 64 years. Thirty-eight fractures were immobilized in a short-arm radial gutter splint and 47 in a sugar tong splint. Forty fractures had a stable pattern and 45 had an unstable fracture pattern. The initial patient follow-up examination occurred a mean of 8 days after splint application. RESULTS: A total of 33 fractures showed loss of fracture reduction at the initial follow-up evaluation. Sixteen of 38 fractures immobilized with the radial gutter splint displaced, whereas displacement was seen in 17 of 47 fractures immobilized with a sugar tong splint; this difference was not significant. When the splint constructs were evaluated based on fracture stability no differences were found between the splints' ability to maintain fracture reduction in both stable and unstable displaced fractures. Patients in the short-arm radial gutter splint group had significantly better Disabilities of the Arm, Shoulder, and Hand scores than those patients whose fractures were immobilized with a sugar tong splint. CONCLUSIONS: Both the sugar tong splint and the short-arm radial gutter splint had comparable performance in maintaining the initial reduction of distal radius fractures, with the short-arm splint tolerated better by patients. Based on our study we recommend the use of a short-arm radial gutter splint for initial immobilization of displaced distal radius fractures. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic, level II.

Adult↗
PubMed1996

[Fractures of the distal radius with dorsal displacement: a comparative study of the predictive value of 6 classifications].

PURPOSE OF THE STUDY: The authors compare six classifications in a prospective study of distal radius fractures surgical treatment. Classifications included Castaing's, Frykman's, Gartland's, Older's, Lindström's and Jenkins'. MATERIAL: 96 patients presenting a distal radius fracture were included in a protocol comparing two surgical treatments. 42 were treated with styloid pinning and immobilization while 54 with intra-focal pinning and immediate mobilization according to Kapandji's technique. METHODS: Each patient was graded initially according to each six classifications. Patients were reviewed at 6 weeks, 3, 6, 12, and 24 months. Clinical and radiographical evaluation were performed. Clinical and radiological results were compared according to each group of classification. RESULTS: None of the six classifications appeared to have any utility to predict functional or radiological results. None was able to distinguish treatment option. DISCUSSION: The six classifications did not permit to predict clinical or radiological outcome of distal radius fractures treated by radial styloid pinning or Kapandji's technique. All those classifications have been described for conservative treatment rarely performed in France for displaced fractures. CONCLUSION: The six classifications tested showed no predictive value in K-wire treatment of dorsally displaced distal radius fractures.

Adolescent↗
PubMed2005

Pisiform bone fracture-dislocation and distal radius physeal fracture in two children.

We report two children with a Salter-Harris type 1 and 2 distal radius physeal fracture associated with a fracture-dislocation of the pisiform bone. The two patients were treated with closed reduction of both the distal radius and dislocated pisiform under general anaesthesia. Then a long-arm cast was applied for 30 days resulting in full healing of the fractures. The patients were re-evaluated after 30 years, and the wrists did not show any functional impairments. On radiographic evaluations, there were no signs of osteoarthritis or misalignment between the pisiform and the triquetral, in contrast to what has been reported in adult carpal fractures.

Adolescent↗
PubMed2006

Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius.

PURPOSE: Despite the recent popularity of volar plating for dorsally displaced distal radius fractures there is a paucity of data documenting the results of this treatment method. The purpose of this study was to determine the functional outcome of patients treated with volar fixed-angle plating for dorsally displaced, unstable distal radius fractures. METHODS: We reviewed the records of all patients treated at our institution with internal fixation using volar plates for dorsally displaced, comminuted distal radius fractures. Patients with follow-up periods shorter than 12 months were excluded from the study. Outcomes were evaluated at the latest follow-up examination with the Disabilities of the Arm, Shoulder, and Hand and the Gartland and Werley scoring systems. RESULTS: We studied 41 patients with a mean age of 53 years. The average follow-up period was 17 months. All fractures were stabilized with volar locking plates. Radiographs in the immediate postoperative period showed a mean radial height of 11 mm, mean radial inclination of 21 degrees , and mean volar tilt of 4 degrees. At fracture healing the mean radial height was 11 mm, mean radial inclination was 21 degrees, and mean volar tilt was 5 degrees. The average score on the Disabilities of the Arm, Shoulder, and Hand questionnaire was 14 and all patients achieved excellent and good results on the Gartland and Werley scoring system, indicating minimal impairment in activities of daily living. Nine patients experienced postoperative complications. There were 4 instances of loss of reduction with fracture collapse, 3 patients required hardware removal for tendon irritation, 1 patient developed a wound dehiscence, and 1 patient had metacarpophalangeal joint stiffness. CONCLUSIONS: Patients with unstable, dorsally displaced fractures of the distal radius treated with volar fixed-angle devices have good or excellent functional outcomes despite a high complication rate. When compared with previous reports on dorsal plating volar plates appear to have a higher incidence of fracture collapse but a lower rate of hardware-related complications. Complex fracture patterns thus mandate a careful and individualized approach. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level III.

Activities of Daily Living↗