[Fractures of the radius neck in children].
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Child↗
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Results for “RADIUS FRACTURES”
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Increased fracture risk in hypercalcemia. Bone mineral content measured in hyperparathyroidism.
In the present study, 39 women with mild hypercalcemia, which had been detected 18 years earlier during a health survey, and presumably caused by primary hyperparathyroidism (HPT), were investigated together with 34 age-matched controls. The bone mineral content (BMC) of the nondominant distal forearm was measured by single-photon absorptiometry, and the occurrence of fractures was recorded. Among women up to the age of 70 years, those with hypercalcemia had lower BMC than the controls (P less than 0.05), whereas among the older women, there was no difference. Twelve of the women with probable primary HPT had suffered a distal radius fracture as compared with 3 of the controls (P less than 0.05). Thus, also mild hypercalcemia is a risk factor for bone loss and distal forearm fractures. The findings constitute arguments in favor of early detection and treatment of primary HPT.
Aged↗
Post-traumatic cystic lesion following fracture of the radius.
Post-traumatic cystic lesions are an uncommon complication of fractures in children. They are benign, asymptomatic, non-expansive and tend to resolve spontaneously. Their cause seems to be the invasion of bone-marrow fat by subperiosteal hematoma, which may be visible on radiographs during fracture consolidation of the newly formed subperiosteal bone. The case we present is of cyst formation following a fracture of the distal radius and we evaluate the role of yellow bone marrow in the pathogenesis of the cyst. Its typical features clear differentiation from other lesions, preventing unnecessary and, possibly, invasive examinations.
Bone Cysts↗
[Damage of a laryngeal mask airway during anesthesia].
A 21-year-old man was scheduled for fixation of a fractured radius and ulna under general anesthesia using a laryngeal mask airway (LM). Anesthesia was induced with propofol 120 mg and fentanyl 0.1 mg. After administration of vecuronium 6 mg, we attempted insertion of the LM (# 5). The first trial was unsuccessful because the tube of the LM was bent in the pharynx. We attempted it again and the LM was successfully inserted. It was connected with the anesthetic circuit, and manual ventilation was started. However, the LM was suddenly broken at the basal part of the tube connector before the start of operation, and it became detached from the anesthetic circuit. Therefore, we removed the remaining LM from the mouth, and inserted a new LM (# 5). The peroperative course was uneventful. We conclude that inspection of a recycled LM is important before using it in order to prevent such an event as the present case.
Adult↗
[Treatment of Galeazzi's fracture - is the surgical revision of the distal radioulnar joint necessary?].
PURPOSE: Fractures of the radial shaft associated with disruption of the distal radioulnar joint (DRUJ) are termed as Galeazzi-fractures. In Galeazzi's fracture, the aim of treatment is restoring the congruency of the joint and the stability of the DRUJ, thus preventing a loss of pronation or supination. PATIENTS AND METHOD: In this study, we included 24 patients (m = 22, f = 2) with 25 Galeazzi fractures treated between 1980 and 1998. Surgical treatment and the duration of therapy were analyzed retrospectively. The clinical and radiological results of 15 patients were followed up. Two children were treated conservatively with immobilization in an above-the-elbow plaster. 19 patients were treated surgically by rigid internal fixation with a plate approximately one week after the accident. Four patients were treated initially in a different way. In 13 cases, the distal radioulnar joint was immobilized by pinning with Kirschner wires. In ten patients, the DRUJ showed no instability. Patients with DRUJ pinning received an above the elbow plaster for six weeks, the other patients received a forearm cast for the time of wound healing. RESULTS: Two patients developed a pseudarthrosis following Kirschner-wire or rush-pin osteosynthesis. The consolidation of remaining fractures was regular. In two patients, the DRUJ was not completely stable after temporary fixation. The remaining patients revealed a stable DRUJ. Eight patients showed a limited pro- or supination after temporary Kirschner wire fixation of the DRUJ. The other patients did not reveal a decrease in range of motion. CONCLUSION: A stable and optimal reduction and a rigid internal osteosynthesis are requisites for healing of the radius fracture. Open reduction of the DRUJ is only indicated when soft tissue interposition prevents exact reposition. Surgical revision of the distal radioulnar joint was not necessary in our patients. Patients after Kirschner-wire fixation showed a diminished pro- or supination. To prevent Kirschner-wire failure, postoperative cast immobilization is indicated. Due to the retrospective nature of the study it is not definitely clear if Kirschner wire fixation is superior to immobilization.
Adolescent↗
Osteosynthesis of the radius by double elastic spring-pinning. Functional treatment of the distal end fractures of the radius. A study of 130 cases.
The insertion of two elastic spring-pins in the marrow cavity of the radius gives automatically setting of the radius distal extremity's fracture. The stabilization so obtained is enough to avoid any kind of plaster immobilization. This quick and simple intervention was systematically practised during a two year period for all fractures of the lower-end of the radius. The pins are introduced directly through the skin without the need for incision. Patients are encouraged to undertake their normal activities immediately after the operation. The operation technic is described in detail in the following article. The study performed on 130 fractures observed and recorded in detail allows the analyses of the complications encountered, results obtained and the definition of indications as well as the method's limitations. Good and excellent anatomical results were obtained in 71%. Good and excellent functional results were obtained in 74% of the cases after the 6th week and, as high as 92%, after the 12th week. The majority of the negative anatomical results obtained only pertains to poor alignment of the radius's front wall. At the present time, this poor alignment must be stabilized and corrected by the introduction of a third anterior pin.
Adolescent↗
[Treatment of childhood unstable radius distal methaphysis fractures with closed reduction and percutaneous Kirschner wires].
OBJECTIVES: We evaluated the results of treatment with closed reduction and percutaneous Kirschner wires in childhood unstable radius distal methaphysis fractures. METHODS: Forty-four fractures of radius distal methaphysis of 43 children (33 boys, 10 girls; mean age 11.7 years; range 8.6 to 16 years) were treated with immediate closed reduction and percutaneous Kirschner wires. Fractures with more than 50% displacement were considered unstable. A satisfactory reduction was defined as the presence of 80% cortical contact on anteroposterior and lateral x-rays, an angulation of less than 20 degrees and 15 degrees at ages below and over 10 years, respectively, and the absence of malrotation. Clinically, the range of motion of the elbow and wrist, forearm rotation, and grip strength were measured and compared with those of the other side in the 12th postoperative week. A restriction of 10 degrees or more in relation to the other side was regarded as failure. Radiologic indications of failure in the postoperative sixth week were residual angulations of more than 15 degrees and 10 degrees at ages below and above 10 years, respectively, and malrotation. RESULTS: Forty-one patients (93.2%) achieved a successful outcome. Failure was encountered in three patients (6.8%). Two patients developed type 1 pin tract infection, which resolved with antibiotic therapy and wound care. Patients returned to their normal activities in a mean of 10 weeks. CONCLUSION: Closed reduction and the use of percutaneous Kirschner wires proved to be the choice of treatment in unstable radius distal methaphysis fractures in children.
Adolescent↗
[Fractures of the distal radius. Changing therapeutic strategies].
Fractures of the distal radius represent one of the most common fractures and do have high social-economic relevance. For treatment they need practicable classification and therapeutic standards. The demand for stable osteosynthesis of A3-, B2-B3 and C1-C2-fractures is connected to dorsal or volar internal fixation with plate and practical autogenous cancellous bone grafting, even for the elder patient. The isolated external fixation with K-wires represent special situation. Supply of implants and biodegradable materials will support this development.
Absorbable Implants↗
Seven-year outcome following Colles' type distal radial fracture. A comparison of two treatment methods.
Eighty-five patients were reviewed 7 years after prospective randomization to bridging external fixation or plaster immobilization for treatment of a Colles' type distal radial fracture. The Gartland and Werley score showed that most patients in each group had an excellent or good outcome and patient satisfaction was comparable and high in both groups. The fixator group had significantly less radial shortening (P<0.05). Despite a high level of radiographic malunion (50%) overall function, range of movement and activities of daily living were not limited. Twenty-five per cent of patients had minor radiological signs of post-traumatic arthritis although only one patient was symptomatic. We conclude that, in the long term, external fixation of distal radius fractures does not confer an improved outcome when compared to plaster immobilization.
Activities of Daily Living↗
A new method of countertraction for fractures of the radius and ulna.
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Fractures, Bone↗
Tomography versus computed tomography for assessing step off in intraarticular distal radial fractures.
Computed tomography scans have supplanted conventional tomography for many applications and often are considered the imaging study of choice for assessing intraarticular distal radial fractures. Concern about cost containment in healthcare delivery prompts the question of whether the two studies provide comparable information and at what cost. Common intraarticular distal radial fractures were created in 12 lightly embalmed cadaveric specimens. The fractures were fixed with radiolucent Kirschner wires. Articular step off was measured with a caliper. Plain radiographs, computed tomography scans, and trispiral tomograms were obtained of each specimen. Maximal step off was measured blindly by two musculoskeletal radiologists and four hand surgeons. The radiographic measurements were compared with the actual step off and expressed as a positive or negative deviation from the actual value. There was no statistically significant difference between computed tomography scans and tomograms in predicting step off. In addition, the difference between actual and radiographic measurements was insignificant in tomogram readings and different in one of the computed tomography measurements. In the authors' institution, a tomogram costs $200, and a computed tomography scan costs $562. Trispiral tomography is more accurate and cost effective than computed tomography, and thus when available should be considered the imaging modality of choice for assessing articular step off in distal radius fractures.
Analysis of Variance↗
Abraham Colles: fracture of the carpal extremity of the radius.
Colles' fracture of the wrist is among the most common bony injuries encountered in emergency practice, and accounts for 10% to 20% of all fractures. Described in an excellent clinical treatise some 8 decades before the advent of radiographs, this fracture of the distal radius continues to pose a source of some disability to large numbers of patients. Complications include residual deformity, loss of mobility, median and ulnar nerve injury, shoulder-hand syndrome, and rupture of the extensor pollicis longus tendon. Although encountered in patients of either sex and in all age groups, this injury classically affects postmenopausal women, who are predisposed to it as a consequence of osteoporosis. The technique of immobilization appears not to be as important in influencing final outcome as does the precision of reduction.
Carpal Bones↗
Anterior interosseous nerve palsy after reduction and percutaneous pinning of open fractures of the radius and ulna.
We report a case of an anterior interosseous nerve palsy after closed reduction and percutaneous pinning of open fractures of the radius and ulna in an adult. Operative findings showed that the anterior interosseous nerve was trapped between the distal and proximal part of the fractured radius. Treatment by neurorrhaphy gave a satisfactory result.
Fracture Fixation, Intramedullary↗
Concomitant skeletal and soft tissue injuries.
The diagnosis and treatment of those injuries most commonly seen in conjunction with distal radius fractures are reviewed in this article. Concomitant tendon, arterial, and nerve injuries often are associated with a high-energy mechanism of trauma. These injuries may complicate an already difficult fracture care plan, especially if the diagnosis of these injuries is delayed. Late tendon rupture and intercarpal injuries are discussed also.
Arteries↗
Arthroscopic assisted internal fixation of volar intraarticular wrist fractures.
Open reduction internal fixation of displaced volar intraarticular distal radius fractures traditionally require sacrificing the volar ligaments to visualize the articular surface. We present a modification of standard arthroscopy that facilitates visualization of the radiocarpal joint while preserving these ligaments.
Arthroscopy↗
An uncommon fracture dislocation of the radius.
Two cases of fracture of the proximal third of the radius, one with anterolateral, and one with posterior dislocation of the radial head are described. In both the ulna remained intact. To the best of our knowledge, only one other similar case had been reported.
Adolescent↗
[On the association of fracture of the radius head and olecranon].
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Elbow↗
Treatment of severe distal fractures of the radius by traction.
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Fractures, Bone↗