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PubMed1983

Fracture of the radius with instability of the wrist.

Review of 190 consecutive fractures of the distal radius revealed 14 instances of ligamentous carpal instability (7.4%). Instability was more likely to occur in older patients but was not related to the degree of fracture displacement. There was an association between instability and radial styloid fracture, and in five of nine Colles fractures a separate radial styloid fragment was present, suggesting a component of avulsive force. The relatively common coexistence of fracture and instability is not generally appreciated, and the findings of instability often are overlooked.

Humans↗
PubMed1975

Compression-plate fixation in acute diaphyseal fractures of the radius and ulna.

At the Campbell Clinic and City of Memphis Hospital from 1960 to 1970, 244 patients (216 with closed and twenty-eight with open fractures) had 330 acute diaphyseal fractures of the radius and ulna which were treated with ASIF compression plates and followed for from four months to nine years. One hundred and twelve patients had fractures of both bones of the forearm; fifty, single fractures of the ulna; and eighty-two, single fractures of the radius. In all, 193 fractures of the radius and 137 fractures of the ulna were treated by compression plating. Sixty-three patients (25.9 per cent) with severely comminuted fractures also had iliac-bone grafts. The over-all rate of union for the radius was 97.9 per cent and for the ulna, 96.3 per cent. ASIF compression plates, therefore, provided a successful method for obtaining union and restoring optimum function after acute diaphyseal fractures of the forearm.

Acute Disease↗
PubMed2005

[Distal fracture of the radius].

The distal radius is the most common site of a fracture. The type of fracture presenting, stability/instability and concomitant injuries are the factors that determine whether the fracture should be treated conservatively or surgically. Possible sequelae include a dystrophy syndrome.

Aged↗
PubMed1987

Conservative treatment of a minimally displaced fracture of the radius of a horse.

The successful conservative treatment of an open, displaced fracture of the radius of a horse suggests that conservative treatment should not be ignored when surgery is not an option. The importance of proper soft-tissue management and the use of broad-spectrum antimicrobial treatment in the management of orthopedic injuries is emphasized.

Animals↗
PubMed2006

Isolated radial shaft fractures are more common than Galeazzi fractures.

PURPOSE: In contrast to isolated diaphyseal fractures of the ulna (so-called night-stick fractures), isolated fractures of the radial diaphysis generally are expected to have associated injury of the distal radioulnar joint (DRUJ), the so-called Galeazzi fracture. This study retrospectively reviewed isolated fractures of the radial diaphysis in a large cohort of patients to determine how often such fractures occur without DRUJ injury METHODS: Thirty-six patients with fracture of the radius without fracture of the ulna were followed up for at least 6 months after injury. Injury of the DRUJ was defined as more than 5 mm of ulnar-positive variance on radiographs taken before any manipulative or surgical reduction. All of the fractures were treated with plate and screw fixation (8 with autogenous bone grafting) and all healed. Patients with DRUJ injury had either temporary pinning or immobilization of the DRUJ or surgical fixation of a large ulnar styloid fracture. Patients without DRUJ injury were mobilized within 2 weeks. RESULTS: Nine patients had dislocation of the DRUJ, 4 with large ulnar styloid fractures. Among the remaining 27 patients 1 had displacement of the proximal radioulnar joint noted after surgery, leading to a secondary procedure for radial head resection. The functional results were satisfactory or excellent in all but 2 patients with functional limitations related to central nervous system injury. No patient had DRUJ dysfunction at the final follow-up evaluation. CONCLUSIONS: Isolated fractures of the radial diaphysis are more common than true Galeazzi fractures. Surgeons should take great care not to overlook injury to the distal or proximal radioulnar joint in association with isolated diaphyseal fractures of the radius; however, fractures without identifiable radioulnar disruption can be treated without specific treatment of the DRUJ and with immediate mobilization. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Adolescent↗
PubMed1994

Compartment pressure in the carpal tunnel in distal fractures of the radius. A prospective study.

In a prospective controlled study, carpal tunnel tissue pressures were determined in a group of 56 patients with distal dislocated fractures of the radius at initial presentation, immediately prior to and after reduction, and 1, 2, 4, 12, and 24 h after reduction. Depending on the severity of the trauma and delay to presentation at the hospital, initial measurements revealed raised pressure averaging 23 mm Hg, which further increased during reduction to 44 mm Hg. After 4 h the average pressure was 37 mm Hg, and it then dropped to 26 mm Hg after 12 h. For anatomical reasons the median nerve is quite vulnerable in the region of the wrist joint. Chronic pressure here may cause carpal tunnel syndrome. Acute pressure in the carpal tunnel, which according to our investigations represents a distinct compartment, results in an overt compartment syndrome. The possibility of a direct relationship between markedly elevated tunnel pressure and the development of Sudeck's dystrophy is discussed.

Adolescent↗
PubMed1983

External fixation of complex hand and wrist fractures.

From 1977 to 1980 fixation with an external fixateur was performed in 33 injuries of the upper extremity: ten fractures of the hand, 22 Colles' fractures, and one osteotomy for Madelung's deformity. Application was primary in 19 patients and after another type of fixation (cast or Kirschner wire) had failed to hold reduction in 14 patients. All ten hand fractures healed in 4 to 12 weeks, and the distal radius fractures united in 6 to 10 weeks. The external fixateur for unstable fractures of the hand and wrist with bone or soft-tissue loss provides rigid skeletal stabilization, accessibility for wound care, and early joint mobilization.

Adolescent↗
PubMed2006

[Treatment of fractures of proximal radius with Ni-Ti shape memory alloy embracing].

OBJECTIVE: To find out an ideal method of internal fixation for the treatment of fractures of proximal radius. METHODS: From August 2001 to April 2004, 24 patients suffering from fractures of proximal radius were treated with Ni-Ti shape memory alloy embracing fixator. Of 24 patients, there were 19 males and 5 females, aging from 16 to 48 years; there were 9 cases of wrestling injury, 5 cases of crush injury, 4 cases of traffic accident injury, 3 cases of direct violence impact injury and 3 cases of high falling injury. All patients were given operation according to fix method of the shape memory alloy embracing fixator. All cases were regularly followed up to observe the fracture healing and functional recovery. RESULTS: All cases were followed up postoperatively from 4 months to 21 months with an average of 10 months. No complication occurred during operation and after operation. Healing by first intention was achieved. X-ray showed that all cases achieved clinical union 8-12 weeks after operation. According to Anderson's criteria and the results were excellent in 18 cases, good in 5 cases, and fair in 1 case. The excellent and good rate was 95.83%. CONCLUSION: The internal fixation with shape memory alloy embracing fixator has as follows advantages: less trauma, esay-to-do, stable fixation, better tissue compatibility and less complication in treating fractures of proximal radius. This method can enhance the fracture healing and functional recovery. So it is a better method to treat fractures of proximal radius.

Adolescent↗
PubMed2005

[Clinical observation on effects of qianggu capsules in treating radius distal osteoporotic fractures].

OBJECTIVE: To explore the effects of qianggu capsules (QGC) on the fracture healing and the bone mineral density (BMD) in radius distal osteoporosis fracture (RDOF) patients. METHODS: Bone mineral density (BMD) of femoral neck in 65 patients with RDOF was detected after the fracture was fixed manually. They were then randomly divided into two groups. Thirty-three patients in the treated group took QC, 1 capsule (180 mg) each time, three times a day, while 32 patients in the control group took D-Cal Biocal 2 tablets (1500 mg) each time, once daily. The therapeutic course for both groups was three months. X-ray examination on the broken end of the fractured bone was taken every month to observe the bony callus formation for comparing the curative effect, and BMD of femoral neck were detected again after patients were treated for 3 months. The bony callus appeared earlier, more in volume with thicker cortex in the treated group after 2 months of treatment versus that in the control group. The fracture healing time in the treated group was 9.4 +/- 2.5 weeks and that in the control group was 12.5 +/- 2.9 weeks, showing significant difference between them (P < 0.05). BMD in the treated group before treatment was 0.621 +/- 0.085 g/cm2, which was lower than that after treatment (0.646 +/- 0.090 g/cm2) with significant difference showing between them (P < 0.05), while no significant change of BMD was found in the control group between before and after treatment, and significant difference was found in BMD between the two groups after treatment (P < 0.05). CONCLUSION: QGC can promote the formation of bony callus ahead of time, increase the volume of bony callus and BMD, improve the bone structure, and thus the time of external fixation in treating RDOF could be reduced.

Aged↗
PubMed2001

Minimally invasive reduction and osteosynthesis of articular fractures of the distal radius.

Treatment of displaced fractures of the distal radius has changed over the course of time. For many years, closed reduction with plaster immobilization was considered the treatment of choice. Subsequent use of pins and plaster, percutaneous pin fixation, and the development of external fixation devices all contributed to improving fracture stability. More recently a new generation of external fixation devices has been developed to permit distraction and palmar translation. In addition, over the past twenty years, we have seen the development of more sophisticated internal fixation devices for the treatment of displaced fractures of the distal radius. The indications for open reduction and internal fixation have been defined largely on the basis of numerous studies which support the concept that articular malreduction is predictive of traumatic arthritis and poor functional result. Knirk and Jupiter have reported poor results for intra-articular fractures of the distal radius having an articular step-off greater than 2 mm. More recently, wrist arthroscopy has been used to improve visualization of articular surfaces and aid fracture reduction. In addition, bone grafting techniques have been employed more frequently to accelerate fracture healing. With improvement in techniques, we are able to provide our patients with better functional results and return them to their activities of daily living and vocation more rapidly.

Arthroscopy↗
PubMed1989

[Differentiated treatment of fractures of the distal radius].

The question of our study was, if in the case of such a numerous fracture as the distal radius fracture, a different individual treatment would be possible and if the results could be thereby improved. Both can be replied by yes. Of the 200 fractures 157 cases in the plaster cast on the forearm or in the plaster cast on the upper arm in the restored position are healed in bone. Forty three times only the conservative routine treatment has not been enough, that means for about 2 patients a week. These ones need an individual adjusted treatment, care and control, a consumption which can absolutely be required. By distinctive operative treatment it was managed to reduce the number of the secondary deviations of the whole collective to 16%. That mainly was for the benefit of the age group 20-59 years, by the patients over 60 years an operation, indicated by the fracture, is not always possible regarding the above-mentioned reasons. In such a case it is useful to discuss with the patient the problems and the result which can be expected for preventing disappointments.

Adolescent↗
PubMed1998

Optimal position for plate fixation of complex fractures of the proximal radius: a cadaver study.

OBJECTIVE: To determine the optimal postion for plate fixation in complex fractures of the proximal radius in which head and neck dissociation occurs. DESIGN: Technical study. SETTING: Tertiary referral center, teaching hospital, U.S. military. SUBJECTS: Five preserved cadavers. MAIN OUTCOME MEASURE: Radioulnar impingement and proximity to neurovascular structures were directly measured in elbows plated in each of three positions: neutral, full pronation, and full supination. RESULTS: Application of the 2.0-millimeter T-plate to the lateral aspect of the radial head and neck with the forearm in neutral position had no impingement, whereas application in full pronation resulted in loss of the last 30 degrees of supination. Plate application in full supination resulted in the loss of the last 10 degrees of pronation. In addition, there was no impingement when the 2.7-millimeter plate was applied similarily in the neutral position. None of these positions resulted in increased risk to neurovascular structures. CONCLUSIONS: The optimal position for plate fixation of complex proximal radius fractures is with the forearm in neutral position, with the plate applied directly lateral. A larger implant, 2.7 millimeters, may be used if this technique is followed without further risk of impingement and loss of motion.

Adult↗
PubMed1999

[The treatment of multi-fragmental fractures of distal radius by external fixators by own construction].

A retrospective analysis of 20 multifragmental fractures of distal radius treated in Clinic of General and Hand Surgery in Szczecin from March 1996 until November 1997 with own constructed fixateur externe showed in 80% very good and good functional results according to the criteria of Gartland and Werley, Castaing. Mean follow-up was 10 months after operation. The 20 patients were on average 56.5 years old. The fixator was removed after five to at least six weeks. An additional osteosynthesis with Kirschner wires was performed in four cases.

Adolescent↗
PubMed1995

Distal anterior radius bone graft in surgery of the hand and wrist.

The distal anterior radius was used as the source of bone graft for 131 reconstructive procedures in the wrist and hand. These included curettage and bone grafting of 9 cysts, 75 arthrodeses of various joints, and 47 scaphoid nonunions. The overall healing rate was 82%. There was one donor site complication; a distal radius fracture through the graft site occurred 46 months after surgery. We conclude that the distal anterior radius provides an excellent source of bone graft for surgery of the hand, with little morbidity.

Adult↗