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At least 1,099 records · Page 61Linked to original sources
PubMed1987

[Hand injuries in Alpine skiing].

In the Innsbruck University Clinic for Traumatology during the years 1978-1985, altogether 17,999 patients received initial treatment for injuries incurred through Alpine skiing. 3240, or 18% of these injuries were trauma to the hand. The most frequently injured area was the thumb, with 1995, or 61.6% of the cases. The most common hand injury in skiing is the socalled "ski thumb", the lesion of the ulnar ligament of the metacarpal-phalangeal joint. Finger injuries accounted for 262 cases, or 8%. The capsule-ligament lesions predominated, especially the palmar capsule lesion of the proximal interphalangeal joint. The most common ligament lesion was the rupture of the radial collateral ligament of the metacarpal-phalangeal joint of the small finger. The metacarpal region was involved in 192 (6%) of the patients. The 4th and 5th metacarpal fractures were often combined with volar dislocation of the caput; the 2nd and 3rd metacarpals showed more often torsion fractures. Luxated fractures were found in all carpal-metacarpal joints. Carpal injuries were the least common, with 2.2%; the bony and ligamentous injuries in this region were, however, more serious. 40 scaphoid fractures were found, along with fractures of the triquetrum, trapezium, hamatum, and pisiform, as well as luxations and luxated carpus fractures. The injuries of the wrist are worthy of more attention. They include lesions of the distal radial-ulnar joint and distal radius fractures, and made up 22.2% of all hand injuries. More emphasis should be placed on diagnostic, therapeutic, and prophylactic measures for these injuries.

Athletic Injuries↗
PubMed1998

[Decompression of the ulnar wrist joint compartment by decompression osteotomy of the head of the ulna].

Both post-traumatic shortening of the radius and positive ulnar variance can lead to a compression syndrome in the ulnar compartment of the wrist. The indication for a decompression osteotomy of the ulnar head after a distal radius fracture is limited to only those cases in which there is a slight shortening without a deviation of the axis of the distal radius. In order to enlarge the space between the ulnar head and proximal row of the carpal bones, a 2 to 3 mm slice is taken from the ulnar head by means of two oblique, parallel osteotomies and fragment retention with two screws. 47 patients were re-examined after an average period of 3 1/2 (1 to 8) years. In 23 cases the results were very good and in 17 cases good. In five cases the results were poor. In two cases, the bone did not heal and the Kapandji-Sauvé procedure was performed.

Adult↗
PubMed2004

The annual incidence and seasonal variation of fractures of the distal radius in men and women over 25 years in Dorset, UK.

Adults who suffer fractures of the distal radius are at increased risk of further osteoporosis related fractures and represent a high-risk group in whom therapies are available to reduce the risk. We have undertaken a prospective study of distal radius fracture patients over the age of 25 years to establish the extent of the problem in Dorset. All patients presenting with any forearm fracture to hospitals serving Dorset residents during 1 year were identified. Fracture type was assessed following scrutiny of the hospital notes. Analysis included calculation of rates per 10,000 population using Dorset Health Authority population estimates and seasonal variation. Ninety-six percent of all patients presented to three of the seven hospitals. One thousand six hundred and eighty-eight individuals with a diagnosis of forearm fracture were identified but only 1300 had a fracture of the distal radius. There was a female:male ratio of 3.9:1. In women, the incidence of distal radius fracture rose from a premenopausal baseline of 10 per 10,000 population per year to a peak of 120 per 10,000 population per year over 85 years. In men, the fracture incidence gradually increased from 10 per 10,000 before 65 years to 33 per 10,000 after 85 years. There was a detectable seasonal variation. Our data are in keeping with recent surveys in Europe and suggest that a change in the incidence of fracture of the distal radius with age has occurred over the last 30 years.

Adult↗
PubMed1993

An alternative method of treating comminuted intra-articular fractures of the distal radius.

Comminuted intra-articular fractures of the distal radius will inevitably end in poor results if inadequately treated. We recommend an external fixator by two proximal and one distal Steinmann pins incorporated into a short plaster of Paris cast. This distraction method is easy, does not need special instrumentation, and is very cost-effective. Our method differs from previous methods in its simplicity and predictably good results if the recommended technique is followed.

Adult↗
PubMed1987

Displaced intraarticular fractures of the distal radius.

The treatment of intraarticular fractures of the distal radius has been dramatically altered over the past decade. Investigations into the pathomechanics of these injuries highlight the problems of arthritis, pain, swelling, weakness, limited range of motion and instability associated with nonanatomic reduction of both intraarticular fragments and their associated ligaments. Factors affecting the prognosis for these injuries include degree and location of articular involvement and the energy of the precipitating force as well as the anatomy of reduction. Operative treatment is reserved for displaced intraarticular fractures. Those extremely comminuted fractures are best fixed with distraction and external fixation. The operative approach to these fractures is dependent on the anatomy. Ligamentous instability, in particular with radial styloid fractures, must be sought and treated. Kirschner wires can be used as "joy sticks" to control unstable carpal bones or fracture fragments prior to fixation. Plates and screws are useful in the stabilization of volar and dorsal rim fractures. The use of intraoperative radiographs is emphasized. Postoperative early range of motion, when possible, greatly improves the long-term results.

Fracture Fixation↗
PubMed1984

Midcarpal instability caused by malunited fractures of the distal radius.

Thirteen patients with malunited fractures of the distal radius developed symptoms of pain and instability of the midcarpal joint. In six cases, a recurrent voluntary midcarpal subluxation was also present during ulnar deviation. These symptoms were first noticed several weeks, and at times several months, after all immobilization for the treatment of the original fracture had been discontinued. We believe that the loss of the normal palmar tilt of the distal articular surface of the radius prepositions the carpus in a dorsal collapse alignment, which enables this instability to develop. Although the instability is localized to the midcarpus , it is treated best, in our opinion, by a corrective osteotomy of the distal radius. In nine patients, osteotomies resulted in relief of preoperative symptoms and correction of midcarpal instability. In one patient, osteotomy of the radius was deemed unnecessary because the loss of palmar tilt of the radius was minimal. Instead the midcarpal ( triquetrohamate ) joint was stabilized by ligament reconstruction. Only transient correction was obtained, with later recurrence of the voluntary midcarpal subluxation.

Adolescent↗
PubMed1994

[Transfixation upper arm plaster bandage for treatment of comminuted fractures of the distal radius].

Thirty-five comminuted fractures of the distal radius in 34 patients were reduced by manipulation and pins, then immobilised with plaster. The Kirschner wires were inserted into the first metacarpal and the olecranon. In five cases, problems with the proximal pin occurred. A clinical and radiological examination could be done in 21 patients three to nineteen years after the accident. Using the demerit-point-system of Gartland and Werley, the result was excellent in three patients, good in nine, and fair in nine; there were no poor results. After careful retrospective consideration of treatment alternatives for these comminuted distal radial fractures, there remain the following indications for pins and plaster: 1. selected cases treated by surgeons experienced with the method, 2. as an emergency procedure when an external fixator seems to be indicated but is not available.

Adolescent↗
PubMed2001

Osteosynthesis of diaphyseal fractures of the radius and ulna using an internal fixator (PC-Fix). A prospective study.

Over a five year period, 121 forearm shaft fractures in 82 patients including nine non unions were fixed using the PC-Fix. Two patients died early; of the remaining 80 patients (119 bones) 96% were followed until bone healing. No non unions or late infections were observed in spite of the fact that no primary bone grafts were used except when treating non unions. In this clinical study with a high follow up rate using a newly developed internal fixator, encouraging overall results were achieved and the technology of monocortical locked screws was proven to be valid.

Adolescent↗
PubMed2001

[Problems of malunited fractures of the distal radius].

The essential problematic of the distal fracture of the radius lies in the quality of its reduction and retention. 35 patients with distal fractures of the radius and strain fractures of the styloid process of the ulna were followed up with regard to their functional and radiological results and their subjective symptoms. Patients with intra-articular fractures were found to have significantly poorer functional results compared to those with extra-articular fractures. 29 out of 35 patients developed a nonunion of the styloid process of the ulna in the form of a compensatory false position with a significant dorsal tilt of the articular surface of the radius. Their functional results were also significantly poorer than those of the other 6 patients. The patients whose radii were shortened by more than 2 mm also had significantly poorer functional results and a median dorsal tilt of 5 degrees of the articular surface. Where the dorsal inclination of the articular surface of the radius exceeded 5 degrees, a significant increase in the scapholunar angle, which averaged 62 degrees, was found. On the basis of these figures, we conclude that in the reduction of the distal fracture of the radius, shortening by not more than 2 mm and a dorsal inclination of the articular surface of the radius, taken laterally, of not more than 5 degrees should be tolerated in order to minimise functional impairments of the wrist.

Fractures, Malunited↗
PubMed2005

[The osteosynthesis of fractures of distal radius with the AO/ASIF Titanium Pi Plate].

The AO/ASIF Titanium Pi Plate has been developed for dorsal plating of fractures of the distal radius. It is designed by reflection of the anatomy, to ensure stability of the angle using a juxtaarticular band and to minimize tissue reaction by low profile design. The aim of this study was to evaluate the subjective and objective outcome of 61 consecutively operated patients after a minimum of 12 months (12-29 months) postoperatively. There were 3 A2, 23 A3, 1 B1, 12 C1 and 22 C2 fractures (AO-Classification). The subjective results were good to very good. The range of motion showed over 80% compared to the uninjured side. Overall, there were no ruptures of tendons and 18% irritations. Extension, ulnar abduction and force were significantly better in patients in which the plate has been removed. In this collective the tendon irritations were only 3.8%. With the AO/ASIF Pi Plate good subjective and objective results can be achieved. The indication for removal of the plate should be given generously.

Adolescent↗
PubMed2005

Correlation between wrist loads and the distal radius volar tilt angle.

BACKGROUND: Based on the phenomenon of bone adaptation to mechanical stimuli (Wolff's law) this study investigates a previously unreported correlation between the maximum wrist joint reaction force and the volar tilt angle of the distal radius. METHODS: Free body analysis of the sagittal-plane forces acting on the supinated distal radius during lifting and radiographic measurements in thirty normal wrists are used to analyse the correlation between the theoretically calculated maximum wrist joint reaction force and the radiographically measured volar tilt angle. FINDINGS: Non-statistically significant difference (p=0.33, 95% confidence interval -0.64 degrees to 0.22 degrees) and statistically significant correlation (R(2)=0.74, r=0.86, p<0.001) between the angle of the maximum wrist force and the volar tilt angle of the distal radius and inverse relationship between the volar tilt angle and the magnitude of the maximum wrist force (R(2)=0.71, r=-0.84, P<0.001) were found. INTERPRETATION: The radiographically measured volar tilt angle of the distal radius appears not to differ significantly from the theoretically calculated angle of the maximum wrist joint reaction force, a possible explanation for the phylogenetical development of the volar tilt angle. Also, an inverse relationship between the volar tilt angle and the magnitude of the maximum joint reaction force was observed suggesting that wrists characterized by a low volar tilt angle may be subjected during lifting activities to maximum joint reaction forces up to 50% higher than those in wrists with a high volar tilt and emphasising the importance of accurate restoration of the volar tilt during treatment of all distal radius fractures.

Adult↗