SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
In Colles fracture good functional results can be achieved by conservative treatment. Surgical procedures should only be performed in rare cases of comminuted fractures.
Maintenance of reduction in Colles fracture can be difficult to achieve. Some of the positions of the wrist in plaster designed to prevent redisplacement produce subsequent difficulty in the recovery of function of the wrist and hand. The author has practised a technique, in a large number of cases, using plaster with radial and dorsal indentations, which has proved capable of maintaining reduction with the wrist in a "physiological" or neutral position. The details of the technique are described and the end results in 162 patients are analysed.
One question which often confronts the clinician is whether or not a Colles' fracture, shown to be redisplaced, should be subjected to renewed reduction. Earlier reports have shown a rather good correlation between the accuracy of reduction and the functional and cosmetic end result. Roentgenograms of 40 rereduced Colles' fractures are reviewed in order to answer the following questions. What are the chances of a lasting improvement resulting from a renewed reduction of a redislocated Colles' fracture? What is the most suitable time for renewed reduction? Permanent improvement was found in about 1/3 of all the case. To establish the most suitable time for rereduction the material was divided into early rereduced (1-6 days after primary reduction) and late rereduced (7-15 days) fractures. It was found that early rereduction led to lasting improvement of the fractures position in only 2 of the 15 cases. Late rereduction led to permanent improvement in 15 of 30 cases with respect to dorsal angulation and in 9 cases to radial compression. If a rereduction is to be performed, it should be done during the second week after primary reduction.
Intravenous regional anaesthesia in the reduction of Colles' fracture was compared in 70 patients with 55 others who were treated with general anaesthetics. It was found to be easier and to involve a shorter waiting time, not to require patients to be supervised so long during recovery, and after this method it was less frequently necessary for patients to be taken home by ambulance. Its disadvantages were that it took longer, and could not be used for psychiatric patients or children.
The effect of dietary calcium supplementation on bone mineral content was studied in 40 postmenopausal women with Colles' fracture. The participants were divided into two groups which were given either placebo or 1 g of calcium per day. The bone mineral content of the femur was determined before and after 1 year of medication. Women with Colles' fracture were found to have the same mineral content in the femur as age-matched controls without fractures. Calcium supplementation had no significant effect on the bone mineral content.
The classic position of immobilization of Colles' fractures with the elbow in flexion, the forearm in pronation, and the wrist in volar flexion and ulnar deviation is probably the main reason for the common and rapid recurrence of the original deformity. Such a position places the brachioradialis muscle, a strong flexor of the elbow and the only muscle attached to the distal fracture fragment, in an ideal physiological position to exert a deforming force on the fracture fragments. Based on this assumption, further supported by electromyographic studies, a method of treatment was developed which calls for the initial immobilization of the arm in an above-the-elbow cast with the elbow in flexion, the forearm in supination, and the wrist inmoderate ulnar and volar flexion. This cast is changed a few days after application for an Orthoplast brace that permits motion of the elbow and volar flexion of the wrist while preventing pronation and supination of the forearm and dorsiflexion of the wrist. The proposed method did not prevent collapse of the fragments in all instances. However, the degree of collapse was minimum. The position of supination of the forearm and the freedom of motion of all joints seemed to reduce the swelling, stiffness, and incapacitation frequently found during active treatment of these fractures.
Seventy-four women were studied at various points in time between 1 month and 12 years after a fracture of the distal end of the radius--Colles' fracture. In 50 cases the maximum loss of bone after fracture was considered to have taken place in that more than 4 months had elapsed since the accident. The bone mineral content was measured in both forearms with gamma absorptiometry. It was demonstrated that the degree of post-traumatic osteoporosis, calculated as the difference between the values obtained for the injured and the uninjured arms, decreased with time. The difference between the arms was greater in peri- and early postmenopausal and in very old women suggesting that these groups had lost more bone and/or been less able to restore lost mineral with time.
Explore the source record for details and available documents.
During a five-year period, a double-pin Roger Anderson apparatus, with pins perpendicularly placed in the second and third metacarpals and in the distal part of the radius, was applied in 130 patients with an unstable Colles fracture. Sixty of the 130 were followed for two years. Shortening was limited to a median of two millimeters and dorsal angulation, to a median of 3 degrees. Wrist dorsiflexion averaged 58 degrees, and volar flexion averaged 50 degrees. Pronation and supination had an average loss of 5 degrees when compared with the uninjured side. Repeat reduction was required in only three patients. Patient assessment revealed that 85 per cent of the patients had good results; 12 per cent, fair; and 3 per cent, unsatisfactory. Objective analysis (McBride system) revealed that 90 per cent had good to excellent results; 8 per cent, fair; and 2 per cent, poor. Ninety-two per cent had no pain, 89 per cent had no deformity, and the mean grip strength was twenty kilograms. Sixteen patients had complications; seven of the sixteen had pin loosening, which occurred most frequently late during the course of treatment and without adverse sequelae.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.