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https://www.readbyqxmd.com/read/27890220/-complications-of-volar-locking-plates-used-to-treat-distal-radius-fractures
#1
G Herzberg, A Marc, M Burnier
About 10 years after volar locking plates were introduced to treat acute distal radius fractures, several papers have reported short-term complications. The aim of this paper was to report our complication rate over a 2-year period and to compare it to the literature. We found similar complication rates despite different classification systems. Because of the prospective nature of our study, we were able to demonstrate that extra-articular and/or intra-articular scores exceeding 8 points on a 12-points scale were statistically associated with more complications, irrespective of the patient's overall health and age...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890218/-is-external-or-internal-distraction-useful-for-treating-distal-radial-fractures
#2
M Rongières
The use of external fixation or internal plating to bridge communitive fractures of the distal radius is discussed based on a review of prospective and meta-analysis studies. Distraction by an external fixator is not advised (ligamentotaxis) because of the high incidence of complex regional pain syndrome and the destabilization of bone and ligaments surrounding the intra-articular fracture site. The external fixator must be used as a neutralization device and supplemented with K-wire or volar plate fixation...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890217/-outcomes-of-minimally-invasive-plate-osteosynthesis-mipo-with-volar-locking-plates-in-distal-radius-fractures-a-review
#3
P Liverneaux, S Ichihara, S Facca, J J Hidalgo Diaz
Minimally invasive plate osteosynthesis (MIPO) has been used in recent years to treat fractures of the distal radius with volar locking plates. Its advantages are the preservation of the pronator quadratus and good esthetics. The MIPO technique was described originally with two incisions: one distal transverse or longitudinal incision and one proximal longitudinal incision. The trend is now to use a single longitudinal incision less than 20mm long. Functional and radiological outcomes are comparable to those of conventional techniques...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890215/-incidence-of-distal-ulna-fractures-associated-with-distal-radius-fractures-treatment-options
#4
G Herzberg, T Castel
Fractures of the neck and/or head of the ulna or distal ulna fracture (DUF) other than ulnar styloid fractures can occur in combination with distal radius fractures (DRF). This combination can have a significant influence on the treatment and prognosis since it causes the entire distal forearm to be unstable. In a series of 1279 consecutive unilateral DRFs, we found an associated ulnar neck fracture in 5.9% of cases, ulnar head and neck fracture in 1.6%, and isolated ulnar head fracture in 1.4%. Overall, 9% of cases in this study had a DUF with a DRF...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890213/-combined-scaphoid-and-distal-radius-fractures-in-adults
#5
C Dumontier, S Carmès, O Kadji
Although isolated distal radius and scaphoid fractures are common, the combination of both fractures is rare, with a reported frequency between 0.5% and 6%. This rarity is probably due to the fact that both fractures share the same injury mechanism. Published studies are limited, but most patients are males in their 40s and the injuries are typically due to high-energy trauma. In most studies, the distal radius fracture is displaced while the scaphoid fracture is not. Since the functional outcome depends of the severity of the radius fracture, we believe, as do others, that it is logical to fix both fractures with stable devices (i...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890203/-distal-radius-fractures-in-children
#6
S Otayek, M Ramanoudjame, F Fitoussi
Metaphyseal and physeal fractures of the distal radius are common in children. Most cases are best treated with closed reduction and cast immobilization. Long-term outcomes of these injuries are excellent when specific treatment principles of reduction and casting are followed. Surgical indications are limited and include open fractures, intra-articular fractures, non-reducible fractures, unstable fractures, and the presence of associated nerve injury. Closed reduction and percutaneous pin fixation is the most commonly used surgical option...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890198/-treatment-of-extra-articular-distal-radius-fractures-in-active-elderly-patients
#7
F Loisel, C Menez, E Boyer, S Huard, L Obert
Extra-articular distal radius fractures in active elderly patients are common and predominantly affect females. The high number of patients lost to follow-up compromises the evaluation of outcomes. Treatment aims to control the comminution and allow fast recovery of pre-injury activity levels. Fixation with volar locking plates is the gold standard. The role of bone substitutes in this type of injury is unclear.
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890196/-nonunion-after-distal-radius-fracture-a-review
#8
P Liverneaux, S Facca, J J Hidalgo Diaz
Nonunion after distal radius fracture is rare, serious and unpredictable. The preferred treatment is resection of the nonunion zone followed by open reduction and internal fixation with autologous iliac crest bone graft. When the distal fragment is less than 5mm high, a dorsal plate that bridges the radiocarpal joint is recommended. In patients with low functional demands, radiocarpal fusion is a logical choice. The bone healing rate is 58% and could be improved by using a vascular graft. Bone healing is not synonymous with good clinical outcomes...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890193/-treatment-of-intra-articular-malunion-of-the-distal-radius-of-young-active-patients
#9
A Durand, C Camps, M Merle
Management of malunion of the distal radius remains difficult. Planning of the correction of the articular displacement requires a comprehensive analysis by CT arthrography to analyze bone, cartilage and ligaments. Arthroscopy is a valuable tool in the context of joint trauma. In the absence of osteoarthritis, the correction can be carried out as early as possible in the weeks or months following the initial fracture. The use of locking plates allows early mobilization after surgery. This correction aims to prevent the development of secondary osteoarthritis...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#10
Austin Mcphillamy, Taylor P Gurnea, Alastair E Moody, Christopher G Kurnik, Minggen Lu
OBJECTIVES: In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27849675/brachioradialis-tendon-coverage-in-volar-distal-radius-plating
#11
Nicholas B Jew, John W Karl, Evan Trupia, Robert J Strauch, James H Calandruccio
Volar plate fixation of unstable distal radius fractures has become the preferred technique by most surgeons for the operative treatment of displaced distal radius fractures. Flexor tendon rupture is a rare but serious complication associated with this operation that is thought to be due to irritation of the flexor tendons over the prominent distal edge of the plate. We describe a novel technique of using the brachioradialis tendon to cover the distal edge of the plate to help prevent tendon irritation and rupture...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27847680/distal-radius-fracture-outcomes-and-rehabilitation
#12
Tochukwu C Ikpeze, Heather C Smith, Daniel J Lee, John C Elfar
Distal radius fractures account for nearly 1 of every 5 fractures in individuals aged 65 or older. Moreover, increased susceptibility to vertebral and hip fractures has been documented in patients a year after suffering a distal radius fracture. Although women are more susceptible to hip fractures, men experience a higher mortality rate in the 7 years following a distal radius fracture. Traditional approaches to distal radius fractures have included both surgical and nonsurgical treatments, with predominant complaints involving weakness, stiffness, and pain...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27847665/an-unusual-and-complicated-course-of-a-giant-cell-tumor-of-the-capitate-bone
#13
Ingo Schmidt
A 51-year-old female patient presented with a carpal giant cell tumor (GCT) of the right capitate bone. The lesion was initially misdiagnosed as having an osteomyelitis. First, the diagnosis of a benign GCT was confirmed by histological examination. Second, an intralesional curettage and packing of the cavity with cancellous iliac crest bone grafts combined with a fusion of the third carpometacarpal (CMC III) joint were carried out. Third, due to a secondary midcarpal osteoarthritis and a secondary scaphoid nonunion, the CMC III joint fusion plate was removed and the midcarpal joint completely excised...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27836497/flexor-tendon-complications-in-comminuted-distal-radius-fractures-treated-with-anatomic-volar-rim-locking-plates
#14
Adnan Kara, Haluk Celik, Yunus Oc, Metin Uzun, Mehmet Erdil, Cihangir Tetik
OBJECTIVE: Anatomic volar rim locking plates are designed with the aim of treating intraarticular distal radius fractures. When used to treat comminuted distal radius fractures, these plates can damage the flexor tendons. In this study, we sought to determine the radiological and functional results and rate of complications of these plates. METHODS: We retrospectively reviewed the records of 36 patients (28 males, 8 females; mean age: 46.4 years) with AO/OTA Type C2-C3 distal radius fractures treated with anatomic volar rim distal radius plates between January 2011 and December 2014...
November 8, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27826652/treatment-of-physeal-fractures-of-the-distal-radius-by-volar-intrafocal-kapandji-method-surgical-technique
#15
Guy Rubin, Hagay Orbach, Avi Chezar, Nimrod Rozen
BACKGROUND: Distal radial physeal fractures with volar displacement are rare. Several methods of operative treatment include volar plate without inserting distal screws, percutaneous technique using two anterior skin incisions and reversed Kapandji technique with pins introduced through a posterior approach and locked at the anterior cortex of the fracture. METHODS: We report three cases along with a literature review of the surgical techniques described in the past and a novel surgical technique for this uncommon fracture termed "Volar Kapandji"...
November 8, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27815606/-distal-radius-fracture-of-the-adult-diagnostics-and-therapy
#16
F Unglaub, M F Langer, B Hohendorff, L P Müller, J M Unglaub, P Hahn, H Krimmer, C K Spies
Fractures of the distal radius are very common. The majority of patients are elderly females. High impact trauma are often responsible for fractures in young men. Clinical and radiological diagnostics, including computer-assisted tomography (CAT) scan, are generally sufficient. The indication for conservative treatment is still recommended for specific fracture patterns. Application of palmar locking plates after open reduction proved to be efficacious for the majority of fracture patterns. Furthermore, precise detection and treatment of concomitant lesions are mandatory in order to prevent complications...
November 4, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27803378/do-volar-locking-plates-fit-the-volar-cortex-of-the-distal-radius
#17
D-S Kwak, J-Y Lee, J-H Im, H-J Song, D Park
: The purpose of this study was to measure the volar cortical angles of the commercially available volar locking plates and evaluate how well they fit the distal radius. We measured the volar cortical angles of the radial and intermediate columns of eight volar locking plates and compared them with the volar cortical angles of 90 cadaver distal radii. The mean radial and intermediate column volar cortical angles of the wider plates were significantly larger than those of narrower plates...
October 31, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27801774/the-efcr-approach-and-the-radial-septum-understanding-the-anatomy-and-improving-volar-exposure-for-distal-radius-fractures-imagine-what-you-could-do-with-an-extra-inch
#18
Jorge L Orbay, Robert Gray, Lauren L Vernon, Scott M Sandilands, Anthony R Martin, Sofia M Vignolo
Locked volar plating is the most common surgical procedure to address distal radius fractures. The extended flexor carpi radialis approach continues to be an excellent method for visualizing distal radius fractures and applying a volar plate. A new understanding of the anatomy allows for better visualization and reduction of the many different distal radius fracture patterns surgeons commonly see. Within the extended flexor carpi radialis approach, we describe the radial septum in further detail including the anatomy which comprises the radial septum triangle...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27795951/volar-locking-distal-radius-plates-show-better-short-term-results-than-other-treatment-options-a-prospective-randomised-controlled-trial
#19
Herwig Drobetz, Lidia Koval, Patrick Weninger, Ruth Luscombe, Paula Jeffries, Stefan Ehrendorfer, Clare Heal
AIM: To compare the outcomes of displaced distal radius fractures treated with volar locking plates and with immediate postoperative mobilisation with the outcomes of these fractures treated with modalities that necessitate 6 wk wrist immobilisation. METHODS: A prospective, randomised controlled single-centre trial was conducted with 56 patients who had a displaced radius fracture were randomised to treatment either with a volar locking plate (n = 29), or another treatment modality (n = 27; cast immobilisation with or without wires or external fixator)...
October 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27783838/ultrasonographic-assessment-of-the-flexor-pollicis-longus-tendon-after-plate-fixation
#20
Chieko Kadoma, Masatoshi Takahara, Masahiro Maruyama, Hiroshi Satake, Michiaki Takagi
Rupture of the flexor pollicis longus tendon is a major complication after volar locking plate fixation of distal radius fracture. This study used ultrasonography to assess the flexor pollicis longus tendon and intermediate tissue. The study assessed 27 patients (28 wrists) who underwent removal of the volar locking plate. Before plate removal, radiography and ultrasonography were performed to assess the relation between the flexor pollicis longus tendon and the volar locking plate. Intraoperatively, the authors evaluated the intermediate tissues between the flexor pollicis longus tendon and the distal volar margin of the plate...
October 25, 2016: Orthopedics
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