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"Distal radius fracture"

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https://www.readbyqxmd.com/read/27921157/assessment-of-pisotriquetral-misalignment-with-magnetic-resonance-imaging-is-it-associated-with-trauma
#1
Hee-Dong Chae, Hye Jin Yoo, Sung Hwan Hong, Ja-Young Choi, Heung Sik Kang
OBJECTIVE: Our objective was to determine whether there is an association between pisotriquetral (PT) malalignment and acute distal radius fracture by using magnetic resonance imaging (MRI). METHODS: We evaluated 138 patients who underwent 3-T MRI of the wrists. Group A comprised 85 patients with acute distal radius fracture, and group B comprised 53 patients without trauma. PT interval and angle and pisiform excursion were measured on oblique axial and sagittal multiplanar reformats...
December 5, 2016: European Radiology
https://www.readbyqxmd.com/read/27916152/volar-ulnar-approach-for-fixation-of-the-volar-lunate-facet-fragment-in-distal-radius-fractures-a-technical-tip
#2
REVIEW
Daniel Tordjman, Richard M Hinds, Omri Ayalon, S Steven Yang, John T Capo
The volar Henry approach is most commonly used for surgical fixation of distal radius fractures. However, this approach is limited in achieving adequate exposure for the fixation of the volar-ulnar portion of the distal radius, rendering it difficult for the ideal placement of the fixation construct. We propose the use of the extensile volar-ulnar approach for fixation of distal radius fracture involving a small volar-ulnar fragment. This approach allows optimal reduction of the sigmoid notch and the volar lunate facet, which anatomically reduces both the radiocarpal joint and the sigmoid notch...
December 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27899222/camera-tracking-gaming-control-device-for-evaluation-of-active-wrist-flexion-and-extension
#3
Dalit Shefer Eini, Navah Z Ratzon, Albert A Rizzo, Shih-Ching Yeh, Belinda Lange, Batia Yaffe, Alexander Daich, Patrice L Weiss, Rachel Kizony
STUDY DESIGN: Cross sectional. INTRODUCTION: Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. PURPOSE OF THE STUDY: To test the reliability and validity of a dynamic ROM assessment, the Camera Wrist Tracker (CWT). METHODS: Wrist flexion and extension ROM of 15 patients with distal radius fractures and 15 matched controls were assessed with the CWT and with a universal goniometer...
November 26, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/27890246/treatment-of-dynamic-scapholunate-instability-dissociation-contribution-of-arthroscopy
#4
C Mathoulin
Scapholunate (SL) ligament injuries generally result from trauma to an extended, supinated wrist, leading to chronic instability that progresses toward osteoarthritis. They can occur together with distal radius fracture. These injuries can be difficult to diagnose, especially early on. Treating chronic SL ligament injuries before the onset of osteoarthritis is still a challenge for surgeons. Until recently, the recommended treatments consisted of open SL ligament reconstruction or repair procedures that reduce pain and improve pinch strength but also lead to wrist stiffness...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890221/-treatment-of-distal-radius-extra-articular-malunion-in-young-active-patients
#5
N Pauchard, S Huguet, F Dap, G Dautel
Malunion is a common complication of distal radius fractures despite new fixation devices. The authors discuss the surgical indications, preoperative management and the various surgical techniques used to treat distal radius extra-articular malunion, specifically in active young subjects. The treatment goals in this population group are anatomical restoration of the distal radius and distal radioulnar joint, short immobilization period, quick functional recovery and stable results over time, consistent with high functional demands...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890220/-complications-of-volar-locking-plates-used-to-treat-distal-radius-fractures
#6
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/27890219/-over-reduction-after-distal-radius-fracture-pinning-in-young-active-patients-prevention-by-multiple-mixed-pinning
#7
O Delattre, G Greffe, L Stratan, F Duroux, J Donatien
Over-reduction is a classical complication following pinning of distal radius fractures. Indeed, the pinning techniques derived from Kapandji's technique do not allow anterior stabilization. A literature review and our experience show that it is an underestimated complication that can affect up to one-third of cases, but that is well tolerated if the anterior tilt is less than 20°. Excessive angulation of the dorsal intrafocal K-wires becomes a significant risk factor beyond 60°. Volar comminution of the fracture is an obvious predisposing factor...
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
#8
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/27890216/-nerve-injuries-associated-with-distal-radius-fractures
#9
J Pierrart, D Tordjman, N Ikeuchi, D Delgrande, T Gregory, E Masmejean
Nerve damage is a common complication of distal radius fractures. It may be a result of the injury event or be iatrogenic. It is the source of disability and potential handicap. There is little published data on this topic and no study has validated the strategies needed to prevent or manage these nerve-related complications. There is no consensus on treatment. Prevention requires a good knowledge of the various surgical approaches and rigorous fracture fixation technique. The objective of this article is to take stock of recent data from the scientific literature...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890215/-incidence-of-distal-ulna-fractures-associated-with-distal-radius-fractures-treatment-options
#10
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/27890214/-pathology-of-the-triangular-fibrocartilaginous-complex-in-distal-radius-fractures
#11
D Fontès
Distal radius fracture is actually quite rarely isolated and triangular fibrocartilaginous complex (TFCC) is often involved with the same mechanism of injury. A contemporary management of the treatment of the initial fracture is ideal and so benefits from a routine arthroscopic management. Nevertheless, in the absence of diagnosis and therefore early treatment, the symptoms may be located at the ulnar crossroads and justify specific treatment of TFCC. It is generally conducted after an accurate arthroscopic lesion classification guiding a procedure, depending on the lesion vascularization as well as its possible destabilization potential (debridement, capsular suture or foveal reattachment)...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890213/-combined-scaphoid-and-distal-radius-fractures-in-adults
#12
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/27890212/-complete-intra-articular-distal-radius-fractures-in-young-active-patients
#13
A-M Gay, P Samson, R Legré
Management of complex intra-articular fractures of the distal radius in young active patients must aim to restore normal anatomy. For optimal planning of the surgical procedure, a thorough analysis of the fracture with appropriate radiological exams and diagnosis of frequently associated lesions are necessary. Surgical management involves use of various types of internal or external fixation. Routine use of standardized analysis tools for these fractures along with prospective follow-up should allow us to define guidelines for each situation in the near future...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890211/-extra-articular-distal-radius-fractures-in-young-adults
#14
M-O Gauci, H Lenoir, T Waitzenegger, J Andrin, C Lazerges, B Coulet, M Chammas
Extra-articular distal radius fractures in young active patients are typically the result of sport injuries or traffic accidents. Displaced fractures are less well tolerated in young patients than in older people, especially in terms of dorsal tilt and radial shortening. Non-surgical treatment is only indicated when the fracture is minimally or not displaced. No fracture fixation method is superior to another, however, the treatment goal is a rapid return to previous activities.
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890210/-surgical-exposures-for-distal-radius-fractures
#15
O Mares, R Coulomb, C Lazerges, C Bosch, P Kouyoumdjian
This is a review of the various approaches that can be used for open reduction and internal fixation (ORIF) of distal radius fractures. The main dissection steps are exposed and the specific indications for each approach are described. The anterior approach is discussed extensively as it is now the gold standard for ORIF of distal radius fractures. The lateral and posterior approaches are also described as they are sometimes needed for complex fractures.
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890209/-patient-accident-fracture-paf-classification-of-distal-radius-fractures
#16
M Burnier, G Herzberg, Y Izem
Despite the huge amount of literature devoted to acute distal radius fractures, there is currently no consensus as to treatment recommendations. There is no universally accepted anatomical classification other than the three main categories of the AO classification. The authors believe that the only way to improve this field is to stratify the patients according to their general health and functional needs. They propose a new classification system that they have used since 2009 and demonstrate its therapeutic, epidemiological and teaching values...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890208/-descriptive-radiographic-topographic-and-functional-anatomy-applied-to-distal-radius-fractures
#17
C Fontaine, R Bry, P Laronde, E Guerre, A Aumar
Extensive anatomical knowledge is needed in order to correctly treat distal radius fractures: normal and pathological osteology of the distal radius, distal radio-ulnar joint and radiocarpal joint-both on the descriptive and functional level-the neurovascular and muscular environments of the distal radius-which are essential to the surgical approaches-and the angles that need to be restored during the reduction. All of these concepts are broached in this article.
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890207/-the-meu-classification-system-for-distal-radius-fractures-prognostic-and-therapeutic-value-of-an-independent-assessment-of-various-fracture-parameters
#18
J Laulan, E Marteau, G Bacle
Distal radius fractures (DRF) are often complex injuries that can impact the radial metaphysis (M), the radial epiphysis (E) and the distal ulna (U). Each of these parameters can influence the outcome. In a given injury, these three DRF components are involved to a varying degree and are variably associated. The MEU classification independently analyzes the three main bone components of the fracture; thus, all possible combinations and each specific injury can be described. It accurately depicts the type and severity of the DRF...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890206/-distal-radius-fractures-which-classification-is-the-right-one
#19
L Obert, D Lepage, R Saadnia, F Mille, P-B Rey, F Loisel
None of the classification systems for distal radius fractures is ideal. However a validated system to analyze these fractures is available that is based on the "metaphysis, epiphysis, ulna" (MEU) classification and the "patient, accident, fracture" (PAF) system. It makes it possible to understand the injury and select the best treatment.
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27890205/-internal-fixation-of-the-distal-radius-medical-liability-considerations
#20
C Lebrun
Fixation of distal radius fractures is now the primary surgical procedure leading to medical liability claims for surgeons dealing with injuries to the upper limb. The main reasons for incrimination are complex regional pain syndrome and an unfavorable progression toward malunion. Infectious problems are relatively rare and, in general, well controlled. The associated capsule and ligament damage can be underestimated at the time of the initial assessment, which points to the need for complementary imaging in case of doubt...
December 2016: Hand Surgery and Rehabilitation
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