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https://www.readbyqxmd.com/read/28057101/-complications-of-open-reduction-and-internal-fixation-versus-external-fixation-for-unstable-distal-radius-fractures-a-meta-analysis
#1
Z Yang, Z Z Yuan, J X Ma, X L Ma
Objective: To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Method: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28040075/results-of-geriatric-distal-radius-fractures-treated-by-intramedullary-fixation
#2
Steffi S I Falk, Thomas Mittlmeier, Georg Gradl
INTRODUCTION: Distal radius fracture are common injuries but no gold standard for their therapy exists. The aim of this study was to evaluate the quality of fracture care in distal radius fractures using an intramedullary implant (Targon DR interlocking nail). The nail had been developed to minimize the surgical exposure, increase fixation strength, to prevent tendon irritations and to allow for a fast return to activity. PATIENTS AND METHODS: Prospective study reports the result of 43 patients with an age over 70 years (range 70-91 years) treated by closed reduction and intramedullary fixation...
December 2016: Injury
https://www.readbyqxmd.com/read/28012704/tomosynthesis-a-new-radiologic-technique-for%C3%A2-rapid-diagnosis-of-scaphoid-fractures
#3
N Compton, L Murphy, F Lyons, J Jones, P MacMahon, J Cashman
Scaphoid fractures constitute 71% of all carpal bone fractures.(1) Early diagnosis and treatment has significant bearing on fracture union rates and better clinical outcomes. While displaced fractures can be readily seen on plain radiograph, undisplaced fractures can require advanced imaging modalities to confirm that diagnosis. Advanced imaging such as Magnetic Resonance Imaging (MRI), Computerised tomography (CT) and bone scintigraphy are routinely used for the diagnosis of scaphoid fractures but require significant radiation exposure, increased cost and can be difficult to access...
December 21, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28005235/examination-of-the-applicability-of-the-disabilities-of-the-arm-shoulder-and-hand-dash-questionnaire-to-patients-with-hand-injuries-and-diseases-using-rasch-analysis
#4
Kathrin Braitmayer, Caroline Dereskewitz, Cornelia Oberhauser, Klaus-Dieter Rudolf, Michaela Coenen
BACKGROUND: The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire is the most commonly applied patient-reported outcome measure used to assess disability and functioning in clinical research and practice for patients with injuries and diseases of the upper extremities. The objective of this study was to assess whether the DASH is a valid and reliable questionnaire to measure disability and functioning in patients with hand injuries and diseases using Rasch analysis. METHODS: We performed a psychometric study using data derived from two multicentre studies carried out to develop the International Classification of Functioning, Disability and Health (ICF) Core Sets for Hand Conditions...
December 22, 2016: Patient
https://www.readbyqxmd.com/read/27920391/dorsal-intercalated-segmental-instability-associated-with-malunion-of-a-reconstructed-scaphoid
#5
J-H Kim, K-H Lee, B G Lee, C-H Lee, S-J Kim, W-S Choi
: We analysed scaphoid deformity as a result of surgical treatment of scaphoid fracture nonunion and assessed the deformity associated with a dorsal intercalated segmental instability pattern of carpal malalignment. A total of 45 patients who were treated for scaphoid fracture nonunion were included in the study. The height-to-length ratio of the scaphoid was measured on computed tomographic images and used to assess scaphoid deformity. Carpal malalignment was quantified based on the radio-lunate angle...
December 5, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27916152/volar-ulnar-approach-for-fixation-of-the-volar-lunate-facet-fragment-in-distal-radius-fractures-a-technical-tip
#6
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/27896458/prognostic-factors-in-the-treatment-of-carpal-scaphoid-non-unions
#7
F Schuind, F Moungondo, W El Kazzi
In this literature review, the authors analyse the prognostic factors in the curative treatment of scaphoid non-unions. The main negative prognostic factors are smoking, the time elapsed since the fracture, and avascular necrosis of the proximal fragment. If the latter is present, the revascularization by a pedicle or microsurgical bone autograft is probably the treatment of choice. In non-unions without evidence of osteonecrosis, vascularized bone grafts are probably not superior to conventional bone grafts, which can presently be performed under arthroscopic control, with minimal morbidity...
January 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27890195/-carpal-malalignment-following-distal-radius-fracture
#8
B Coulet, M-O Gauci, C Lazerges, M Chammas
Adaptive carpal malalignment is the consequence of malunion of the distal radius. Since the radial metaphysis and capitate have to be aligned, any disorientation of the radial epiphysis will force the proximal carpal row to adapt, as it is the only mobile element. There are two types of adaptation depending where the compensative occurs: (1) midcarpal - leading to flexion between the lunate and capitate, with the lunate maintaining a normal relationship with the radial epiphysis axis; (2) radiocarpal - combining flexion and dorsal displacement of the lunate relative to the axis of the radial epiphysis, with the midcarpal joint remaining aligned...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27886841/management-of-upper-extremity-injury-in-divers
#9
REVIEW
Steven C Haase
Modern competitive diving-especially platform diving-applies dramatic stress to the upper extremity. Some stress occurs during handstand-style takeoffs, but more force is delivered to the hand, wrist, elbow, and shoulder during hands-first entry. Hand positions that minimize the amount of splash result in forceful wrist extension. This repetitive impact can lead to chronic upper extremity pain and acute injuries that require operative intervention. Many divers use taping and bracing to prevent or treat this type of injury, but these are only modestly effective...
February 2017: Hand Clinics
https://www.readbyqxmd.com/read/27856939/magnetic-resonance-imaging-investigation-of-radio-lunate-relations-use-in-assessing-distal-radial-fracture-reduction
#10
G Medlock, J M Wohlgemut, I M Stevenson, A J Johnstone
: Reformatted magnetic resonance imaging scans of 27 normal wrists were examined in incremental degrees of rotation around the central axis of the radial shaft to 30° in both directions from true lateral. A line was superimposed on the outer border of the radial dorsal cortex and continued distally to the carpal region. Measurements were made from the superior pole of the lunate to this line. This distance did not change significantly with rotation. This allows a quick and accurate way of assessing distal radial fracture reduction from poorly taken lateral radiographs...
November 16, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27855045/-four-corner-fusion-in-patients-with-wrist-arthritis
#11
María Francisca Vázquez-Alonso, Alberto Viñas-Silva
Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27830329/management-of-scaphoid-nonunion-with-iliac-crest-bone-graft-and-k-wire-fixation
#12
Erin Meisel, Alex Seal, Caroline A Yao, Alidad Ghiassi, Milan Stevanovic
PURPOSE: Scaphoid nonunion can occur in both non-operative and operatively treated scaphoid fractures. Without treatment, this can lead to a predictable pattern of carpal collapse and degenerative arthritic change and patients can experience both pain and functional loss in the early and late phases of progression. An operative technique with a high success rate for union is important. This paper describes a technique for treatment of scaphoid nonunion with K-wire fixation and iliac crest cancellous bone graft...
November 9, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27811625/internal-bone-grafting-for-the-treatment-of-scaphoid-nonunions
#13
Utkan Aydin, Sunil M Thirkannad
Scaphoid fracture is the most common carpal fracture of the upper extremity and a significant proportion of these can eventually progress to nonunion. Excision of pseudoarthrosis and fibrous scar tissue at the nonunion site is regarded as one of the important steps in management of scaphoid nonunions. We describe a technique of internal bone grafting, where curettage of the nonunion site was performed through a drill hole in the scaphoid and bone graft was packed through this same hole before fixation with a headless compression screw...
November 2, 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27806538/epidemiology-of-the-upper-extremity-trauma-in-a-traumatic-center-in-iran
#14
Maryam Ameri, Kamran Aghakhani, Ebrahim Ameri, Shahrokh Mehrpisheh, Azadeh Memarian
INTRODUCTION: Orthopedic injuries are the most common types of traumatic injuries and present as fractures of the limbs, pelvis, and vertebrae or lesions in soft tissues, muscles, ligaments, and tendons. The upper limb fractures occur in distal radius and ulna, metacarpals, fingers, scapula, and carpal bones, Proximal, diaphysis, distal humerus, clavicle, proximal ulna and radio and distal humero and humero, radio, ulna, and metacarpo. The objective of this project was to accurately describe the occurrence of injuries of the upper extremity and the mechanisms of such injuries in a representative sample of Iranian population...
August 10, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27793442/pulling-harder-than-the-hamate-tolerates-evaluation-of-hamate-injuries-in-rock-climbing-and-bouldering
#15
Christoph Lutter, Andreas Schweizer, Thomas Hochholzer, Thomas Bayer, Volker Schöffl
OBJECTIVE: Hamate hook fractures are rare injuries, comprising 2% to 4% of all carpal fractures. Climbing athletes seem to be affected more frequently than others, as they strain the passive and active anatomical structures of their hands and fingers to maximum capacity during training or competing. This stress is transmitted to the hook of the hamate by tightened flexor tendons, which creates high contact pressure to the ulnar margin of the carpal tunnel. Injuries of the hamate hook, caused by contact pressure of the anatomical structures, are rare and occur nearly exclusively during climbing...
December 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/27788215/comparison-of-diagnostic-accuracy-of-radiation-dose-equivalent-radiography-multidetector-computed-tomography-and-cone-beam-computed-tomography-for-fractures-of-adult-cadaveric-wrists
#16
Jakob Neubauer, Matthias Benndorf, Carolin Reidelbach, Tobias Krauß, Florian Lampert, Horst Zajonc, Elmar Kotter, Mathias Langer, Martin Fiebich, Sebastian M Goerke
PURPOSE: To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. METHODS: As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging...
2016: PloS One
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#17
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27770167/-surgical-treatment-of-a-complex-adolescent-carpal-fracture-a%C3%A2-rare%C3%A2-injury-to-the-growing-skeleton
#18
D Saul, J C Ammon, F August
We report the case of a 15-year-old boy with combined fractures of the scaphoid, capitate, and hamate that represents a rare variation of the well-known Fenton's syndrome. Fixation was performed for the unstable fractures of the scaphoid and capitate with the use of cannulated Herbert screws and K‑wires respectively. K‑wires were removed after 6 months, with subsequent physiotherapy. After 6 months, CT confirmed complete consolidation of the two surgically treated carpal fractures and the conservatively treated fracture of the hamate...
October 21, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27764034/triple-fracture-of-the-intra-articular-second-metacarpal-head-intra-articular-fourth-metacarpal-base-and-ulnar-styloid-of-an-ice-hockey-player-a-case-report
#19
Hiroyoshi Hagiwara, Takashi Ajiki, Suguru Hagiwara, Naoya Sugimoto, Katsushi Takeshita
We present a case of simultaneous ipsilateral fractures at the intra-articular second metacarpal head, intra-articular fourth metacarpal base, and ulnar styloid. These fractures were caused by the peculiar condition of a blow to the fist during an ice hockey game; the hand was struck while it was gripping a stick. The specific combination of these fractures has not been previously reported in the literature. In this incident, axial compression force was transmitted from the second and fourth metacarpal heads while skipping the third metacarpal head to the ulnar side of the wrist via the carpometacarpal joints and carpal bones...
July 27, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/27725994/-acute-scaphoid-fractures-management-under-consideration-of-the-new-s3-level-guideline
#20
M Schädel-Höpfner, B Bickert, C Dumont, P Laier, R Meier, A Nusche, T Pillukat, H Rosenthal, R Schmitt, F Siemers, A Zach, M Jung
BACKGROUND: Scaphoid fractures represent the most common carpal fractures and are often problematic and frequently lead to nonunion with osteoarthritis and collapse of the wrist. The reasons for the nonunion are manifold. Therefore, the main goal of diagnosis and therapy of acute fractures is to achieve bony union and to restore the anatomic shape of the scaphoid. In the long run, only this can preserve the normal function of the wrist. METHODOLOGY: The given recommendations are based on the new S3-level guideline of the AWMF (Association of the Scientific Medical Societies)...
November 2016: Der Orthopäde
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