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proximal radius fractures

Devin Ganesh, Ben Service, Brian Zirgibel, Kenneth Koval
OBJECTIVES: To assess the utility of the dorsal tangential view (DTV) in detecting intraoperative dorsal screw penetration in distal radius fractures treated with volar locked plating. DESIGN: Retrospective cohort study. SETTING: Academic level 1 trauma center. PATIENTS/PARTICIPANTS: Skeletally mature patients where open reduction internal fixation with volar locked plating was the definitive treatment. A total of twenty-six patients were evaluated...
November 2016: Journal of Orthopaedic Trauma
Yaiza Lópiz, Ana González, Carlos García-Fernández, Javier García-Coiradas, Fernando Marco
INTRODUCTION: At present, surgical treatment of comminuted radial head fractures without associated instability continues to be controversial. When anatomical reconstruction is not possible, radial head excision is performed. However, the appearance of long-term complications with this technique, along with the development of new radial head implants situates arthroplasty as a promising surgical alternative. The purpose of the present study was to compare the mid-term functional outcomes of both techniques...
September 2016: Injury
Richard Eastell, Terence W O'Neill, Lorenz C Hofbauer, Bente Langdahl, Ian R Reid, Deborah T Gold, Steven R Cummings
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population...
2016: Nature Reviews. Disease Primers
A Asmus, M Lautenbach, B Schacher, S Kim, A Eisenschenk
BACKGROUND: Operative treatment of the scaphoid nonunion includes avascular corticocancellous and cancellous bone grafts and increasingly the use of vascular pedicled and free vascular corticocancellous grafts. Especially the latter require a fair amount of operative expertise and experience in microsurgical techniques. OBJECTIVE: Which criteria lead to the decision for or against an avascular graft used for reconstruction of scaphoid nonunion? Is our current classification system of a scaphoid pseudarthrosis able to illustrate our diagnostic potential in a way that makes us refer to operative procedures? METHODS: Evaluation of current literature and expert opinions RESULTS: Avascular bone grafts show a high union rate as long as a sufficient vascularisation of the remaining fragments is present...
September 16, 2016: Der Orthopäde
B Schacher, R Böttcher, A Vogel, A Asmus, S Kim, A Eisenschenk, F Eichenauer
BACKGROUND: Nonunion of the scaphoid as a result of proximal fractures, failed surgical reconstruction, and especially avascular fragment necrosis are possible indications of vascularized bone grafts. Various techniques of vascularized (pedicled and free) grafts have been described. Pedicled grafts from the direct vicinity of the wrist provide several benefits. Harvest-site morbidity is reduced and preserved graft perfusion, without the need for blood vessel anastomosis, may lead to an improved consolidation...
September 15, 2016: Der Orthopäde
A Bhattacharyya, S Kumar
Deformity of wrist is very common after mal union of extra articular fractures over distal end of Radius. It causes limitation of movements too in different directions with or without pain. Deformity may be treated by different types of corrective osteotomy. We treated cases of this type of malunion with Fernandez osteotomy. This study is to observe the amount of correction and recovery of functional status in patients with malunited distal radius fractures treated with Fernandez osteotomy. This is a prospective study...
July 2016: Mymensingh Medical Journal: MMJ
Donlaporn Kittivanichhkul, Narattaphol Charoenphandhu, Phisit Khemawoot, Suchinda Malaivijitnond
Since the in vitro and in vivo anti-osteoporotic effects of Pueraria mirifica (PM) in rodents have been verified, its activity in menopausal monkeys was evaluated as required before it can be applicable for human use. In this study, postmenopausal osteoporotic monkeys were divided into two groups (five per group), and fed daily with standard diet alone (PMP0 group) or diet mixed with 1,000 mg/kg BW of PM powder (PMP1000 group) for 16 months. Every two months, the bone mineral density (BMD), bone mineral content (BMC) and bone geometry parameters (cortical area and thickness, and periosteal and endosteal circumference) at the distal radius and proximal tibia were determined using peripheral quantitative computed tomography together with plasma and urinary bone markers...
September 6, 2016: Journal of Endocrinology
Keiichiro Oura, Hisao Moritomo, Toshiyuki Kataoka, Kunihiro Oka, Tsuyoshi Murase, Kazuomi Sugamoto, Hideki Yoshikawa
BACKGROUND: The purposes of this study were to quantitatively analyze osteophyte formation of the distal radius following scaphoid nonunion and to investigate how fracture locations relate to osteophyte formation patterns. METHODS: Three-dimensional surface models of the scaphoid and distal radius were constructed from computed tomographic images of both the wrists of 17 patients' with scaphoid nonunion. The scaphoid nonunions were classified into 3 types according to the location of the fracture line: distal extra-articular (n = 6); distal intra-articular (n = 5); and proximal (n = 6)...
August 30, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
John W Karl, Lauren H Redler, Peter Tang
BACKGROUND: Long-term outcomes of radial head resection for radial head fracture have shown mixed outcomes, depending on the integrity of the soft-tissue stabilizers of the elbow, forearm, and wrist. METHODS: We report a case of a symptomatic delayed proximal migration of the radius after radial head excision for radial neck nonunion which was managed with a staged radial head replacement. Informed consent was obtained from the individual in this case report. RESULTS: At 7 months after radial head replacement, the patient had 90 degrees of forearm supination and 85 degrees of pronation...
2016: Iowa Orthopaedic Journal
B Collier Watson, Benjamin C Taylor, Adam Madsen, Freddie D Persinger, Andy R Malarkey
Volar plating of distal radius fractures was introduced as a means to circumvent some of the issues with dorsal-based plating but has been shown not to be a complete panacea, as other advantages and challenges have subsequently been discovered. Careful attention and proper technique must be utilized to restore and maintain volar tilt. This study reports a technique of using a locking screw as a proximal peg to reliably obtain the volar tilt in a simple fashion.
2016: Journal of Surgical Orthopaedic Advances
Hideyoshi Sawada, Takaaki Shinohara, Tadahiro Natsume, Hitoshi Hirata
BACKGROUND: Ulnar styloid fractures are often associated with distal radius fractures. However, controversy exists regarding whether to treat ulnar styloid fractures. This study aimed to evaluate clinical effects of internal fixation for ulnar styloid fractures after distal radius fractures were treated with the volar locking plate system. METHODS: We used prospectively collected data of distal radius fractures. 111 patients were enrolled in this study. A matched case-control study design was used...
August 7, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
J T Schousboe, O Riekkinen, J Karjalainen
: Pulse-echo ultrasonometry can be used as a pre-screen for hip osteoporosis before dual-energy x-ray absorptiometry (DXA), potentially allowing DXA to be avoided for the majority of post-menopausal women. Pulse-echo ultrasound measures of tibia cortical thickness are also associated with radiographically confirmed prior fractures, independent of femoral neck bone mineral density. INTRODUCTION: To estimate how well a pulse-echo ultrasound device discriminates those who have from those who do not have hip osteoporosis (femoral neck bone mineral density [BMD] or total hip BMD T-score ≤ -2...
August 4, 2016: Osteoporosis International
D Schray, C Neuerburg, J Stein, M Gosch, M Schieker, W Böcker, C Kammerlander
INTRODUCTION: The prevalence of osteoporosis in female patients over 75 years of age is 59.2 %. In Germany ~6.3-7.8 million patients are affected by osteoporosis. In 77 % of german patients osteoporosis is not treated adequately. Even after fragility fractures only 16-21 % of female patients and 3 % of male patients are supplied with a specific osteoporosis therapy. Establishing a Fracture Liaison Services (FLS) is a possible addition to co-management for an efficient treatment of osteoporosis in orthogeriatric patients...
October 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Valerie H Tan, Pei Yein Tong, Janice Liao, Han Jing Lee, Tun-Lin Foo
BACKGROUND: The anatomy of the lateral antebrachial cutaneous nerve (LABCN) in relation to volar approaches to the distal radius is not well visited. With the increasing popularity of distal radius fracture fixation with volar locking plates, it is prudent to study the innervation pattern of the LABCN to minimize the risk of nerve injury. METHODS: Ten cadaveric distal radial forearms were dissected to study the relationship between the LABCN, flexor carpi radialis (FCR), superficial branch of radial nerve (SBRN), and scaphoid tubercle (ST)...
February 2016: J Hand Surg Asian Pac Vol
Lindsay M Griffin, Stephen Honig, Cheng Chen, Punam K Saha, Ravinder Regatte, Gregory Chang
PURPOSE: To use 7T magnetic resonance imaging (MRI) to determine how trabecular bone microarchitecture varies at the epiphysis, metaphysis, and diaphysis of the distal radius. MATERIALS AND METHODS: The distal radius of 24 females (mean age = 56 years, range = 24-78 years) was scanned on a 7T MRI using a 3D fast low-angle shot sequence (0.169 × 0.169 × 1 mm). Digital topological analysis was applied at the epiphysis, metaphysis, and diaphysis to compute: total trabecular bone volume; trabecular thickness, number, connectivity, and erosion index (a measure of network resorption)...
July 20, 2016: Journal of Magnetic Resonance Imaging: JMRI
Douglas S Weinberg, Paul J Park, Kaeleen A Boden, Kevin J Malone, Daniel R Cooperman, Raymond W Liu
BACKGROUND: Evaluating rotation during open reduction and internal fixation of a forearm fracture is of paramount importance. In challenging cases, surgeons may utilize radiographic relationships between proximal and distal radial and ulnar landmarks to assess rotational position. However, to our knowledge, limited anatomic data are available to confirm these relationships. METHODS: Six hundred cadaveric radii and ulnae were obtained. Digital representations of the bicipital tuberosity, the radial styloid, the coronoid process, and the ulnar styloid were acquired, and the rotational profiles between respective landmarks were calculated...
July 6, 2016: Journal of Bone and Joint Surgery. American Volume
C Büren, S V Gehrmann, A O Scholz, J Windolf, T Lögters
BACKGROUND: The Surgical Safety Checklist (SSC) was introduced by the World Health Organization (WHO) in 2008 in order to analyse and reduce perioperative surgical morbidity. Preoperative estimation of the expected surgery time (EST) by the surgeon is an integral part of the SSC. OBJECTIVE: The aim of the present study was to correlate EST and factual surgery time (FST), to identify factors influencing the correlation between the two parameters and to collect more information about planning surgical capacity...
June 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Saeko Fujiwara
Estimated number of those with osteoporosis was about 12,800,000, and about 23%, 3,000,000 were male osteoporosis in Japan. Incidence of hip, vertebral, distal radius, and proximal humeral fracture in men was half of that in women. Lifetime risk of hip fracture was 5.6% in men. Risk factors for osteoporotic fracture in men were low bone mineral density(BMD), previous fracture, low body mass index, smoking, family history of fracture, glucocorticoid use and others. For osteoporotic fractures, the fracture risk in smokers was significantly higher in men than in women...
July 2016: Clinical Calcium
Christian Kammerlander, Carl Neuerburg, Jorrit-Jan Verlaan, Werner Schmoelz, Theodore Miclau, Sune Larsson
There are an increasing number of fragility fractures, which present a surgical challenge given the reduced bone quality of underlying osteoporosis. Particularly in aged patients, there is a need for early weight bearing and mobilization to avoid further complications such as loss of function or autonomy. As an attempt to improve fracture stability and ultimate healing, the use of biomaterials for augmentation of osseous voids and fracture fixation is a promising treatment option. Augmentation techniques can be applied in various locations, and fractures of the metaphyseal regions such as proximal humerus, femur, tibia and the distal radius remain the most common areas for its use...
June 2016: Injury
Christian von Rüden, Peter Augat
This manuscript will provide an overview of how the age and osteoporosis related changes in mechanical properties of bone affect the stability of osteosynthesis constructs, both from a mechanical as well as from a clinical perspective. The manuscript will also address some of the principles of fracture fixation for osteoporotic fractures and discuss applications of osteoporotic fracture fixation at sites typically affected by fragility fractures, namely the distal radius, the proximal humerus, the femur and the spine...
June 2016: Injury
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