Distal radius

BACKGROUND: Childhood obesity is a national problem that has gained significant attention in both the medical literature and the national media. Obesity in the adult population has been associated with increased failure of conservative treatments. Our hypothesis is that childhood obesity is associated with a loss of reduction after closed treatment of distal radius fractures. METHODS: A total of 157 patients with consecutive distal radius fractures who underwent closed reduction in the emergency department or the operating room were included from the office records of the sole pediatric orthopaedic subspecialist group in a metropolitan area from January 2011 to June 2012...

Fractures of the distal radius are among the most common pediatric fractures. Although most of these fractures heal without complication, some result in partial or complete physeal arrest. The risk of physeal arrest can be reduced by avoiding known risk factors during fracture management, including multiple attempts at fracture reduction. Athletes may place substantial compressive and shear forces across the distal radial physes, making them prone to growth arrest. Timely recognition of physeal arrest can allow for more predictable procedures to be performed, such as distal ulnar epiphysiodesis...

Controversies span the entire spectrum of management of distal radius fractures-fracture assessment, diagnosis, treatment, and evaluation of outcomes. The utility of multiple radiographic views described in the literature has not been validated. Likewise, the several classification systems that exist have yet to demonstrate substantial interobserver and intraobserver reliability. Nonsurgical controversies involve fracture reduction, use of anesthesia, type of fracture immobilization, and forearm position during healing...

Carpal tunnel syndrome is a common condition and is a well-recognized phenomenon following a distal radius fracture. The treating surgeon should be vigilant in noticing the signs and symptoms. If acute carpal tunnel syndrome is noted, then surgical release of the carpal tunnel and fracture fixation should be performed urgently. If early carpal tunnel syndrome findings are noted during distal radius fracture management, all potential causes should be evaluated. Delayed carpal tunnel syndrome presenting after a distal radius fracture has healed is best managed in standard fashion...

BACKGROUND: Optimal surgical management of unstable distal radial fractures is controversial, and evidence from rigorous comparative trials is rare. We compared the functional outcomes of treatment of unstable distal radial fractures with external fixation, a volar plate, or a radial column plate. METHODS: Forty-six patients with an injury to a single limb were randomized to be treated with augmented external fixation (twenty-two patients), a locked volar plate (twelve), or a locked radial column plate (twelve)...