The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius
|
|
- Brendan Mosley
- 5 years ago
- Views:
Transcription
1 The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius Y. Zenke, A. Sakai, T. Oshige, S. Moritani, T. Nakamura From Kagawa Rosai Hospital, Marugame, Japan A total of 118 consecutive patients with a fracture of the distal radius were treated with a volar locking plate; 50 patients had no ulnar styloid fracture, 41 had a basal ulnar styloid fracture, and 27 had a fracture of the tip of the ulnar styloid. There were no significant differences in radiological and clinical results among the three groups. The outcome was good and was independent of the presence of a fracture of the ulnar styloid. A total of five patients (4.2%) had persistent ulnar-sided wrist pain at final follow-up. Nonunion of the ulnar styloid fracture did not necessarily lead to ulnar wrist pain. Patients with persistent ulnar pain had a higher mean initial ulnar variance and increased post-operative loss of ulnar variance. The presence of an associated ulnar styloid fracture of the ulnar styloid does not adversely affect the outcome in patients with a fracture of the distal radius treated by volar plating. Y. Zenke, MD, Orthopaedic Surgeon S. Moritani, MD, Orthopaedic Surgeon Department of Orthopaedic Surgery Kagawa Rosai Hospital, Jyoto-cho, Marugame , Japan. A. Sakai, MD, PhD, Orthopaedic Surgeon, Associate Professor T. Oshige, MD, Orthopaedic Surgeon T. Nakamura, MD, PhD, Orthopaedic Surgeon, Professor Department of Orthopaedic Surgery, School of Medicine University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu , Japan. Correspondence should be sent to Dr A. Sakai; a- sakai@med.uoeh-u.ac.jp 2009 British Editorial Society of Bone and Joint Surgery doi: / x.91b $2.00 J Bone Joint Surg [Br] 2009;91-B: Received 12 March 2008; Accepted after revision 11 August 2008 Fractures of the distal radius are common in the elderly. 1 Various surgical techniques are available to treat these unstable fractures of the distal radius, such as percutaneous pinning, 2,3 external fixation, 4-6 and internal fixation with various types of plate. 7,8 Recently, encouraging results have been reported following the use of volar locking plates, 9-13 and we have reported better correction with early recovery of hand function when using volar plates than after intrafocal pinning. 14 Arthroscopy of the wrist at the time of fixation of intra-articular distal radial fractures may improve the outcome. 15 The treatment of an associated ulnar styloid fracture remains controversial. It may be treated non-operatively or by external fixation, pinning or plate fixation. 16,17 Anatomical and biomechanical studies indicate that the triangular fibrocartilage complex and its attachments to the ulnar styloid are important in maintaining the stability of the distal radio-ulnar joint. Disruption of the triangular fibrocartilate complex insertion into the foveal region of the distal ulna can produce instability. 18 Fractures of the ulnar styloid may be associated with instability of the distal radio-ulnar joint 19,20 and a poor outcome. 21 Others, however, have found that a fracture of the ulnar styloid has no impact on the anatomical, radiological or functional result when it accompanies a distal radial fracture We attempted to determine whether the presence of an associated fracture of the ulnar styloid affects the outcome of patients with a distal radial fracture when treated with a volar locking plate. Patients and Methods A total of 118 consecutive patients (118 wrists) with a dorsally angulated, unstable fracture of the distal radius which had been treated by internal fixation with a volar locking plate between October 2004 and June 2007 were included in the study. There were 28 men and 90 women with a mean age of 64.1 years (25 to 94). The right wrist was injured in 58 patients and the left in 60. The mean time from injury to surgery was 1.5 days (0 to 11). The mean follow-up was 14.9 months (6 to 38). The indications for internal fixation included dorsal tilt > 5, radial inclination angle < 20, and ulnar variance contralateral > 2 mm when compared with the side, and/or an intra-articular step of > 1 mm. No ulnar styloid fractures were treated surgically. We excluded patients with ipsilateral upper extremity injuries, a nonunion of a previous ulnar styloid fracture or a different type of distal radial fracture, those with systemic, multiple-organ or head injuries, those who had previously undergone surgery for a fracture of the distal ulna, and those who had undergone surgical treatment more than two weeks after the injury. 102 THE JOURNAL OF BONE AND JOINT SURGERY
2 THE EFFECT OF AN ASSOCIATED ULNAR STYLOID FRACTURE ON THE OUTCOME AFTER FIXATION OF A FRACTURE OF THE DISTAL RADIUS 103 Table I. Demographic data Fractures of ulnar styloid No fractures of ulnar styloid group Base group Tip group Total Number of cases Mean age (yrs) Gender Male:female 13:37 6:35 9:18 28:90 Injured side Right:left 22:28 20:21 16:11 58:60 Mean period from injury to surgery (days) Mean follow-up period (mths) The DRV locking plate system (Mizuho Medical Department Instrument Company, Tokyo, Japan) 26,27 was used in 29 patients between November 2004 and October 2005, and the Volar Distal Radius Plating System (Stellar plate, Japan Universal Technologies, Inc, Tokyo, Japan) in 89 patients between November 2005 and September We changed system because the Stellar plate could be delivered more rapidly by the company. There were no marked differences in implant design between the two. The study was approved by the Ethics Review Committee, and consent was obtained from each patient. The 118 patients were divided into three groups: 50 had no fracture of the ulnar styloid, 41 had a fracture of the base of the ulnar styloid (base group), and 27 had a fracture of the tip of the ulnar styloid (tip group). We divided fractures into base and tip based on the midpoint of the height of styloid process. 28 The mean age of the base group was 65.5 years (25 to 89), and that of tip group was 57.3 years (22 to 81). There was no significant difference in age between the groups (chi-squared test). For the base group, the gap distance at the fracture site was < 2 mm in 35 patients and > 2 mm in six, whereas for the tip group, the gap distance was < 2 mm in nine patients and > 2 mm in 18. The demographic characteristics of the patients are given in Table I. According to the AO classification, 29 there were 60 type A fractures (extra-articular fractures involving neither the radiocarpal nor the radio-ulnar joint) of which 29 were A2 and 31 A3 and 58 type C fractures (complex articular fractures affecting the joint surface and metaphyseal area) of which 17 were C1, 31 C2 and 10 C3. Surgery was performed under brachial plexus block. A longitudinal skin incision was made next to the tendon of flexor carpi radialis which was retracted medially with the flexor pollicis longus muscle. The radial border of the pronator quadratus muscle was divided longitudinally. The volar aspect of the radius was exposed subperiosteally. The plate was placed directly onto the radius after reduction of the fracture, using the condylar stabilising method. 30 No bone graft was used. After fixation, the pronator quadratus was repaired and the wound closed. The mean duration of surgery was 62 minutes (40 to 125). No plaster cast was used. Active exercises were started as comfort permitted. Formal physiotherapy started four or five days after surgery and continued for three months. The patients were reviewed each week for four weeks, and thereafter at six and eight weeks, three and six months, and at final follow-up. Deformity was assessed on standard anteroposterior and lateral radiographs by measuring the angles of volar tilt and radial inclination and the degree of ulnar variance using criteria described previously. 31,32 These measurements were made at the first visit, immediately after surgery and at final follow-up. Union of the ulnar styloid fractures was evaluated at final follow-up. All measurements were accurate to 0.01 mm or 0.01 by use of a semi-automatic image analysis system (Toshiba Diagnostic Viewer system, Tokyo, Japan). The range of movement of the wrist and forearm, grip strength, and the presence of ulnar wrist pain were recorded at each visit. The Disability of the Arm Shoulder and Hand outcome (DASH) score 33 was recorded regularly (at one, two, four, eight, 12 and 24 weeks) and at final follow-up. Patient-related hand performance was evaluated using the criterion of Cooney et al. 34 The bone mineral density of the lumbar spine (L2 to L4) was measured by dual-energy X-ray absorptiometry (QDR- 4500, Hologic Inc., Bedford, Massachusetts) at the first visit. Statistical analysis. Results were expressed as means (SEM). Differences were evaluated using the Mann- Whitney U test for age, period from injury to surgery, duration of follow-up, bone mineral density, grip strength, DASH score, and each parameter of deformity of the radius at each time point, and the chi-squared test for gender, injured side, proportion of patients with AO type C, and proportion of patients with ulnar styloid fractures. A p-value of < 0.05 was considered significant. All statistical analyses were performed using Stat-View 5.0 software (Hulinks Inc, Tokyo, Japan). VOL. 91-B, No. 1, JANUARY 2009
3 104 Y. ZENKE, A. SAKAI, T. OSHIGE, S. MORITANI, T. NAKAMURA Fig. 1a Fig. 1b Fig. 1c Graphs showing changes in the deformity of the radius on radiographs according to a) volar tilt, b) radial inclination and c) ulnar variance. There were no significant differences in these parameters between the three groups at each time point (Mann-Whitney U test, p > 0.05). Fig. 2 Graph showing changes in post-operative grip strength. There were no significant differences between the three groups at each time point (Mann-Whitney U test, p > 0.05). Results At the final follow-up, all 118 radial fractures had united, whereas only 22 of the 68 (32.4%) associated ulnar styloid fractures were united. The union rate in the tip group (11 of 27, 40.7%) was significantly higher than that in the base group (11 of 41 patients, 26.8%, chi-squared test, p < 0.05). With regard to the gap distance, the union rates were 16.7% (one of six) for cases of > 2 mm and 28.6% (10 of 35) for cases of < 2 mm in the base group, and the respective rates in the tip group were 16.7% (three of 18) and 88.9% (eight of nine). Patients with a gap distance of > 2 mm on the initial radiographs tended not to unite. A total of 12 patients (10.2%) developed post-operative complications, including three with tendon injuries (extensor pollicis longus in two and flexor pollicis longus in one), two with a nerve palsy (carpal tunnel syndrome in one, and involvement of the superficial palmar branch of the median nerve in one), one with flexor tendonitis of the thumb, one with an incomplete injury of the radial artery, and five with symptoms relating to the plate (loosening of a cortical screw in two and protrusion of a distal locking screw into the wrist joint in three). None had a deep infection or complex regional pain syndrome. Radiological findings. The mean volar tilt angle was 12.6 (1 to 20 ) immediately after surgery and 11.9 (5 to 20 ) at final follow-up in the no-fracture group (Fig. 1a). The respective values of the base and tip groups were 11.1 (5 to 25 ) and 10.3 (5 to 20 ), and 9.7 (4 to 21 ) and 9.3 (0 to 21 ). The mean radial inclination angle was 24.2 (15 to 30 ) immediately after surgery and 23.9 (13 to 30 ) at final follow-up in the no-fracture group (Fig. 1b). The respective values of the base and tip groups were 24.3 (14 to 32 ) and 24.0 (14 to 30 ), and 23.3 (14 to 30 ) and 23.1 (17 to 28 ). There were no significant differences in volar tilt and radial inclination among the three groups Mann-Whitney U test, p > 0.05). Maintenance of volar tilt and radial inclination was noted in all patients. For the mean ulnar variance (mm), the loss of correction occurred between immediately after surgery and final follow-up (Fig. 1c) the change being -0.4 to 0.5 in the no-fracture group, 0.1 to 1.1 in the base group, and -0.4 to 1.4 in the tip group. Range of movement and grip strength. The movements returned satisfactorily in all groups. There were no significant differences in the range of movement at each time point among the three groups (Mann-Whitney U test, p > 0.05). Recovery of grip strength was expressed as a per- THE JOURNAL OF BONE AND JOINT SURGERY
4 THE EFFECT OF AN ASSOCIATED ULNAR STYLOID FRACTURE ON THE OUTCOME AFTER FIXATION OF A FRACTURE OF THE DISTAL RADIUS 105 Fig. 3 Graph showing changes in Disability of the Arm Shoulder and Hand outcome (DASH) score. There were no significant differences between the three groups at each time point (Mann-Whitney U test, p > 0.05). Fig. 4 Patients with ulnar wrist pain at final examination. There were no significant differences in the percentages of patients with ulnar wrist pain between the two groups. centage of the opposite uninjured side (Fig. 2). At the final follow-up, grip strength was 90.8% in the no-fracture group, 92.5% in the base group and 94.7% in the tip group. There was no significant difference between the groups in grip strength at each time point (Mann-Whitney U test, p > 0.05). DASH score and self-rated hand performance. The mean DASH score improved substantially in each group (Fig. 3). There were no significant differences in the scores between the three groups (Mann-Whitney U test). The hand performance was rated excellent in 86 (73%), good in 26 (22%) and fair in six (5%). Ulnar wrist pain and nonunion of ulnar styloid fractures. Ulnarsided wrist pain improved gradually with time. The number of patients with ulnar pain was 16 (13.6%) at three months, ten (8.5%) at six months, six (5.1%) at 12 months, and five (4.2%) at final follow-up. There was no significant difference in the incidence between the three groups (no-fracture group: 6.0% (3 of 50), base group: 4.9% (2 of 41), tip group: 0% (0 of 27). There was no relationship between ulnar pain and union of the ulnar styloid fracture. Ulnar pain occurred in 6.0% of the nofracture group (3 of 50), in none of those with united styloid fractures (0 of 22) and 4.3% of those with nonunion of styloid fractures (two of 46) (Fig. 4). Comparison of patients with and without ulnar wrist pain. We compared the background factors between patients with and without ulnar wrist pain at the final examination (Table II). Only the initial ulnar variance and its final use of correction were significantly different between the two groups, being greater in those with pain (Table II). Discussion In this series of patients with a distal radial fracture treated with a volar locking plate the presence of an associated untreated fracture of the ulnar styloid was not associated with a worse outcome. This finding is consistent with those of Ekenstam et al, 22 who reported no difference in outcome after operative or non-operative treatment for a fracture of the ulnar styloid associated with an extra-articular fracture of the distal radius, although a triangular fibrocartilage complex injury was found in all patients who had operative treatment. This suggests that there is no benefit to be gained by fixing a fracture of the ulnar styloid when stabilising a fracture of the distal radius with a volar plate. Shaw, Bruno and Paul, 35 however, reported on the basis of a biomechanical study and primary repair of displaced ulnar styloid fractures, that this form of treatment stabilises the radioulnar joint. Patients in whom the ulnar styloid fracture can be reduced and maintained in supination can be treated effectively with external fixation in supination. 36 Nakamura et al 34 reported that a fracture of the ulnar styloid and triangular fibrocartilage complex injury leads to instability of the distal radio-ulnar joint, and that repair of the triangular fibrocartilage complex should be performed as well as fixation of the ulnar styloid fracture. The radiological results in this series are comparable with those of previous reports Reduction of the fracture of the ulnar styloid was not lost despite early postoperative mobilisation. The mean time from injury to surgery was 1.5 days and surgery was performed on the same day as injury in 46 of 118 patients (40.0%). In our series, five patients (4.2%) had persistent ulnar wrist pain at the final follow-up and the incidence of ulnar pain was independent of union of the fracture of the ulnar styloid. Our results suggest that greater initial ulnar variance and loss of correction of that variance between immediately after surgery and final follow-up can predict persistent ulnar pain. A high-energy injury with a large ulnar variance value causing a triangular fibrocartilage complex tear has been reported to be related to a high rate of distal radio-ulnar joint instability. 37 Persistent ulnar wrist pain might mainly be caused by dysfunction of the triangular fibrocartilage complex, incongruity of the distal radio-ulnar joint, 24 or ulnocarpal abutment due to radial VOL. 91-B, No. 1, JANUARY 2009
5 106 Y. ZENKE, A. SAKAI, T. OSHIGE, S. MORITANI, T. NAKAMURA Table II. Comparison of cases with and without ulnar wrist pain (final) Cases with ulnar wrist pain (n = 5) Cases without ulnar wrist pain (n = 113) p-value Mean age (yrs) 63.8 (48 to 75) 63.9 (25 to 94) 0.41 AO type C (%) ns. # Ulnar styloid fractures (%) ns. # Bone mineral density (g/cm 2 ) (0.65 to 1.19) (0.49 to 1.04) 0.62 Ulnar variance (mm) (mean, range) At the initial examination 6.40 (2 to 13) 3.30 (-1 to 11) 0.04 * Immediately after surgery 0.30 (-2 to 2) (-3 to 3) 0.38 At the final follow-up 2.00 (0 to 4) 0.65 (-3 to 5) 0.08 Of the opposite side 1.20 (0 to 4) 1.14 (-2 to 7) 0.49 Loss of correction of ulnar variance (mm) 2.10 (1 to 3) 0.88 (-1 to 4) * * significant differences between two groups by Mann-Whitney U-test (except #) or by chi-squared test # NS, not significant shortening, rather than nonunion of the fractured ulnar styloid. Ulnar wrist pain gradually improves up to two years after surgery. 38 MR scans have shown that an intra-articular soft-tissue injury accompanies the distal radial fracture in 47.6% of cases, % with scapholunate ligament rupture, 9.5% with triangular fibrocartilage complex disruption, 4.8% with extensor carpi ulnaris tenosynovitis and 4.8% with dorsal radiocarpal ligament tear. A fracture of the ulnar styloid is rarely associated with a triangular fibrocartilage complex tear. 39 Many soft-tissue lesions have been reported to be associated with intra-articular distal radial fractures at arthroscopy: triangular fibrocartilage complex lesions in 61.9%, scapholunate ligament lesions in 33.3%, and a lunotriquetral lesion in 4.8%. 40 There are two limitations of this study: there was no control group in which the ulnar styloid fracture was surgically treated, and we have no information about the soft-tissue element of the injury. We have, however, shown that the presence of an ulnar styloid fracture does not affect the outcome of a fracture of the distal radius which is stabilised with a volar locking plate. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. References 1. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg [Am] 2001;26: Kapandji A. Intra-local pinning of the distal end of the radius 10 years later. Ann Chir Main 1987;6:57-63 (in French). 3. Sasaki S. Modified Desmanet s intramedullary pinning for fractures of the distal radius. J Orthop Sci 2002;7: Atroshi I, Brogren E, Larsson GU, et al. Wrist-bridging versus non-bridging external fixation for displaced distal radius fractures: a randomized assessor-blind clinical trial of 38 patients followed for 1 year. Acta Orthop 2006;77: Melamed E, Robinson D. Effectiveness of external fixation and percutaneous pinning in maintaining distal radius fracture reduction over a 6-month period. J Trauma 2006;60: Egol K, Walsh M, Tejwani N, et al. Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. J Bone Joint Surg [Br] 2008;90-B: Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg [Am] 2006;31: Orbay JL. The treatment of unstable distal radius fractures with volar fixation. Hand Surg 2000;5: Orbay JL, Fernandez DL. Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. J Hand Surg [Am] 2002;27: Chung KC, Watt AJ, Kotsis SV, et al. Treatment of unstable distal radial fractures with the volar locking plate system. J Bone Joint Surg [Am] 2006;88-A: Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 2003;27: Murakami K, Abe Y, Takahashi K. Surgical treatment of unstable distal radius fractures with volar locking plates. J Orthop Sci 2007;12: Downing ND, Karantana A. A revolution in the management of fractures of the distal radius? J Bone Joint Surg [Br] 2008; 90-B: Oshige T, Sakai A, Zenke Y, Moritani S, Nakamura T. A comparative study for clinical and radiological outcomes of dorsally displaced, unstable distal radius fractures: intrafocal pinning versus volar locking plating. J Hand Surg [Am] 2007;32: Varitimidis SE, Basdekis GK, Dailiana ZH, et al. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction? J Bone Joint Surg [Br] 2008;90-B: Hauck RM, Skahen J 3rd, Palmer AK. Classification and treatment of ulnar styloid nonunion. J Hand Surg [Am] 1996;21: Arora R, Lutz M, Hennerbichler A, et al. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007;21: Haugstvedt JR, Berger RA, Nakamura T, et al. Relative contributions of the ulnar attachments of the triangular fibrocartilage complex to the dynamic stability of the distal radioulnar joint. J Hand Surg [Am] 2006;31: May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg [Am] 2002;27: Zimmerman R, Rudisch A, Fritz D, Gschwentner M, Arora R. MR imaging for the evaluation of accompanying injuries in cases of distal forearm fractures in children and adolescents. Handchir Mikrochir Plast Chir 2007;39:60-7 (in German). 21. Oskarsson GV, Aaser P, Hjall A. Do we underestimate the predictive value of the ulnar styloid affection in Colles fractures? Arch Orthop Trauma Surg 1997;116: af Ekenstam F, Jakobsson OP, Wadin K. Repair of the triangular ligament in Colles fracture: no effect in a prospective randomized study. Acta Orthop Scand 1989;60: Roysam GS. The distal radio-ulnar joint in Colles fractures. J Bone Joint Surg [Br] 1993;75-B: Tsukazaki T, Iwasaki K. Ulnar wrist pain after Colles fracture: 109 fractures followed for 4 years. Acta Orthop Scand 1993;64: Richards RS, Bennett JD, Roth JH, Milne K Jr. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg [Am] 1997;22: Osada D, Fujita S, Tamai K, et al. Biomechanics in uniaxial compression of three distal radius volar plates. J Hand Surg [Am] 2004;29: THE JOURNAL OF BONE AND JOINT SURGERY
6 THE EFFECT OF AN ASSOCIATED ULNAR STYLOID FRACTURE ON THE OUTCOME AFTER FIXATION OF A FRACTURE OF THE DISTAL RADIUS Osada D, Fujita S, Yamaguchi T, Tamai K, Saotome K. Volar-locking plate fixation for unstable distal radius fractures in elderly patients. J Jpn Soc Surg Hand 2005;22: Nakamura R, Horii E, Imaeda T, et al. Ulnar styloid malunion with dislocation of the distal radioulnar joint. J Hand Surg [Br] 1998;23: Graff S, Jupiter J. Fracture of the distal radius: classification of treatment and indications for external fixation. Injury 1994;25(Suppl 4): Kiyoshige Y. Condylar stabilizing technique with AO/ASIF distal radius plate for Colles fracture associated with osteoporosis. Tech Hand Up Extrem Surg 2002;6: Metz VM, Gilula LA. Imaging techniques for distal radius fractures and related injuries. Orthop Clin North Am 1993;24: Goldfarb CA, Yin Y, Gilula LA, Fisher AJ, Boyer MI. Wrist fractures: what the clinician wants to know. Radiology 2001;219: Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) Am J Ind Med 1996;29: Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures: perilunate fracture-dislocations of the wrist. Clin Orthop 1987;214: Shaw JA, Bruno A, Paul EM. Ulnar styloid fixation in the treatment of posttraumatic instability of the radioulnar joint: a biomechanical study with clinical correlation. J Hand Surg [Am] 1990;15: Ruch DS, Lumsden BC, Papadonikolakis A. Distal radius fractures: a comparison of tension band wiring versus ulnar outrigger external fixation for the management of distal radioulnar instability. J Hand Surg [Am] 2005;30: Nakamura T, Takayama S, Horiuchi Y, Yabe Y. Origins and insertions of the triangular fibrocartilage complex: a histological study. J Hand Surg [Br] 2001;26: Porter M, Stockley I. Fractures of the distal radius: intermediate and end results in relation to radiologic parameters. Clin Orthop 1987;220: Spence LD, Savenor A, Nwachuku I, Tilsley J, Eustace S. MRI of fractures of the distal radius: comparison with conventional radiographs. Skeletal Radiol 1998;27: Kordasiewicz B, Pomianowski S, Orlowski J, Rapala K. Interosseous ligaments and TFCC lesions in intraarticular distal radius fractures: radiographic versus arthroscopic evaluation. Orthop Traumatol Rehabil 2006;8: VOL. 91-B, No. 1, JANUARY 2009
MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS FOR DISTAL RADIUS FRACTURES: SURGICAL TECHNIQUE M. TOBE 1, K. MIZUTANI 1, Y. TSUBUKU 1, Y.
Riv Chir Mano - Vol. 43 (3) 2006 MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS FOR DISTAL RADIUS FRACTURES: SURGICAL TECHNIQUE M. TOBE 1, K. MIZUTANI 1, Y. TSUBUKU 1, Y. YANAGIHARA 2 1 Department of 2nd Orthopaedic
More informationIndex. Note: Page numbers of article titles are in boldface type. Hand Clin 21 (2005)
Hand Clin 21 (2005) 501 505 Index Note: Page numbers of article titles are in boldface type. A Antibiotics, following distal radius fracture treatment, 295, 296 Arthritis, following malunion of distal
More informationJMSCR Vol 05 Issue 04 Page April 2017
www.jmscr.igmpublication.org Impact Factor 5. Index Copernicus Value: 3.7 ISSN (e)-37-17x ISSN (p) 55-5 DOI: https://dx.doi.org/1.1535/jmscr/v5i.1 Functional Outcome after Surgical Stabilization of Fractures
More informationBridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius
Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius A RANDOMISED, PROSPECTIVE TRIAL K. Egol, M. Walsh, N. Tejwani,
More informationTreatment of unstable distal radius fractures with the volar locking plate
Upsala Journal of Medical Sciences. 2011; 116: 280 284 ORIGINAL ARTICLE Treatment of unstable distal radius fractures with the volar locking plate HANAE MINEGISHI 1, OSAMU DOHI 1, SOUKAN AN 2 & HIDETSUGU
More informationUniversity of Groningen. Fracture of the distal radius Oskam, Jacob
University of Groningen Fracture of the distal radius Oskam, Jacob IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document
More informationDisclosures. Distal Radius Fractures 5/16/2017. Distal Radius Fractures: Complications & Limitations of the Volar Approach
Distal Radius Fractures: Complications & Limitations of the Volar Approach Frank R. Avilucea, MD Assistant Professor Department of Orthopaedic Surgery University of Cincinnati Medical Center Disclosures
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/35777 holds various files of this Leiden University dissertation. Author: Wijffels, Mathieu Mathilde Eugene Title: The clinical and non-clinical aspects
More informationjournal ORIGINAL RESEARCH
texas orthopaedic journal ORIGINAL RESEARCH Assessment of Volar Tilt Measurements with Variations in X-Ray Beam Centralization Along the Longitudinal Axis of the Radius Russell A. Wagner, MD; Will Junius,
More information6/5/2018. DISCLOSURES Hassan R. Mir, MD, MBA, FACS. Evolution of Distal Radius Fracture Treatment [Chung Hand Clinics 2012]
DISCLOSURES Hassan R. Mir, MD, MBA, FACS Paid Consultant for a Company or Supplier Smith & Nephew Zimmer Biomet Trice Medical Stock or Stock Options Core Orthopaedics OrthoGrid Systems Research Support
More informationIndex. Springer International Publishing Switzerland 2016 J.N. Lawton (ed.), Distal Radius Fractures, DOI /
Index A AAOS. See American Academy of Orthopaedic Surgeons (AAOS) Abductor pollicis longus (APL) tendon, 34, 73 Acute carpal tunnel syndrome, 93 American Academy of Orthopaedic Surgeons (AAOS), 66, 238
More informationResidual wrist pain after volar locking plate fixation of distal radius fractures
Acta Orthop. Belg., 2012, 78, 603-610 ORIGINAL STUDY Residual wrist pain after volar locking plate fixation of distal radius fractures Shigeru KUriMOTO, Masahiro TATEBE, Takaaki SHiNOHArA, Tetsuya ArAi,
More informationSurgical Management of Distal end Radius Fractures by Various Methods: A Prospective Study
Original Article 1, 3 Assoc. Professor 2 Professor & HOD 4, 5 PG Students Department of Orthopedics MGM Hospital Kakatiya Medical College Warangal. Telangana State India. CORRESPONDENCE : Dr.Jhatosh.Venkateshwarlu,
More informationNeglected trans-scaphoid trans-styloid volar dislocation of the lunate
CASE REPORT Neglected trans-scaphoid trans-styloid volar dislocation of the lunate LATE RESULT FOLLOWING OPEN REDUCTION AND K-WIRE FIXATION P. Givissis, A. Christodoulou, B. Chalidis, J. Pournaras From
More informationDistal radius fractures raises considerable interest and
Original Article Two peg spade plate for distal radius fractures A novel technique Sharad M Hardikar, Sreenivas Prakash, Madan S Hardikar, Rohit Kumar Abstract Background: The management of distal radius
More informationAcute Rupture of Flexor Tendons as a Complication of Distal Radius Fracture
60 pissn : 1226-2102, eissn : 2005-8918 Case Report J Korean Orthop Assoc 2015;50: 60-65 http://dx.doi.org/10.4055/jkoa.2015.50.1.60 www.jkoa.org Acute Rupture of Flexor Tendons as a Complication of Distal
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,000 116,000 120M Open access books available International authors and editors Downloads Our
More informationKousuke Iba 1*, Yasuhiro Ozasa 1, Takuro Wada 1, Tomoaki Kamiya 1, Toshihiko Yamashita 1, Mitsuhiro Aoki 2. Abstract
RESEARCH ARTICLE Open Access Efficacy of radial styloid targeting screws in volar plate fixation of intra-articular distal radial fractures: a biomechanical study in a cadaver fracture model Kousuke Iba
More informationTechnique Guide. 2.4 mm Variable Angle LCP Distal Radius System. For fragment-specific fracture fixation with variable angle locking technology.
Technique Guide 2.4 mm Variable Angle LCP Distal Radius System. For fragment-specific fracture fixation with variable angle locking technology. Table of Contents Introduction 2.4 mm Variable Angle LCP
More informationFactors Predicting Late Collapse of Distal Radius Fractures
http://dx.doi.org/10.5704/moj.1111.006 Factors Predicting Late Collapse of Distal Radius Fractures, MD Regional Hospital Durres, Orthopaedic Clinic, Durres, Albania ABSTRACT Background: Although fractures
More informationCASE REPORT. Distal radius nonunion after volar locking plate fixation of a distal radius fracture: a case report
Nagoya J. Med. Sci. 79. 551 ~ 557, 2017 doi:10.18999/nagjms.79.4.551 CASE REPORT Distal radius nonunion after volar locking plate fixation of a distal radius fracture: a case report Takaaki Shinohara 1
More informationFractures of the distal end of the radius should be
FRACTURES OF THE DISTAL END OF THE RADIUS TREATED BY INTERNAL FIXATION AND EARLY FUNCTION A PRELIMINARY REPORT OF 20 CASES DANIEL A. RIKLI, PIETRO REGAZZONI From the University Hospital, Basel, Switzerland
More informationVolar fixed-angle plating for distal radius fractures 刀圭会協立病院 津村敬
Volar fixed-angle plating for distal radius fractures 刀圭会協立病院 津村敬 Normal distal radius anatomy Radial styloid process EPL Volar lip Lister s s tubercle Radial styloid process Sigmoid notch palmar view
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/35777 holds various files of this Leiden University dissertation. Author: Wijffels, Mathieu Mathilde Eugene Title: The clinical and non-clinical aspects
More informationMalunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
J Orthopaed Traumatol (2014) 15:285 290 DOI 10.1007/s10195-014-0307-x ORIGINAL ARTICLE Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate Luigi Tarallo
More informationFUNCTIONAL AND RADIOLOGICAL OUTCOMES AFTER VOLAR LOCKING PLATE FIXATION IN TYPE C DISTAL RADIUS FRACTURES A RETROSPECTIVE STUDY
FUNCTIONAL AND RADIOLOGICAL OUTCOMES AFTER VOLAR LOCKING PLATE FIXATION IN TYPE C DISTAL RADIUS FRACTURES A RETROSPECTIVE STUDY Surendra Singh Yadav 1, Vikas Singhal 2 1 - Associate Professor, Department
More informationCOMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF EXTERNAL AND INTERNAL FIXATION IN TREATMENT OF COMMINUTED DISTAL RADIUS FRACTURES
COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF EXTERNAL AND INTERNAL FIXATION IN TREATMENT OF COMMINUTED DISTAL RADIUS FRACTURES R. Sahaya Jose 1 1Assistant Professor, Department of Orthopaedics, Sree Mookambika
More informationORIGINAL ARTICLE TREATMENT DISTAL RADIUS FRACTURE WITH VOLAR BUTTRESS TECHNIQUE- A CLINICAL STUDY
TREATMENT DISTAL RADIUS FRACTURE WITH VOLAR BUTTRESS TECHNIQUE- A CLINICAL STUDY Neelanagowda V P Patil 1, Lingaraj 2, P S Kaladagi 3, Paramanda Hospeti 4, Nizamuddin 5. 1. Assistant professor, Department
More informationJMSCR Vol 05 Issue 06 Page June 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i6.32 Functional & Radiological Outcome of the
More informationChapter 7. Anatomy of the Triangular Fibrocartilage Complex: Current Concepts. Introduction. Anatomy. Histology
Chapter 7 Anatomy of the Triangular Fibrocartilage Complex: Current Concepts Introduction The triangular fibrocartilage complex (TFCC) is one of the intrinsic ligaments of the wrist. It is often injured
More informationDegrees Of Volar Angulation In Distal Radius Fracture Effects Distal Radioulnar Joint Stability:a Biomechanical Study
Degrees Of Volar Angulation In Distal Radius Fracture Effects Distal Radioulnar Joint Stability:a Biomechanical Study Yuki Bessho, MD, Toshiyasu Nakamura, MD PhD, Takeo Nagura, MD PhD, Yoshimori Kiriyama,
More informationIntra articular distal radius fractures and volar plate fixation: a prospective study
International Journal of Research in Orthopaedics Kundu AK et al. Int J Res Orthop. 2017 May;3(3):589-594 http://www.ijoro.org Original Research Article DOI: http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20171907
More informationTriangular Fibrocartilage Complex Repair. The triangular fibrocartilage complex (TFCC) is one of the main stabilizers of the
Michelle Brandt and Megan Passarelle Surgical Assignment Due: 11/9/14 Triangular Fibrocartilage Complex Repair Abstract The triangular fibrocartilage complex (TFCC) is one of the main stabilizers of the
More informationAcute Wrist Injuries OUCH!
Acute Wrist Injuries OUCH! Case the athlete FOOSH from sporting event 2 days ago C/O wrist swelling, pain, worse with movement Hmmm Wrist pain Exam of the wrist - basics Appearance Swelling, bruising,
More informationInteresting Case Series. Ulnolunate Impaction Syndrome
Interesting Case Series Ulnolunate Impaction Syndrome Saptarshi Biswas, MD, FRCS Westchester University Medical Center, Valhalla, NY Keywords: ulnar impaction, ulnar impaction syndrome, ulnar wrist pain,
More informationMark VanDer Kaag 1, Ajmal Ikram 2. Hand Unit, Tygerberg Hospital University of Stellenbosch
A Prospective, Randomized Controlled Study To Determine The Radiological And Functional Outcomes Of IMN Fixation Of Distal Radius Fractures Using A Novel Device The Sonoma Wrx Distal Radius Nail Compared
More informationWINSTA-R. Distal Radius System
Distal Radius System Table of Contents Introduction WINSTA-R System 2 Indication 2 Surgical Technique Palmar Access for Radius Plate 3 Dorsal Access for Radius Plate 3 Positioning of the Radius Plate
More informationUniversity of Groningen. Fracture of the distal radius Oskam, Jacob
University of Groningen Fracture of the distal radius Oskam, Jacob IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document
More informationEmile N. Brown, MD, and Scott D. Lifchez, MD
Flexor Pollicis Longus Tendon Rupture After Volar Plating of a Distal Radius Fracture: Pronator Quadratus Plate Coverage May Not Adequately Protect Tendons Emile N. Brown, MD, and Scott D. Lifchez, MD
More informationISSN (Online) ISSN (Print) Hospital, 7, Works Road, Chromepet, Chennai , Tamilnadu, India.
Scholars Academic Journal of Biosciences (SAJB) Sch. Acad. J. Biosci., 2016; 4(3B):237-243 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationDisclosures. Epidemiology 10/12/2015. Distal Radius Fractures: Staying Out of Trouble
Distal Radius Fractures: Staying Out of Trouble Brad Palmer, MD Allegheny General Hospital Pittsburgh, PA Disclosures Nothing to Disclosure in the past 12 months, neither my spouse nor myself have had
More informationHand and wrist emergencies
Chapter1 Hand and wrist emergencies Carl A. Germann Distal radius and ulnar injuries PEARL: Fractures of the distal radius and ulna are the most common type of fractures in patients younger than 75 years.
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/35777 holds various files of this Leiden University dissertation. Author: Wijffels, Mathieu Mathilde Eugene Title: The clinical and non-clinical aspects
More informationUniversity of Groningen. Fracture of the distal radius Oskam, Jacob
University of Groningen Fracture of the distal radius Oskam, Jacob IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document
More informationInjury, Int. J. Care Injured 42 (2011) Contents lists available at ScienceDirect. Injury. journal homepage:
Injury, Int. J. Care Injured 42 (2011) 385 392 Contents lists available at ScienceDirect Injury journal homepage: www.elsevier.com/locate/injury Comparison of angle stable plate fixation approaches for
More informationA STUDY OF THE FUNCTIONAL OUTCOME OF LOW PROFILE DORSAL PLATING IN DISTAL END RADIUS FRACTURES
Original Article Orthopaedics A STUDY OF THE FUNCTIONAL OUTCOME OF LOW PROFILE DORSAL PLATING IN DISTAL END RADIUS FRACTURES Sunil H. Shetty 1, Amit B. Dhond 2, Manavdeep Singh 3, Atul Kharat 4, Abhimanyu
More informationCommon Limb Fractures. Mr Sheraz Malik MB BS MRCS Instructor Mr Paul Ofori-Atta Mb ChB FRCS President Motc Life UK April 2009
Common Limb Fractures Mr Sheraz Malik MB BS MRCS Instructor Mr Paul Ofori-Atta Mb ChB FRCS President Motc Life UK April 2009 Objectives To be able to describe all characteristics of a fracture Describe
More informationIncidence 643,000 per year United States 15% of all fractures, peak occurrence age 60 70, Classification - AO/OTA (Murray 2013)
Treatment of Distal Radial Fractures John M. Bednar, M.D. Associate Clinical Professor Orthopaedic Surgery, Thomas Jefferson University School of Medicine and The Philadelphia Hand Center Incidence 643,000
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/97579
More informationCase Report Bone Resection for Isolated Ulnar Head Fracture
Hindawi Case Reports in Orthopedics Volume 2017, Article ID 3519146, 4 pages https://doi.org/10.1155/2017/3519146 Case Report Bone Resection for Isolated Ulnar Head Fracture Hiromasa Akino, Shunpei Hama,
More informationInt J Clin Exp Med 2017;10(1): /ISSN: /IJCEM
Int J Clin Exp Med 2017;10(1):1139-1144 www.ijcem.com /ISSN:1940-5901/IJCEM0040515 Original Article Comparison of open reduction volar locking plate fixation and closed reduction percutaneous K-wire fixation
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/35777 holds various files of this Leiden University dissertation. Author: Wijffels, Mathieu Mathilde Eugene Title: The clinical and non-clinical aspects
More informationIS CASTING AN ACCEPTABLE TREATMENT APPROACH FOR A DISTAL RADIUS FRACTURE THAT HAS UNDERGONE A SATISFACTORY CLOSED REDUCTION?
Original Article FOR A DISTAL RADIUS FRACTURE THAT HAS UNDERGONE A SATISFACTORY CLOSED REDUCTION? Khalid Masood *, Muhammad Jamil **, Farooq Ibrahim Pasha*, Khalid Zulfiqar Quresshi **, Naveed Ishaq Malik
More informationEvaluation of volar locking plate fixation for management of intraarticular fractures of distal end of radius
International Journal of Research in Orthopaedics Pathak RS et al. Int J Res Orthop. 2018 Mar;4(2):193-197 http://www.ijoro.org Original Research Article DOI: http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20180400
More informationDistal radius fractures are
Clin Orthop Relat Res (2015) 473:3098 3104 / DOI 10.1007/s11999-015-4335-5 Clinical Orthopaedics and Related Research A Publication of The Association of Bone and Joint Surgeons Published online: 21 May
More informationInteresting Case Series. Perilunate Dislocation
Interesting Case Series Perilunate Dislocation Tom Reisler, BSc (Hons), MB ChB, MRCS (Ed), Paul J. Therattil, MD, and Edward S. Lee, MD Division of Plastic and Reconstructive Surgery, Department of Surgery,
More informationFractures and dislocations around elbow in adult
Lec: 3 Fractures and dislocations around elbow in adult These include fractures of distal humerus, fracture of the capitulum, fracture of the radial head, fracture of the olecranon & dislocation of the
More informationComparative Study between Bridging External Fixation vs Volar Plating (Ellis-T Plate) for Comminuted Fracture of the Distal End Radius
SK Venkatesh Gupta, Pradeep Mandapalli Clinical study 10.5005/jp-journals-10017-1051 Comparative Study between Bridging External Fixation vs Volar Plating (Ellis-T Plate) for Comminuted Fracture of the
More informationThe functional importance of malunion in distal radius fractures
The functional importance of malunion in distal radius fractures Nadine HOLLEVOET, René VERDONK The purpose of our study was to investigate which radiological parameter had the maximal detrimental effect
More informationLong term results of the Sauvé-Kapandji procedure in the rheumatoid wrist
Acta Orthop. Belg., 2013, 79, 655-659 ORIGINAL STUDY Long term results of the Sauvé-Kapandji procedure in the rheumatoid wrist Miklós Papp, Levente Papp, Balázs Lenkei, Zoltán Károlyi From Borsod County
More informationComparison between Distractor Application on Both Radial & Ulnar Side and Radial Side Only for Fracture Distal Radius with Ulnar Styloid Fracture
Open Journal of Orthopedics, 2013, 3, 227-233 http://dx.doi.org/10.4236/ojo.2013.35043 Published Online September 2013 (http://www.scirp.org/journal/ojo) 227 Comparison between Distractor Application on
More informationDisclosure. 85% Dorsal. 15% Volar. Distal Radius Fractures- Volar Plating for All. Skeletal Dynamics- Consultant
Distal Radius Fractures- Volar Plating for All Frontiers in Upper Extremity Surgery 2017 Francisco Rubio, M.D. Miami Hand and Upper Extremity Institute Miami, FL Disclosure Skeletal Dynamics- Consultant
More informationDistal Radius Plate Instrument and Implant Set. Discontinued December 2017 DSUS/TRM/0916/1063(1)
Distal Radius Plate Instrument and Implant Set Surgical Technique Discontinued December 2017 DSUS/TRM/0916/1063(1) The Distal Radius Plates Indications For fixation of fractures and osteotomies, including
More informationTrans-scaphoid Perilunate Fracture-dislocation with Concomitant Lunotriquetral Ligament Disruption: A Case Report
Case Reports Trans-scaphoid Perilunate Fracture-dislocation with Concomitant Lunotriquetral Ligament Disruption: A Case Report Kentaro Sonoki, Yuji Tomori, Yoshinori Obara, Mitsuhiko Nanno, Norie Kodera
More informationBreakage of a volar locking plate after delayed union of a distal radius fracture
cta Orthop. elg., 2007, 73, 785-790 CSE REPORT reakage of a volar locking plate after delayed union of a distal radius fracture Tom DE ERE, Frédéric LECOUVET, Olivier RIER From Cliniques Universitaires
More informationDistal Radius Fractures Using Acu-Loc Volar Plate
Soonchunhyang Medical Science 17(1):1-6, June 2011 pissn: 2233-4289 I eissn: 2233-4297 ORIGINAL ARTICLE Distal Radius Fractures Using Acu-Loc Volar Plate Kheng Mab 1, Byung Sung Kim 2, Eung Ha Kim 2, Soo
More informationTherapeutic Effects of Volar Anatomical Plates Versus Locking Plates for Volar Barton s Fractures
n Feature Article Therapeutic Effects of Volar Anatomical Plates Versus Locking Plates for Volar Barton s Fractures Zhibing Tang, MD; Huilin Yang, MD, PhD; Kangwu Chen, MD; Genlin Wang, MD, PhD; Xiaoyu
More informationDynamic CT Assessment of Distal Radioulnar Instability
Dynamic CT Assessment of Distal Radioulnar Instability Poster No.: P-0114 Congress: ESSR 2016 Type: Educational Poster Authors: S. Dumonteil, M. A. Shah, A. Srikanthan, V. Ejindu, N. Papadakos; London/UK
More informationCarpal Injuries. AO Advanced Principles of Fracture Management Middelfart, april 2016
Carpal Injuries AO Advanced Principles of Fracture Management Middelfart, 11.-14. april 2016 Overlæge Marianne Vestergaard Lind Traumesektionen Ortopædkirurgisk Klinik Rigshospitalet AOT Advanced Principles
More informationDistal Radius and Distal Ulna Plates System Self-Tapping Spherical Locking Screw Self-Tapping Conical Locking Screw Cortex Screw
DISTAL RADIUS AND ULNA LOCKING PLATE SYSTEM Surgical Technique Distal Radius and Distal Ulna Plates System Self-Tapping Spherical Locking Screw Self-Tapping Conical Locking Screw Cortex Screw Approved
More informationYi-xin Chen, Xin Zheng, Hong-fei Shi *, Yu-fan Wangyang, Han Yuan, Xiao-xiao Xie, Dong-ya Li, Chang-jun Wang and Xu-sheng Qiu
Chen et al. BMC Musculoskeletal Disorders 2013, 14:186 RESEARCH ARTICLE Open Access Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external
More informationReproducibility of Three Dimensional Digital Preoperative Planning for the Osteosynthesis of Distal Radius Fractures
Reproducibility of Three Dimensional Digital Preoperative Planning for the Osteosynthesis of Distal Radius Fractures Yuichi Yoshii, 1 Takuya Kusakabe, 1 Kenichi Akita, 2 Wen Lin Tung, 3 Tomoo Ishii 1 1
More informationClient centered approach to distal radius fracture management. Jared Rasmussen OTR
Client centered approach to distal radius fracture management Jared Rasmussen OTR Disclosures Sadly, no financial disclosures Objectives Review of anatomy, common fractures of the distal radius, fixation
More informationThe Utility of the Fluoroscopic Skyline View During Volar Locking Plate Fixation of Distal Radius Fractures
Scientific Article 245 The Utility of the Fluoroscopic Skyline View During Volar Locking Plate Fixation of Distal Radius Fractures Lucile Vaiss, MD 1 Satoshi Ichihara, MD, PhD 1,2 Sarah Hendriks, MD 1
More informationQUICK REFERENCE GUIDE. The Pennig Dynamic Wrist Fixator. Part A: Trans-articular application
10 The Pennig Dynamic Wrist Fixator Part A: Trans-articular application B1 B2 B3 III IV TRANS-ARTICULAR APPLICATION The fractures that can be treated with this technique include AO type B and C fractures,
More informationLigaments of Elbow hinge: sagittal plane so need lateral and medial ligaments
Ligaments of Elbow hinge: sagittal plane so need lateral and medial ligaments Ulnar Collateral ligament on medial side; arising from medial epicondyle and stops excess valgus movement (lateral movement)
More informationHardware-Related Complications After Dorsal Plating for Displaced Distal Radius Fractures
Hardware-Related Complications After Dorsal Plating for Displaced Distal Radius Fractures Jonas L. Matzon, MD; Julia Kenniston, MD; Pedro K. Beredjiklian, MD abstract There has been a trend away from dorsal
More informationORIGINAL PAPER. Department of Hand Surgery, Nagoya University School of Medicine ABSTRACT
Nagoya J. Med. Sci. 74. 167 ~ 171 2012 ORIGINAL PAPER TILT OF THE RADIUS FROM FOREARM ROTATIONAL AXIS RELIABLY PREDICTS ROTATIONAL IMPROVEMENT AFTER CORRECTIVE OSTEOTOMY FOR MALUNITED FOREARM FRACTURES
More informationComparisonofUlnar-ShorteningOsteotomyWitha NewTrimedDynamicCompressionSystemVersusthe SynthesDynamicCompressionSystem:ClinicalStudy
SCIENTIFICARTICLE ComparisonofUlnar-ShorteningOsteotomyWitha NewTrimedDynamicCompressionSystemVersusthe SynthesDynamicCompressionSystem:ClinicalStudy ShaiLuria,MD,AnthonyJ.Lauder,MD,ThomasE.Trumble,MD
More informationSean Walsh Orthopaedic Surgeon Dorset County Hospital
Sean Walsh Orthopaedic Surgeon Dorset County Hospital Shapes and orientation of articular surfaces Ligaments Oblique positioning of scaphoid Tendons surrounding the joints Other soft tissues Peripheral
More informationForearm and Wrist Regions Neumann Chapter 7
Forearm and Wrist Regions Neumann Chapter 7 REVIEW AND HIGHLIGHTS OF OSTEOLOGY & ARTHROLOGY Radius dorsal radial tubercle radial styloid process Ulna ulnar styloid process ulnar head Carpals Proximal Row
More informationClinical Study Rate of Improvement following Volar Plate Open Reduction and Internal Fixation of Distal Radius Fractures
SAGE-Hindawi Access to Research Advances in Orthopedics Volume 2011, Article ID 565642, 4 pages doi:10.4061/2011/565642 Clinical Study Rate of Improvement following Volar Plate Open Reduction and Internal
More informationClinical Study Dorsally Comminuted Fractures of the Distal End of the Radius: Osteosynthesis with Volar Fixed Angle Locking Plates
ISRN Orthopedics Volume 2013, Article ID 131757, 6 pages http://dx.doi.org/10.1155/2013/131757 Clinical Study Dorsally Comminuted Fractures of the Distal End of the Radius: Osteosynthesis with Volar Fixed
More informationParesh Patil, Kiran Gaonkar, Adish Patil, Nishant Gaonkar, Ketan Gupta*, Nirav Patel, Himanshu Kulkarni
International Journal of Research in Medical Sciences Patil P et al. Int J Res Med Sci. 2015 Apr;3(4):883-890 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Research Article DOI: 10.5455/2320-6012.ijrms20150412
More informationComplications of Distal Radius Fractures. How to Treat a Distal Radius Fx 11/13/2017. Michael S. Bednar, M.D. Loyola University Chicago
Complications of Distal Radius Fractures Michael S. Bednar, M.D. Loyola University Chicago How to Treat a Distal Radius Fx Need to restore motion, begin with uninvolved parts Need to reduce an unreduced
More informationFunctional Outcome in Distal Radius Fractures Treated with Locking Compression Plate
Functional Outcome in Distal Radius Fractures Treated with Locking Compression Plate Sanjay Agarwala*, Ganesh S Mohrir**, Shreyans D Gadiya*** Abstract Purpose: To determine outcome of patient on treatment
More informationTotal distal radioulnar joint replacement for symptomatic joint instability or arthritis
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Total distal radioulnar joint replacement for symptomatic joint instability or arthritis Instability of
More informationDifferentiated approach to repair of displaced distal radial metaepiphyseal fractures. R.P. Matveev, S.V. Bragina, A.M. Shneiveis
s A group of authors, 2017 DOI 10.18019/1028-4427-2017-23-4-396-400 Differentiated approach to repair of displaced distal radial metaepiphyseal fractures R.P. Matveev, S.V. Bragina, A.M. Shneiveis FSBEI
More informationAbstract INTRODUCTION. Martin Vlček 1 *, Edib Jaganjac 1, Jan Pech 1, David Jonáš 1, Radek Kebrle 2
Is minimally invasive application by intramedullary osteosynthesis in comparison with volar plating real benefit in the treatment of distal radius fractures? Martin Vlček 1 *, Edib Jaganjac 1, Jan Pech
More informationManagement of intra-articular fractures of distal end radius in adults
International Journal of Research in Orthopaedics Gawali SR et al. Int J Res Orthop. 2016 Dec;2(4):220-228 http://www.ijoro.org Original Research Article DOI: http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20163148
More informationof intramedullary nailing for correction of posttraumatic
J Orthopaed Traumatol (2017) 18:37 42 DOI 10.1007/s10195-016-0422-y ORIGINAL ARTICLE Intramedullary nailing for correction of post-traumatic deformity in late-diagnosed distal radius fractures Alvin Chao-Yu
More informationORIGINAL ARTICLE. possible. Accurate assessment of standard radiographs is essential for appropriate 3. management. And includes true posterior- 4
ORIGINAL ARTICLE Treatment of Colle's Fracture with Wrist Immobilization in Palmar flexed & Dorsiflexed Position Sohail Iqbal Shaikh, Abdul Basit, Javed Iqbal, Saba Sohail Shaikh, Imran Sohail Shaikh 26
More informationEssential Radiographic Evaluation for Distal Radius Fractures
Hand Clin 21 (2005) 279 288 Essential Radiographic Evaluation for Distal Radius Fractures Robert J. Medoff, MD Department of Orthopaedic Surgery, University of Hawaii, 30 Aulike Street #506, Kailua, HI
More informationAcomparison of percutaneous and pin-and-plaster techniques in distal radius fracture
Original Research Medical Journal of the Islamic Republic of Iran.Vol. 22, No. 4, February, 2009. pp. 159-163 Acomparison of percutaneous and pin-and-plaster techniques in distal radius fracture Farshid
More informationAnatomic Foveal Reconstruction of the Triangular Fibrocartilage Complex With a Tendon Graft
TECHNIQUE Anatomic Foveal Reconstruction of the Triangular Fibrocartilage Complex With a Tendon Graft Gregory I. Bain, MBBS, FRACS, FA (Orth) A, PhD,*wz Duncan McGuire, MBBCH, FCS (Orth), MMed,*w Yu Chao
More informationComplications and functional outcome following fixation of complex, intra-articular fractures of the distal radius with the AO Pi-Plate
Acta Orthop. Belg., 2005, 71, 672-677 ORIGINAL STUDY Complications and functional outcome following fixation of complex, intra-articular fractures of the distal radius with the AO Pi-Plate Vikas KHANDUJA,
More informationUNFAVORABLE RESULTS AND degenerative arthritis. Arthroscopically Guided Osteotomy for Management of Intra-Articular Distal Radius Malunions
SCIENTIFIC ARTICLE Arthroscopically Guided Osteotomy for Management of Intra-Articular Distal Radius Malunions Francisco del Piñal, MD, PhD, Leopoldo Cagigal, MD, Francisco J. García-Bernal, MD, PhD, Alexis
More informationTitle. Author(s)Iwasaki, Norimasa; Minami, Akio. CitationThe Journal of Hand Surgery, 34(7): Issue Date Doc URL.
Title Arthroscopically Assisted Reattachment of Avulsed Tr Author(s)Iwasaki, Norimasa; Minami, Akio CitationThe Journal of Hand Surgery, 34(7): 1323-1326 Issue Date 2009-09 Doc URL http://hdl.handle.net/2115/39285
More informationArthroplasty for advanced Kienböck s disease using a radial bone flap with a vascularised wrapping of pronator quadratus
Arthroplasty for advanced Kienböck s disease using a radial bone flap with a vascularised wrapping of pronator quadratus H. S. Gong, M. S. Chung, Y. H. Lee, S. Lee, J. O. Lee, G. H. Baek From Seoul National
More informationHand numbness and carpal tunnel syndrome after volar plating of distal radius fracture
HAND (2011) 6:34 38 DOI 10.1007/s11552-010-9283-7 ORIGINAL ARTICLE Hand and carpal tunnel syndrome after volar plating of distal radius fracture Angela Wing Hang Ho & S. T. Ho & S. C. Koo & K. H. Wong
More information