No abstract available.
Carpal Bones/*injuries ; Female ; Fractures, Bone/*complications ; Hand Injuries/*complications ; Humans ; Male ; Radius Fractures/*complications

PURPOSE: To compare the functional and radiological outcomes of volar plating to that of external fixation for treating unstable osteoporotic distal radius fracture. MATERIALS AND METHODS: From March 2006 to March 2008, 36 patients with osteoporosis over 60-year old were selected for this study. They were divided into two groups; group I (open reduction and internal fixation with volar fixed angle plate) and group II (closed reduction and external fixation). Clinical outcomes and radiologic outcomes were evaluated. RESULTS: There was no statistical difference between group I and group II in range of motion and DASH score, BMD score. However, the grip strength and PRWE score were found to be higher in group II (p<0.05). In radiologic evaluation, group I showed higher radial inclination, volar tilting angle (p<0.05). CONCLUSION: Internal fixation using Volar-fixed Angle Plate seems to give more stable fixation for distal articular fragments compared to external fixation. it could allow early postoperative exercise and could result in low incidence of postoperative complication such as pin track infections and joint stiffness. Therefore, the internal fixation could be more desirable treatment method to manage unstable distal radius fracture.
Hand Strength ; Humans ; Incidence ; Joints ; Osteoporosis ; Postoperative Complications ; Radius ; Radius Fractures ; Range of Motion, Articular ; Track and Field

PURPOSE: To evaluate clinical and radiological results of AO type C distal radius fractures treated with a volar locking plating system. MATERIALS AND METHODS: We retrospectively reviewed 31 patients with AO type C distal radius fracture treated with a volar locking plating system. We evaluated the clinical results according to the Mayo wrist performance scoring system and disabilities of the arm, shoulder and hand (DASH) score and evaluated the radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance score was 81.9. The mean DASH score was 11.2. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 8.8 mm to 13mm, radial inclination from 14.7degrees to 22.5degrees, volar tilt from -11.3degrees to 9.4degrees and intra-articular step-off from 2.2 mm to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured under 1 mm, radial inclination under 1degrees, volar tilt under 1degrees and intra-articular step-off under 1 mm (p>0.05). Internal fixation using volar locking compression plate could allow early postoperative exercise and could result in low incidence of postoperative complication. All cases showed bone union showing no evidence of malunion, nounion, nor metal failure. CONCLUSION: Treatment of AO type C fractures using a volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.
Arm ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Postoperative Complications ; Radius ; Radius Fractures ; Retrospective Studies ; Shoulder ; Wrist

PURPOSE: To evaluate clinical and radiological results of AO type C distal radius fractures treated with a volar locking plating system. MATERIALS AND METHODS: We retrospectively reviewed 31 patients with AO type C distal radius fracture treated with a volar locking plating system. We evaluated the clinical results according to the Mayo wrist performance scoring system and disabilities of the arm, shoulder and hand (DASH) score and evaluated the radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance score was 81.9. The mean DASH score was 11.2. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 8.8 mm to 13mm, radial inclination from 14.7degrees to 22.5degrees, volar tilt from -11.3degrees to 9.4degrees and intra-articular step-off from 2.2 mm to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured under 1 mm, radial inclination under 1degrees, volar tilt under 1degrees and intra-articular step-off under 1 mm (p>0.05). Internal fixation using volar locking compression plate could allow early postoperative exercise and could result in low incidence of postoperative complication. All cases showed bone union showing no evidence of malunion, nounion, nor metal failure. CONCLUSION: Treatment of AO type C fractures using a volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.
Arm ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Postoperative Complications ; Radius ; Radius Fractures ; Retrospective Studies ; Shoulder ; Wrist

PURPOSE: To evaluate outcomes 2.4 mm volar locking compression plate for treatment of unstable distal radius fractures. MATERIALS AND METHODS: We retrospectively analyzed the results in 22 cases, which were treated by 2.4 mm volar locking compression plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance score was 85.23. Between preoperative and immediate postoperative radiographic measurements, the mean radial length was improved from 6.04 mm to 9.68 mm, radial inclination from 15.61degrees to 19.61degrees, volar tilt from -13.73degrees to 7.66degrees and intraarticular step-off from 0.79 mm to 0.33 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.86 mm, radial inclination 0.41degrees, volar tilt 0.54degrees and intraarticular step-off 0.02 mm (p>0.05). Postoperative complication included that flexor pollicis longus and 2nd flexor digitorum profundus were ruptured in 1 case. CONCLUSION: Treatment of unstable distal radius fractures using a 2.4 mm volar locking compression plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.
Follow-Up Studies ; Postoperative Complications ; Radius ; Radius Fractures ; Retrospective Studies ; Wrist

A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on right forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnar nerve has not been reported in English language literature to the best of our knowledge. A mechanism is proposed for the injury. In acute presentations, restoration of both the radioulnar joints should be done and neglected nature of such injury leads to suboptimal outcomes.
Female ; Humans ; Joint Dislocations ; complications ; Middle Aged ; Radius ; injuries ; Radius Fractures ; complications ; Ulna ; injuries ; Ulnar Nerve Compression Syndromes ; etiology

PURPOSE: Percutaneous pin fixation is commonly applied for pediatric diaphyseal forearm fractures. We analyzed the results of percutaneous transphyseal intramedullary K-wires fixation for pediatric forearm fractures and evaluated the safety of this procedure in terms of growth. MATERIALS AND METHODS: Thirty-six pediatric patients with forearm diaphyseal fractures treated with transphyseal intramedullary K-wire fixation were reviewed retrospectively. Authors analyzed size and number of fixed K-wires and evaluated postoperative complications, bone length discrepancy and any deformity at the last follow-up. We also evaluated range of motion of wrist and forearm as a functional result. RESULTS: The mean age was 9.5 years old and the average period of follow-up was 53 months (range: 23-85 months). Single wire was applied in each bone, and 1.6 mm sized K-wire was most commonly used for radius fractures and 1.1 mm K-wire for ulnar fractures. There was one superficial pin site infection which was healed by conservative treatment. There were no other complications such as premature epiphyseal closure, discrepancy of forearm length or any deformity. All patients showed no significant difference in range of motion compared to opposite side at the last follow-up. CONCLUSION: Percutaneous transphyseal intramedulaary K-wire fixation is one of the effective and safe operative treatment for pediatric forearm fractures without any deleterious effects on subsequent growth of radius and ulna.
Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Humans ; Postoperative Complications ; Radius ; Radius Fractures ; Range of Motion, Articular ; Retrospective Studies ; Ulna ; Wrist

PURPOSE: Percutaneous pin fixation is commonly applied for pediatric diaphyseal forearm fractures. We analyzed the results of percutaneous transphyseal intramedullary K-wires fixation for pediatric forearm fractures and evaluated the safety of this procedure in terms of growth. MATERIALS AND METHODS: Thirty-six pediatric patients with forearm diaphyseal fractures treated with transphyseal intramedullary K-wire fixation were reviewed retrospectively. Authors analyzed size and number of fixed K-wires and evaluated postoperative complications, bone length discrepancy and any deformity at the last follow-up. We also evaluated range of motion of wrist and forearm as a functional result. RESULTS: The mean age was 9.5 years old and the average period of follow-up was 53 months (range: 23-85 months). Single wire was applied in each bone, and 1.6 mm sized K-wire was most commonly used for radius fractures and 1.1 mm K-wire for ulnar fractures. There was one superficial pin site infection which was healed by conservative treatment. There were no other complications such as premature epiphyseal closure, discrepancy of forearm length or any deformity. All patients showed no significant difference in range of motion compared to opposite side at the last follow-up. CONCLUSION: Percutaneous transphyseal intramedulaary K-wire fixation is one of the effective and safe operative treatment for pediatric forearm fractures without any deleterious effects on subsequent growth of radius and ulna.
Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Humans ; Postoperative Complications ; Radius ; Radius Fractures ; Range of Motion, Articular ; Retrospective Studies ; Ulna ; Wrist

OBJECTIVETo analyze the reason of error diagnosis and inappropriate treatment of radius head fractures complicating distal radioulnar joint dislocation (Essex-Lopresti injury) and to seek for the reasonable treatment.

METHODSFrom 2008 to 2009, 2 male patients of radius head fractures complicating distal radioulnar joint dislocation were treated, the age was 56 and 66 years old respectively. The symptom included elbow swelling and limitation of forearm rotation. X-ray showed comminuted fractures of capitulum radius. There were 1 case of Mason type III and 1 cases of type IV. Two patients were treated by resection of capitulum radius and plaster fixation after operation.

RESULTSBoth of the 2 cases had limited rotation of forearm and the distal radioulnar joint pain. The X-ray showed that the distal radioulnar joint was separated obviously and the proximal radius was translocated.

CONCLUSIONThe early diagnosis is very important for the Essex-Lopresti injury. Rebuilding the longth of the radius and reduction fixating the distal radioulnar joint after fixated is an effective treatment while the interosseous membranes can't be repaired and rebuilded.

Aged ; Diagnostic Errors ; Elbow Joint ; injuries ; Humans ; Joint Dislocations ; diagnosis ; therapy ; Male ; Middle Aged ; Radius Fractures ; complications ; Ulna Fractures ; complications

Ulnar nerve palsy subsequent to a fracture of the distal radius is extremely rare compared to a median nerve injury. The lesion tends to occur in younger patents with a high-energy mechanism of injury and a severe injury pattern consisting of wide displacement, comminution, combined distal ulnar fracture and open fracture. The mechanism of injury can contribute to a direct contusion and traction, compression secondary to prolonged edema and tissue fibrosis, intraneural fibrosis and laceration. We report 2 cases of progressive ulnar nerve palsy subsequent to closed fractures of the distal radius. The neurological symptoms recovered in all cases who underwent nerve decompression and neurolysis at 2 or 3 months after the trauma. It is recommended that cases with high-energy, widely displaced or comminuted fractures of the distal radius be evaluated carefully for ulnar nerve as well as median nerve injury.
Adult ; Fracture Fixation, Internal ; Fractures, Closed/*complications/surgery ; Fractures, Comminuted/*complications/surgery ; Humans ; Male ; Radius Fractures/*complications/surgery ; Ulnar Neuropathies/*etiology/surgery ; Young Adult