Distal radius fractures are quite common in clinical practice. At present,various classification systems of distal radius fractures may cause confusion in diagnosis,treatment and evaluating prognosis,which is unfavourable to clinical dicision making. We made a conclusion of current classification systems of distal radius fracture to assist in guiding treatment.
Humans ; Radius ; injuries ; surgery ; Radius Fractures ; classification ; diagnosis ; surgery

Fracture Fixation ; methods ; Humans ; Radius Fractures ; surgery

Fracture Fixation ; methods ; Humans ; Radius Fractures ; surgery

Child ; Humans ; Joint Dislocations ; surgery ; Male ; Orthopedic Procedures ; Radius ; injuries ; surgery ; Radius Fractures ; surgery ; Treatment Outcome

OBJECTIVETo assess the clinical effectiveness of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius.

METHODSAccording to Cochrane Systematic Review, Medline, Embase, Cochrane Li- brary, CNKI and CBM, randomised controlled trials (RCTs) of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius were searched for from 1966 to 2014. Data analysis was performed with the Cochrane Collaboration's RevMan 5.0 software.

RESULTSTotally 391 patients of 6 RCTs and 2 retrospective cohort studys were included and divided into volar plate group (187 cases) and radial column plate group (204 cases). Meta-analysis result showed: compared with radial column plate group, volar plate group had significant difference in recovery of wrist function [SMD = 0.74, 95% CI (0.47, 1.01), P < 0.00001], Gartland-Werley scores [SMD = -1.39, 95% CI (-2.24, -0.53), P = 0.001], postoperative neural in- jury [OR = 3.67, 95% CI (1.37, 9.84), P = 0.01 1 and postoperative wrist pain [OR = 0.32, 95% CI (0.13, 0.74), P = 0.008]. But no significant difference was identified in DASH scores [SMD = -0.36, 95% CI (-0.97, 0.26), P = 0.25], radiographic result assess- ment [SMD = -0.18, 95% CI (-0.53, 0.16), P = 0.3], postoperative grip strength [SMD = 0.71, 95% CI (-0.12, 1.54),P = 0.09], postoperative tendinous damage [OR = 0.31, 95% CI (0.10, 0.98), P = 0.05] and carpal tunnel syndrome [OR = 0.96, 95% CI (0.63, 1.48), P = 0.87].

CONCLUSIONCompared with radial column plate internal fixation, volar approach plate fixation for treat- ment of distal radius intra-articular fracture has advantage of recovery of joint functionand. However, the volar approach plate fix- ation was associated with a higher risk of long-term complications than the radial column approach plate fixation.

Bone Plates ; Fracture Fixation, Internal ; methods ; Humans ; Radius Fractures ; surgery

Bone Plates ; Fracture Fixation, Internal ; Humans ; Radius Fractures/surgery*

Dislocation of the elbow along with shaft fractures of both bones of the ipsilateral forearm is a rare injury though elbow dislocation or fracture of the forearm bones may occur separately. Such injuries need a concentric reduction of the dislocation and an anatomical fixation of forearm bones for optimal functional outcomes. We report a case of elbow dislocation with fracture of the lateral condyle of the humerus along with fractures of shafts of the radius and ulna in a 44-year-old female. Closed reduction of the elbow and operative stabilization of all fractures were done with good clinical, radiological and functional outcomes in 2 years follow-up period. A significant degree of force is needed to produce a combined dislocation of a joint and fracture of bones around that joint and these complex injuries may be missed if the clinician is not aware of the possibility of such injuries. The fact that the previously reported cases had a posterolateral dislocation while our case had a posteromedial dislocation and a fracture of the lateral humeral condyle as well makes it unique in its presentation and worth reporting. We have also included an up to date literature review on this topic.
Adult ; Elbow Joint ; injuries ; Female ; Humans ; Humeral Fractures ; surgery ; Joint Dislocations ; surgery ; Radius Fractures ; surgery ; Ulna Fractures ; surgery

A new injury pattern of comminuted fractures of ipsilateral radial head and distal radius of forearm in an adult was described. To the best of our knowledge, this type of injury pattern had not been previously reported in the English literature. The possible mechanisms of injury were that the rebound forces were volar to the distal radius as the fracture was dorsally angulated, with a continuation of the radial head fracture due to the longitudinal impaction of the radius against the capitellum. Open reduction and internal fixation can obtain excellent results within 7-12 days after injury. We hope that our experience will increase the awareness of the occurrence of a double injury of the forearm.
Adult ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Radius Fractures ; surgery

OBJECTIVETo evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back".

METHODSFrom January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function.

RESULTSAll patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist.

CONCLUSIONUsing the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

Adolescent ; Child ; Female ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Ulna Fractures ; physiopathology ; surgery

During imaging studies or surgical procedures, anomalous forearm and wrist muscles are occasionally encountered. Among them, the flexor carpi radialis brevis is very rare. Because the trend is growing toward treating distal radius fractures with volar plating, the flexor carpi radialis brevis is worth knowing. Here, we report two cases with a review of the literature.
Female ; Forearm/*abnormalities ; Fractures, Comminuted/surgery ; Humans ; Middle Aged ; Muscle, Skeletal/*abnormalities ; Radius Fractures/surgery ; Ulna Fractures/surgery ; Wrist/*abnormalities