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External Fixation for Distal Radius Fractures.

Journal of the Korean Society for Surgery of the Hand.2015;20(2):85-88. doi:10.12790/jkssh.2015.20.2.85

External fixation with or without ancillary K-wire fixation, once being one of the most popular methods of surgery for unstable distal radius fractures, is now losing its position due to a recent surge in the use of volar locking plates. However, these changes are not firmly grounded on scientific evidence. Recent clinical trials showed that a similar wrist function was achieved when the use of external fixation was compared with that of volar locking plates at 1 year after surgery for the treatment of unstable distal radius fractures, even though the rate of functional recovery was slower in the former. In addition, it is still a question whether additional costs and time paid for volar locking plates can be justified by such a small gain in wrist function. We will review recent studies comparing external fixation with volar locking plates regarding wrist function and costs, and discuss current indication of external fixation for unstable distal radius fractures.
Radius Fractures* ; Wrist

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Dorsal Approach for Distal Radius Fractures.

Hyeok Bin KWON ; Jae Sung LEE

Journal of the Korean Society for Surgery of the Hand.2015;20(2):77-84. doi:10.12790/jkssh.2015.20.2.77

Since the advent of volar locking plate, volar approach for internal fixation has become a major trend in the treatment for unstable distal radius fracture. However, dorsal approach is preferred for certain fracture pattern include AO type C3, dorsal Barton's fractures and concomitant intercarpal ligament injury, because it can afford excellent exposure of the articular surface. Although dorsal approach and plating technique has inherent disadvantages include extensor tendon irritation and rupture, improvements in implant design lead to decrease complication rate. Here, we provide overview of the pros and cons through historic perspective, indications, and surgical technique of the dorsal approach for the distal radius fracture.
Ligaments ; Radius Fractures* ; Rupture ; Tendons ; Palmar Plate

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Surgical Indications for Distal Radius Fractures.

Jae Hoon LEE

Journal of the Korean Society for Surgery of the Hand.2015;20(2):72-76. doi:10.12790/jkssh.2015.20.2.72

In determining the treatment plan of distal radius fractures, the fracture type, stability, age, activity of patient may be concerned and radiologic parameters such as radial length, dorsal and volar tilt, radial inclination, joint incongruity have to be measured. In unstable distal radius fractures, secondary dislocation after primary closed reduction can be possible and a variety of factors affecting secondary displacement have been known, which are age, radial shortening, volar and dorsal cortical comminution et al. In general, the indications for surgical treatment are including step-off more than 2 mm, dorsal tilt more than 15degrees, radial inclination less than 15degrees, or radial shortening more than 5 mm.
Dislocations ; Humans ; Joints ; Radius Fractures*

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Arthroscopically Assisted Reduction of Distal Radius Fractures.

Midum JEGAL ; Jong Pil KIM

Journal of the Korean Society for Surgery of the Hand.2015;20(2):64-71. doi:10.12790/jkssh.2015.20.2.64

Wrist arthroscopy has been used as an important adjunct procedure to distal radius fracture management. This procedure allows minimal surgical intervention and provides excellent visualization of the joint for anatomical restoration of articular fracture of the distal radius and early management of associated injuries. To many, it is still technically challenging to adequately perform arthroscopy in the distal radius fractures. With this review, we aimed to provide an updated arthroscopic technique in the management of distal radius fractures and potential pitfalls of this technique.
Arthroscopy ; Joints ; Radius ; Radius Fractures* ; Wrist

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Idiopathic Compartment Syndrome of the Forearm.

Young Jun KIM ; Duke Whan CHUNG ; Jung Suk KIM

Journal of the Korean Society for Surgery of the Hand.2015;20(2):59-63. doi:10.12790/jkssh.2015.20.2.59

Compartment syndrome is caused by elevated pressure in a restricted compartment. It typically occurs after fractures of the extremities and usually has an acute clinical progression. Chronic compartment syndrome is another relatively well known form, typically associated with forceful exercise. Also, there are various reports of compartment syndrome not associated with typical causes. However, reports on compartment syndrome with unknown etiology are rare and there has been none in Korean literature. We report a case of compartment syndrome with no recognizable cause, hence classified as idiopathic.
Compartment Syndromes* ; Extremities ; Forearm* ; Upper Extremity

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Ulnar Artery Thrombosis in Guyon's Canal.

Ki Won LEE ; Hyun Il LEE ; Chung Hwan KIM ; Sang Jun SHIM ; Hyung Kwon CHO ; Dae Woon EOM

Journal of the Korean Society for Surgery of the Hand.2015;20(2):55-58. doi:10.12790/jkssh.2015.20.2.55

Causes of ulnar nerve compression in Guyon's canal are various, but thrombosis of the ulnar artery due to a single trauma is rarely reported. We report a case of ulnar nerve compression caused by traumatic thrombosis of the ulnar artery in Guyon's canal. Surgical excision of the ulnar artery thrombus and end to end anastomosis resulted in complete relief of the patient's symptoms.
Thrombosis* ; Ulnar Artery* ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes

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Avulsion Rupture of Flexor Digitorum Profundus in Zone 1, Diagnosed in Early Stage.

Ki Do HONG ; Jae Cheon SIM ; Sung Sik HA ; Tae Ho KIM ; Min Chul SUNG

Journal of the Korean Society for Surgery of the Hand.2015;20(2):51-54. doi:10.12790/jkssh.2015.20.2.51

Avulsion injury of the flexor digitorum profundus (FDP) tendon from the distal phalanx is considered as a rare injury. We report a patient who sustained a FDP tendon rupture insertion on her fifth finger as a result of a closed, hyperextension with no accompanying laceration or predisposing pathologic condition. Preoperative ultrasonography showed complete rupture of FDP and the gap between the tendon ends. According to the classification by Leddy and Pacter, this case is type II. The reconstruction of flexor tendon using pull-out suture and tie-over button. We are reporting a case with brief review of literatures.
Classification ; Fingers ; Humans ; Lacerations ; Rupture* ; Sutures ; Tendon Injuries ; Tendons ; Ultrasonography

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Comparative Study of Outcomes between Operative and Non-Operative Treatment of Unstable Distal Radius Fracture in the Elderly Patients.

Jong Min KIM ; Hyun Je SEO ; Young Dae JEON ; Hyung Min LEE ; Jung Hwan SON

Journal of the Korean Society for Surgery of the Hand.2015;20(2):43-50. doi:10.12790/jkssh.2015.20.2.43

PURPOSE: The goal of this retrospective study is to compare radiologic outcome and clinical outcome between operative and non-operative treatment of unstable distal radius fracture in patients over 65-year-old. METHODS: From December 2006 to December 2011, 114 patients over 65-year-old were enrolled in the present study. 45 patients underwent non-operative treatment, and 69 patients underwent operative treatment. We retrospectively reviewed radiologic results and clinical results and then compared the two groups. Radiologic results include radial inclination (RI), volar tilt angle (VT) and radial shortening (RS) shown on the last radiograph and clinical results including disabilities of the arm, shoulder and hand (DASH) scores, modified Mayo wrist score (MMWS), and range of motion (ROM) of wrist. RESULTS: All cases presented bone-union. Among the patients who received non-operative treatments, average RI of 15.5degrees, average VT of 14.1degrees, average RS of 5.3 mm, The patients who received operative treatments showed average volar tilt of 3.9degrees, average VT of 18.2degrees, and average RS of 1.1 mm. RS showed a significant difference (p<0.05). At Clinical evaluation, DASH score, MMWS score, the ROM of wrist joint did not show significant difference (p>0.05). CONCLUSION: Our results suggest that non-operative treatment is initially recommended in patients over 65 years who have an unstable distal radius fracture in terms of functional results.
Aged* ; Arm ; Hand ; Humans ; Radius Fractures* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Wrist ; Wrist Joint

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Treatment of the Distal Radius Fractures in the Elderly Patients.

Young Do KOH ; Dong Joon KIM ; Jae Kwang KIM

Journal of the Korean Society for Surgery of the Hand.2013;18(2):95-102. doi:10.12790/jkssh.2013.18.2.95

Distal radius fractures are one of the most common types of fractures in the elderly. It is well documented that increased risk of a distal radius fracture in older patients is associated with decreased bone mineral density. Also, low bone mineral density increased severity of fracture and instability of fracture after reduction. Fracture displacement in the elderly does not necessarily result in functional impairment. Therefore, conservative treatment has been a mainstay treatment even in unstable fracture in the elderly. However, there is an increasing trend toward operative treatment recently, because functional demand increased in the elderly due to active life style and volar locking plate fixation enables the elderly early return to daily activity even in osteoporotic distal radius fracture.
Aged ; Bone Density ; Displacement (Psychology) ; Humans ; Life Style ; Osteoporosis ; Radius ; Radius Fractures

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Current Treatment of Triangular Fibrocartilage Complex Injuries.

Byung Sung KIM

Journal of the Korean Society for Surgery of the Hand.2013;18(2):85-94. doi:10.12790/jkssh.2013.18.2.85

The Palmer class 1B triangular fibrocartilage complex injury has two entities: a lesion with stable distal radioulnar joint and a lesion with distal radioulnar joint instability. Arthroscopic debridement of fibrocartilage disk is used in Palmer class 1A lesion. The surgeon should remove the portion of the fibrocartilage tissue until a mechanically stable and smooth residual rim remains. Arthroscopic repair is used in Palmer class 1B or 1D lesion using meniscal repair sutures. Ulnar detachment that can produce distal radioulnar ligament instability can also be repaired using bone anchor or pull out suture. Old age as well as positive ulnar variance is poor prognostic factors.
Arthroscopy ; Debridement ; Fibrocartilage ; Joint Instability ; Joints ; Ligaments ; Suture Anchors ; Sutures ; Triangular Fibrocartilage

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