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Journal articles on the topic 'Distal radius bone fracture'
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1
Engelhardt, Lucas, Frank Niemeyer, Patrik Christen, et al. "Simulating Metaphyseal Fracture Healing in the Distal Radius." Biomechanics 1, no. 1 (2021): 29–42. http://dx.doi.org/10.3390/biomechanics1010003.
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Simulating diaphyseal fracture healing via numerical models has been investigated for a long time. It is apparent from in vivo studies that metaphyseal fracture healing should follow similar biomechanical rules although the speed and healing pattern might differ. To investigate this hypothesis, a pre-existing, well-established diaphyseal fracture healing model was extended to study metaphyseal bone healing. Clinical data of distal radius fractures were compared to corresponding geometrically patient-specific fracture healing simulations. The numerical model, was able to predict a realistic fracture healing process in a wide variety of radius geometries. Endochondral and mainly intramembranous ossification was predicted in the fractured area without callus formation. The model, therefore, appears appropriate to study metaphyseal bone healing under differing mechanical conditions and metaphyseal fractures in different bones and fracture types. Nevertheless, the outlined model was conducted in a simplified rotational symmetric case. Further studies may extend the model to a three-dimensional representation to investigate complex fracture shapes. This will help to optimize clinical treatments of radial fractures, medical implant design and foster biomechanical research in metaphyseal fracture healing.
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Dr., M. Rassiwala, P. Neema Pramod Dr., D.K. Sharma Dr., and S. Mishra Dr. "Evaluation of the Results of Volar Plating in the Treatment of Fractures of Distal End Radius." Orthopaedic Journal of M P Chapter 23, no. 1 (2017): 4–11. https://doi.org/10.5281/zenodo.3970548.
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Background: Fractures of lower end radius are most common fractures of the upper extremity. Increased awareness of the complexity of the distal end radius fractures have stimulated a growing interest and promoted new ideas regarding their management. Close reduction and cast immobilization had been the mainstay of treatment of these fractures but poor functional and cosmetic results are not uncommon. The volar plate system has been shown to be reliable for the fixation of distal radius fractures. As open reduction and volar plating ensures more consistent correction of displacement and maintenance of reduction, this prospective study evaluates the anatomical and functional outcome of open reduction and plate fixation in the management of fracture distal end radius. Method: In this study 40 patients with distal end radius fractures were included, informed consent was and clearance from ethical committee of the institute was taken. The study was Prospective, interventional and observational for the methods used for management of the fracture. Patients were evaluated pre operatively and post operatively at the end of first, fourth, sixth week,3 months and then once in 3months up to 12 months. Results: In the prospective study conducted with forty patients,88% anatomical and 93% functional, excellent to good results suggests that stabilizing the fracture fragments with volar plate and screws in the management of the fractures of distal radius, is an effective method to maintain the reduction till union and prevent collapse of the fracture fragments, even when the fracture is grossly comminuted / intra-articular / unstable and / or the bone is osteoporotic. Conclusion: This study concludes that open reduction and internal fixation with volar plating has excellent functional outcome with minimal complications. The procedure is applicable for all types of Frykman fractures in young patients with a good bone stock as well as in elderly osteoporotic patients.
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Tada, Kaoru, Kazuo Ikeda, and Hiroyuki Tsuchiya. "Distal Radius Fracture with Bone Fragment Protruded into the Radiocarpal Joint: Two Case Reports." Journal of Hand Surgery (Asian-Pacific Volume) 26, no. 03 (2021): 460–62. http://dx.doi.org/10.1142/s2424835521720164.
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Distal radius fractures often involve comminuted fragments of the dorsal cortex of the radius, but bone fragments rarely protrude into the radiocarpal joint. We report two cases of distal radius fracture with bone fragment protrusion into the radiocarpal joint. To the best of our knowledge, there are no English reports of distal radius fracture with bone fragment protrusion into the radiocarpal joint. Despite the rarity of these cases, clinicians should still be mindful of such injuries and not overlook the possibility of presence of bone fragments within the joint. Missed intra-articular fragments may cause pain, limited range of motion, and subsequent osteoarthritis.
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Akino, Hiromasa, Shunpei Hama, Masataka Yasuda, Kenta Minato, and Masahiro Miyashita. "Bone Resection for Isolated Ulnar Head Fracture." Case Reports in Orthopedics 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/3519146.
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Distal ulnar fractures often occur with distal radius fractures (DRFs), and ulnar styloid fractures commonly occur in the setting of DRF. However, isolated ulnar head fractures are rare. We report a case of isolated ulnar head fracture in which we performed bone resection because the ulnar head bone fragment fractured when internal screw fixation was attempted. His outcome at 18 months postoperatively was considered excellent. However, we do not advocate bone resection other than failure of fixation and the difficult case to perform internal fixation. Longer follow-up would be needed because bone resection might lead to osteoarthritis of the distal radioulnar joint in the future.
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Mehta, JA, JP Slavotinek, and J. Krishnan. "Local Osteopenia Associated with Management of Intra-Articular Distal Radial Fractures by Insertion of External Fixation Pins in the Distal Fragment: Prospective Study." Journal of Orthopaedic Surgery 10, no. 2 (2002): 179–84. http://dx.doi.org/10.1177/230949900201000213.
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Purpose. To assess the restoration of the bone mass of the distal radius following the use of implants in the distal radial fragment. Highly comminuted Frykman type 7 and 8 fractures were studied to determine whether the use of fixation pins in the comminuted distal radial fragment leads to osteopenia in the distal radial fragment after healing of the fracture. Methods. As part of a clinical trial, 30 patients with comminuted intra-articular fractures of the distal radius were treated with closed reduction, external non-bridging fixation, and early postoperative mobilisation. To detect local osteopenia, bone density measurements were taken at the distal metaphysis and mid-diaphysis following healing of the fractured radius and the contralateral unaffected radius in 12 patients. Results. The mean age of the 12 patients for whom bone density measurements were recorded was 52.5 years (range, 39–87 years). There were 9 females and 3 males included in the study. Seven patients had a Frykman type 8 fracture and 5 patients had a Frykman type 7 fracture. Significant osteopenia was absent despite the use of four 2.5-mm fixation pins in the distal fragments of the healed distal radial fracture. The median value of the maximal step was 2.8mm (range, 0–9.1mm). The median value of the intra-articular interfragmentary gap was 1.8 mm (range, 0–13.4mm). Conclusion. The findings of this study do not suggest long-term osteopenia following the use of four 2.5-mm pins in the distal fragments. The non-bridging fixator, by allowing early physical activity, possibly led to satisfactory functional and structural results.
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Biver, Emmanuel. "Is radius bone mineral density helpful for fracture risk assessment?" Osteologie 28, no. 02 (2019): 109–11. http://dx.doi.org/10.1055/a-0849-1264.
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AbstractAlthough peripheral DXA is not recommended for the diagnosis of osteoporosis or to monitor osteoporotic treatments, its use for fracture risk assessment is supported by several studies. In addition, its potential interest is supported by the recent demonstration, in prospective cohorts, of the contribution of distal radius microstructure and strength, assessed by high-resolution peripheral QCT (HRpQCT), to predict incident fractures beyond the classical clinical tools (femoral neck BMD and FRAX). Indeed, areal BMD measured by DXA at the ultra-distal radius is highly correlated with bone strength derived from HRpQCT measurements at the same site. Ultra-distal radius areal BMD is therefore highly associated with fracture risk, with associations of higher magnitude than at the “classically recommended” one-third distal radius. Furthermore, ultra-distal radius areal BMD is also associated with incident fractures in non-osteoporotic women in women with T-score > –2.5 SD on hip and spine DXA or women with FRAX score below the intervention threshold for age. Since more than half of low-trauma fractures occur in individuals not identified as being at high risk by BMD testing at the spine or hip, radius bone mineral density may help to refine fracture risk in patients with osteopenia defined by central DXA (spine or hip), or relatively few clinical risk factors.
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Dipak, Suthar, Kotak Abhinav, and P. Shah Amit. "The Clinical Efficacy of the Radius Bone Plates in the Treatment of Radius Bone Fractures." International Journal of Current Pharmaceutical Review and Research 16, no. 05 (2024): 168–72. https://doi.org/10.5281/zenodo.12785549.
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AbstractBackground and Aim: Distal radius intraarticular fractures can have a significant impact on clinical outcomes.Treatment of intraarticular fractures is a topic of debate in the medical community, with varying outcomesreported in the literature. Our study aimed to assess the effectiveness of radius bone plate fixation in thetreatment of radius bone fractures.Material and Methods: A group of fifty patients who had fractures in the distal part of their radius underwenttreatment using the fixed angle plate fixation method. Patients were monitored through radiographs, physicalexamination, ASA and VAS score.Results: Among the 50 patients, 30% (15) were found to have 2R3A1, while 22% (11) were found to have2R3B1.Out of the total number of patients, 20% (10) were found to have 2R3B1. Out of the 28 patients, 14 werediagnosed with 2R3A2.1 types of fracture based on the AO fracture classification. According to thisretrospective study, fractures were found to occur more frequently on the left side of the radius (56%) comparedto the right side (44%). Based on data from the American Society of Anaesthesiologists (ASA), the majority ofpatients (84%) were classified as grade 1, indicating that they were normal and healthy. A smaller percentage ofpatients (16%) were classified as grade 2, indicating that they had mild systemic disease.Conclusion: The utilization of radius plates in the treatment of unstable distal end radius fractures has beenfound to result in favorable functional outcomes and few complications.
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Naito, Kiyohito, Yoichi Sugiyama, Hiroyuki Obata, Atsuhiko Mogami, Osamu Obayashi, and Kazuo Kaneko. "Screw Fixation and Autogenous Bone Graft for an Irreducible Distal Ulna Fracture Associated with Distal Radius Fracture." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 02 (2017): 236–39. http://dx.doi.org/10.1142/s0218810417720145.
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Distal ulna fractures often occur with distal radius fractures, and their treatment method is still controversial. We considered reduction of the distal radio-ulnar joint (DRUJ) surface the most important factor when treating distal ulna fractures accompanied by residual dislocation. We herein presented a patient with a distal ulna fracture accompanied by dislocation of the DRUJ surface in whom an autogenous bone fragment collected from the radius was grafted onto the ulnar bone defect after open reduction and Herbert screw fixation. In this technique, the bone fragment was supported through the medullary cavity by inserting a Herbert screw, which was less likely to cause irritation between the screw and surrounding tissue, because the screw was almost entirely present in the bone. In addition, an autogenous bone graft from the same surgical field may be less invasive than that from another region.
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Belloti, João Carlos, João Baptista Gomes dos Santos, Álvaro Nagib Atallah, Walter Manna Albertoni, and Flavio Faloppa. "Fractures of the distal radius (Colles' fracture)." Sao Paulo Medical Journal 125, no. 3 (2007): 132–38. http://dx.doi.org/10.1590/s1516-31802007000300002.
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CONTEXT AND OBJECTIVE: Although Colles' fracture is a common clinical situation for the orthopedist, we did not find any information in the literature that would allow safe decision-making on the best treatment for each fracture type. The aim of the present study was to investigate Brazilian orthopedists' opinions regarding the main aspects of treatments for Colles' fracture. DESIGN AND SETTING: Cross-sectional study conducted during the 34th Brazilian Congress of Orthopedics and Traumatology. METHODS: Five hundred questionnaires containing 12 items were randomly distributed to orthopedists who were attending the congress; 439 were filled out correctly and were considered in this study. RESULTS: The main factors in making decisions on interventions in fracture cases were whether the fracture was intra-articular, the existence of shortening of the distal radius and the patient's age. The classification method most used was Frykmann. The closed reduction method most used was manual reduction. The principal surgical interventions were percutaneous pinning (39%), external fixation (27%) and volar plate (19%). Most of the interviewees only used bone grafts for osseous gaps in special cases. The most frequent complications were impairment of joint mobility and residual pain. CONCLUSIONS: Brazilian orthopedists have concordant opinions regarding conservative treatment methods and the use of bone grafts. There were conflicting opinions regarding surgical treatment methods, classification types and complications.
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Greco, Victor E., Jon E. Hammarstedt, Shaelyn O’Connor, and Steven Regal. "Masquelet Technique and Proximal Tibial Autograft Utilizing Avitus® Bone Harvester for Severely Comminuted Open Distal Radius Fracture with Extensive Bone Loss: A Case Report." Journal of Orthopaedic Case Reports 12, no. 4 (2022): 49–53. http://dx.doi.org/10.13107/jocr.2022.v12.i04.2762.
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Introduction: Distal radius fractures are one of the most common fractures in the United States. Treatment usually involves internal fixation using a volar Henry approach with placement of a volar locking plate. Optimal treatment becomes less apparent when significant bone loss occurs. No case of an open distal radius fracture treated using a staged Masquelet technique involving proximal tibial autograft is available in the literature. Herein, we describe and discuss a case report of a novel technique to treat a large (5 cm) bone defect for an open distal radius fracture. Case Report: A 59-year-old man suffered an open, comminuted, and intra-articular distal radius fracture with 5 cm of bone loss. He was treated using a staged Masquelet technique with incorporation of ipsilateral proximal tibial autograft with a bone harvester to obtain cancellous autograft and bone marrow graft. The patient initially underwent emergent I and D, acute carpal tunnel release, and internal and external fixation. A 5 cm bone void was filled with antibiotic cement. Four weeks later, the antibiotic cement was removed, cancellous bone graft and marrow were harvested from the proximal tibia, and the graft was placed within the prior bone void. Fracture site healing was confirmed radiographically and with computer-tomography imaging 3 months later. The patient has demonstrated excellent results 1 year post-operative with 60° of wrist flexion, 40° of wrist extension with mild pain, and full finger range of motion with radiographic union. Conclusion: Internal fixation with placement of a volar locking plate remains the mainstay of treatment for distal radial fractures. However, in more comminuted fractures with bone loss, treatment becomes more challenging. We have presented a unique case utilizing a staged Masquelet technique with incorporation of a proximal tibial autograft to educate readers on an alternative option and technique for autograft donor sites in these more complicated fractures.
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Jaya Santika, I. Kadek. "Characteristics of Distal Radius Fracture Patients at Gema Santi Nusa Penida Hospital in 2020-2021." International Journal of Health Sciences and Research 12, no. 7 (2022): 103–8. http://dx.doi.org/10.52403/ijhsr.20220714.
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Introduction: Distal radius fracture is the most common fracture found in Gema Santi Nusa Penida Hospital. The incidence of distal radius fracture peaks in the paediatric who experience high energy fall which predominantly males and then the elderly population with osteoporotic bone experiencing low energy fall which predominantly females. A study is needed to determine the fracture characteristics which in this study discusses about the distal radius fracture. Methods: This research is a retrospective study with the population was all distal radius fracture patients who were treated at Gema Santi Nusa Penida Hospital from 2020 to 2021. The research sample was collected using a total sampling technique obtained from the patient medical record of the emergency unit and general surgery clinic. Results: Of the 44 samples obtained, the most cases of distal radius fracture were in the age range of 11-20 years with male gender caused by traffic accidents and then in the age range of 61-70 years with female gender caused by falling from a standing height. Conclusion: Most cases in the elderly female may relate to the onset of postmenopausal osteoporosis. Cases that often occur at a young age due to traffic accidents need further policy to improve the safety of motorized vehicle drivers. Special treatment also needs to be done in osteoporotic elderly women to reduce complications that can occur due to osteoporosis such as fractures of the distal radius. Key words: Distal radius fracture; Young; Elderly; Traffic accidents; Osteoporotic bone .
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ITOH, S., T. OHTA, H. SAMEJIMA, and K. SHINOMIYA. "Bone Mineral Density in the Distal Radius in a Healthy Japanese Population and in Relation to Fractures of the Distal Radius." Journal of Hand Surgery 24, no. 3 (1999): 334–37. http://dx.doi.org/10.1054/jhsb.1999.0073.
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Changes in bone mineral density with age were measured in the distal radius of healthy adults using dual energy X-ray absorptiometry. A total of 2789 healthy women (20–95 years old) and 1255 healthy men (20–87 years old), and 72 women (52–94 years old) and 23 men (51–79 years old) with fractures of the distal radius were assessed. Bone mineral density remains relatively stable in men despite aging, and was significantly higher than in women in every decade. In women aged 70 years and more, the bone mineral density was significantly lower in the fracture group than the nonfracture group. In men with fractures of the distal radius, there were no significant differences between bone mineral density and age. In the fracture groups loss of radial inclination after reduction correlated with decreased bone mineral density, but there was no significant regression between bone mineral density and the decrease in radial length or palmar tilt.
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Sengab, Alysia, Pieta Krijnen, and Inger Birgitta Schipper. "Risk factors for fracture redisplacement after reduction and cast immobilization of displaced distal radius fractures in children: a meta-analysis." European Journal of Trauma and Emergency Surgery 46, no. 4 (2019): 789–800. http://dx.doi.org/10.1007/s00068-019-01227-w.
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Abstract Purpose Displaced distal radius fractures in children are common and often reduced if necessary and immobilized in cast. Still, fracture redisplacement frequently occurs. This can be prevented by fixation of fracture fragments with K-wires, but until now, there are no clear guidelines for treatment with primary K-wire fixation. This meta-analysis aimed to identify risk factors for redisplacement after reduction and cast immobilization of displaced distal radius fractures in children, and thereby determine which children will benefit most of primary additional K-wire fixation. Methods Eight databases were searched to identify studies and extract data on the incidence of and risk factors for redisplacement of distal radius fractures after initial reduction and cast immobilization in children. Results Twelve studies, including 1256 patients, showed that initial complete displacement (odds ratio [OR] 4.69, 95% confidence interval [CI] 2.98–7.39) and presence of a both-bone fracture (OR 1.95, 95% CI 1.34–2.85) were independent risk factors for redisplacement. Anatomical reduction reduced the redisplacement risk (OR 0.14, 95% CI 0.05–0.40). No significant influence on redisplacement risk could be established for female sex, experience level of the attending surgeon, Cast Index < 0.8, Three-Point Index < 0.8 and patient’s age. Conclusions For children with a displaced distal radius fracture, the presence of a both-bone fracture, complete displacement of the distal radius and non-anatomical reduction are risk factors for redisplacement after reduction of their initially displaced distal radius fracture. Children with one or more of these risk factors probably benefit most of reduction combined with primary K-wire fixation.
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Lee, Anderson, Brian Rao, Dave Yatsonsky, Kyle Behrens, Phillip J. Stokey, and Nabil Ebraheim. "Fixation of 3-Part Intra Articular Distal Radius Fracture with Combined Volar Plate and Dorsal Spanning Plate: A Case Report." Journal of Orthopaedic Case Reports 14, no. 11 (2024): 143–47. http://dx.doi.org/10.13107/jocr.2024.v14.i11.4944.
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Introduction: The aim of this study is to illustrate a case in which the use of a dorsal spanning plate followed by volar plating may be indicated in the setting of a complex intra-articular distal radius fracture. Combined dorsal spanning plate and volar plating is a rare procedure reserved typically for comminuted fractures of the distal radius. This case highlights the first reported incidence in which a dorsal spanning plate of a distal radius fracture resulted in the volar displacement of the fragments, requiring subsequent volar plating. In the end, the outcome was favorable, as the follow-up imaging displayed good bone healing and union with minimal complications. Case Report: A 52-year-old male presented to the ED at our institution following a traumatic fall onto his left upper extremity. Radiographic imaging revealed fractures at the midshaft of the humerus as well as a very distal three-part intra-articular radius fracture. Due to the nature of the patient’s distal radius fracture, initial fixation with a dorsal spanning plate was planned. However, follow-up imaging 3 weeks postoperatively revealed volar displacement of his fracture, so the patient underwent open reduction internal fixation with a volar distal radius plate. Follow-up over the next few months displayed a union of the fracture fragments and the dorsal spanning plate was removed 4 months postoperatively with imaging showing no complications. Conclusion: We present this case to highlight the complication of volar displacement that may follow initial dorsal spanning plate fixation of a three-part intra-articular distal radius fracture that can be resolved with the addition of a volar plate, as well as possible indications for combined dorsal spanning plate and volar plate fixation of complex distal radius fractures at the time of initial fixation. Keywords: Distal radius, volar plate, spanning plate, fracture, comminution, intra-articular fracture.
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MADELEY, N. J., A. B. STEPHEN, N. D. DOWNING, and T. R. C. DAVIS. "Changes in Scaphoid Bone Density after Acute Fracture." Journal of Hand Surgery 31, no. 4 (2006): 368–70. http://dx.doi.org/10.1016/j.jhsb.2006.03.164.
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The radiographic density of the proximal fragments of 16 scaphoid fractures was assessed on scaphoid series radiographs taken at 6 to 12 weeks. In addition, dual energy X-ray absorptiometry measurements of bone mineral density in the distal radius and proximal and distal fracture fragments were performed at 1 to 2 weeks and 6 to 12 weeks. Median reductions of 9% and 10% were observed in bone mineral density in the proximal fracture fragment and the distal radius respectively, but these did not correlate with the radiographic density of the proximal fragment. A greater median reduction in bone mineral density (27%) was observed in the distal fracture fragment and more bone loss occurred at this site when there was an apparent increase in the radiographic density of the proximal fragment (median fall of 0.23 g/cm2 versus 0.14 g/cm2). Thus, apparent increased radiographic density of the proximal fragment may be due to increased bone loss from the distal fragment.
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Li, Jun, Guangyue Zhao, and Weiliang Zhang. "Comminuted lunate fracture combined with distal radius fracture and scaphoid fracture: A case report." Medicine 102, no. 29 (2023): e34393. http://dx.doi.org/10.1097/md.0000000000034393.
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Rationale: Incidence of lunate fractures is very low, less than 1% of all fractures. Lunate fractures generally come from high-energy injuries, often combined with other wrist fractures. Simple lunate fractures can be fixed with screws or Kirschner wires. However, Comminuted lunate fractures are difficult to reduce and fixe by conventional methods. Patient concerns: Here we report a 42-year-old male construction worker who was crushed by an excavator bucket and presented with comminuted lunate fracture combined with distal radius fracture and scaphoid fracture. Diagnoses: Comminuted lunate fracture, distal radius fracture, and scaphoid fracture. Interventions: The posterior approach was used to reconstruct the radial lunate bone with polymethylmethacrylate cement, and cannulated screws were used to fix the scaphoid and distal radius fractures. Outcomes: At the 3rd month after surgery, the movement of the right wrist joint improved. At the sixth month after surgery, the patient returned to the building site and began working at the same intensity as before the injury. Lessons: Although the incidence of comminuted lunate fractures is very low, they occur sometimes. For comminuted lunate fractures, early identification and intervention can preserve most of the function of the wrist joint.
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Scharf, Markus, Nike Walter, Markus Rupp, and Volker Alt. "Treatment of Fracture-Related Infections with Bone Abscess Formation after K-Wire Fixation of Pediatric Distal Radius Fractures in Adolescents—A Report of Two Clinical Cases." Children 10, no. 3 (2023): 581. http://dx.doi.org/10.3390/children10030581.
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Closed reduction and K-wire fixation of displaced distal radius fractures in children and adolescents is an established and successful surgical procedure. Fracture-related infections after K-wire fixation are rare but can have significant consequences for the patient. There is a lack of literature on the treatment of K-wire-associated fracture-related infections in children and adolescents. Herein, we report two cases of fracture-related infection after initial closed reduction and Kirschner wire fixation in two adolescents. One 13-year-old boy and one 11-year-old girl were seen for fracture-related infections 4 and 8 weeks after closed reduction and percutaneous K-wire fixation of a distal radius, respectively. X-ray and magnetic resonance imaging (MRI) revealed a healed fracture with osteolytic changes in the metaphyseal radius with periosteal reaction and abscess formation of the surrounding soft tissue structures. A two-staged procedure was performed with adequate debridement of the bone and dead space management with an antibiotic-loaded polymethyl methacrylate (PMMA) spacer at stage 1. After infection control, the spacer was removed and the defect was filled with autologous bone in one case and with a calcium sulphate–hydroxyapatite biomaterial in the other case. In each of the two patients, the infection was controlled and a stable consolidation of the distal radius in good alignment was achieved. In one case, the epiphyseal plate was impaired by the infection and premature closure of the epiphyseal plate was noted resulting in a post-infection ulna plus variant. In conclusion, a fracture-related infection after Kirschner wire fixation of pediatric distal radius fractures is a rare complication but can occur. A two-stage procedure with infection control and subsequent bone defect reconstruction was successful in the presented two cases. Premature closure of the epiphyseal growth plate of the distal radius is a potential complication.
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Reichler, I. M., P. M. Montavon, and B. Haas. "Use of the tubular external fixator in the treatment of distal radial and ulnar fractures in small dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 16, no. 03 (2003): 132–37. http://dx.doi.org/10.1055/s-0038-1632769.
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SummaryTwenty-two fractures of the distal radius and ulna in small dogs and cats treated with a tubular external fixator system were evaluated. Radius/ulna fractures in toy breeds often occur in the distal metaphyseal region. Placing two screws through a bone plate in the distal radius in such cases is difficult even if a miniplate is used. The tubular external fixator allows multiple-pin clamping in parallel with a single connecting bar. Using this technique, four pins can be placed in a bone fragment, the length of which would hold only two screws in a 2.0 mini-DCP. The tubular external fixator was found to be a satisfactory alternative to bone plating for the fixation of distal radial/ulnar fractures, providing sufficient fracture stability with minimal soft tissue trauma.
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COŞKUN, Tamer, Hasan ARIK, and Sertaç MEYDANERİ. "Relationship Between Carpal Bone Morphology and Distal Radius Fracture Pattern." Journal of Contemporary Medicine 12, no. 6 (2022): 901–6. http://dx.doi.org/10.16899/jcm.1174520.
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Abstract
 Background: In this study, we examined whether carpal bones (lunate, hamate, capitate) morphologies and fourth metecarp-capitate articulation have an effect on the distal radius fracture pattern.
 
 Methods: 206 patients who applied to the emergency department with distal radius fracture between 2016-2020 were included in the study. Preoperative and pre-reduction x-ray films of the patients were examined. Lunate, hamate, capitate morphologies and 4.metacarp articulation analyzed and classified. Distal radius fracture types were classified according to AO and Fernandez. The relationship between carpal bone morphology and distal radius fracture type was analyzed.
 
 Results: This study consisted of 101 men and 103 women. AO fracture types and carpal bone morphologies (lunate joint type according to Viegas, lunate type according to Zapico, capitate morphology, hamate morphology and capitate-4 metacarpal joint morphology) did not differ significantly (p > 0.05). Fernandez fracture types and carpal bone morphologies (lunate joint type according to Viegas, lunate type according to Zapico, capitate morphology, hamatum morphology and capitate-4.metacarp joint morphology) were compared, there was no significant difference (p > 0.05).
 Conclusion: As a result, no clear relationship could be demonstrated between carpal bone morphology and distal radius fracture pattern.
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Pramudita, Jonas, Wataru Hiroki, Takuya Yoda, and Yuji Tanabe. "Variations in Strain Distribution at Distal Radius under Different Loading Conditions." Life 12, no. 5 (2022): 740. http://dx.doi.org/10.3390/life12050740.
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Distal radial fractures exhibit various fracture patterns. By assuming that the strain distribution at the distal radius affects the diversification of the fracture pattern, a parameter study using the finite element model of a wrist developed from computed tomography (CT) images was performed under different loading conditions. The finite element model of the wrist consisted of the radius, ulna, scaphoid, lunate, triquetrum, and major carpal ligaments. The material properties of the bone models were assigned on the basis of the Hounsfield Unit (HU) values of the CT images. An impact load was applied to the scaphoid, lunate, and triquetrum to simulate boundary conditions during fall accidents. This study considered nine different loading conditions that combine three different loading directions and three different load distribution ratios. According to the analysis results, the strain distribution at the distal radius changed with respect to the change in the loading condition. High strain concentration occurred in regions where distal radius fractures are commonly developed. The direction and distribution of the load acting on the radius were considered to be factors that may cause variations in the fracture pattern of distal radius fractures.
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Farah, N., L. Nassar, Z. Farah, and F. Schuind. "Secondary displacement of distal radius fractures treated by bridging external fixation." Journal of Hand Surgery (European Volume) 39, no. 4 (2013): 423–28. http://dx.doi.org/10.1177/1753193413483424.
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Loss of reduction remains an important problem after treatment of distal radius fractures, whatever the type of bone fixation. We assessed retrospectively the rate of secondary displacement after external fixation of distal radius fractures in order to identify possible risk factors for instability. We reviewed the pre-operative and serial post-operative radiographs of a retrospective series of 35 distal radius fractures treated by bridging external fixation. When classified according to the Société Française d’Orthopédie et Traumatologie (SOFCOT) criteria, the rate of secondary displacement was 48.5%. At final follow up, the reduction was anatomical in 12% and acceptable in 83%. There was malunion in 5%. The loss of reduction concerned primarily the distal radius palmar tilt and was moderate. No correlation was found with age, gender, type of fracture, degree of initial displacement, associated ulnar fracture, or seniority of the treating surgeon.
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Niaz, Hussain* Imran Javed Muhammad Ali. "FUNCTIONAL RESULTS OF COLLES' FRACTURE MANAGED BY PERCUTANEOUS CROSSED KIRSCHNER WIRES." Indo American Journal of Pharmaceutical Sciences 04, no. 12 (2017): 4415–19. https://doi.org/10.5281/zenodo.1101098.
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Objectives: To observe functional outcome of Colles' fracture managed by Percutaneous Crossed Kirschner Wires. Study Design: Descriptive case study. Setting: Department of Orthopaedic Surgery, Liaquat University of Medical and health science, Hyderabad/ Jamshoro. Period: 1st January 2016 to 31st December 2016. Methods: 124 patients with Colles' fractures were taken for this study. For operative procedure all patients were operated under general anaesthesia. Close manipulating was done, reduction was checked under Image Intensifier and fracture were fixed with 2 cross k-wires, one starting from radial steroid and engaging in medial cortex of the radius and one from medial side of distal radius tip and engaging lateral cortex of radius. Functional outcome was assessed after 3 months and recorded on preformed proforma. Results: functional outcome of percutaneous Kirschner wire fixation for Colles' fracture was observed in 80.65% (100/124) cases. Conclusions: functional outcome of percutaneous Kirschner wire fixation is satisfactory in Colles’ fractures and it appears to be an effective, easy, and technically less demanding procedure for stabilization, so this procedure can be applied for patients with these fractures. Key words: Colles' fractures, Percutaneous Kirschner wire fixation, distal radius bone fracture
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Stramazzo, Leonardo, Giuseppe Rovere, Alessio Cioffi, et al. "Peri-Implant Distal Radius Fracture: Proposal of a New Classification." Journal of Clinical Medicine 11, no. 9 (2022): 2628. http://dx.doi.org/10.3390/jcm11092628.
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A peri-implant fracture near the volar plate of the distal radius represents a rarity and can be associated with a mechanical failure of the devices. A literature review was conducted including all fractures that occurred around a volar wrist plate, which could be associated with an ulna fracture. All articles published until December 2021 were considered according to the guidelines presented in the PRISMA Statement. The search was conducted with the PubMed electronic database, Cochrane Database of Systematic Reviews, Medline, Embase, and Google Scholar. Only nine cases of these fractures were reported in the literature. The causes could be due to delayed union/non-union of the old fracture after low energy traumas, high energy trauma in patients with poor bone quality, or hardware mechanical failure. Furthermore, the literature review of peri-implant radius fracture shows different level of radius fracture and types of implant failure. In accordance with these different cases, a new classification of peri-implant fracture of the distal radius is proposed.
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Lee, H. C., Y. S. Wong, B. K. Chan, and C. O. Low. "Fixation of Distal Radius Fractures Using AO Titanium Volar Distal Radius Plate." Hand Surgery 08, no. 01 (2003): 7–15. http://dx.doi.org/10.1142/s0218810403001339.
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This study is to assess the effectiveness and outcome of the AO titanium volar distal radius plate (Synthes) in the treatment of peri-articular volar rim fractures of the distal radius. It was conducted on 22 patients with distal radius fractures who underwent open reduction, internal fixation using the AO titanium volar distal radius plate between July 1998 and December 1999 at the Changi General Hospital. The radiographs of the patients were analysed upon fracture union and assessment of wrist function was done using Gartland and Werley criteria. There were four extra-articular AO Type A2(1) and A3(3): the remaining 18 intra-articular fractures consisted of AO B3(2), AO C1(11), AO C2(2) and AO C3(3). The average follow-up period was 12.6 months (range 7–23). Radiological review showed bone healing in 21 patients (95.5%) and good articular congruity for all intra-articular fractures with less than 2 mm step-off. Three patients defaulted follow-up. Complications were few with one wound infection, one tendon rupture and three neuropraxia of the superficial radial nerve. Wrist function was excellent in three patients, good in 12 and fair in four. The AO titanium plate with its distal buttressing ability is an effective treatment modality in patients with distal radius fractures involving the peri-articular volar rim.
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Rego Diniz, João, Rui Moreira Sousa, Gonçalo Pires, Rafaela Costa, and João Ribeiro Afonso. "Osteogenesis Imperfecta no Desporto Adaptado: Um caso Atípico de Fratura do Rádio Distal." Revista de Medicina Desportiva Informa 15, no. 4 (2024): 8–10. http://dx.doi.org/10.23911/osteogenesis_imperfecta_2024_jul.
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Sport practice by patients with Osteogenesis Imperfecta should be encouraged, however contact sports should always be duly considered due to the risk of bone fractures. The authors describe the clinical case of a Wheelchair Basketball athlete (WB) who went to the Emergency Department due to a distal radius fracture in the context of wrist trauma caused by a Basketball ball. Distal radius fractures typically occur in the context of high-kinetic trauma. Due to the increased bone fragility of the athlete presented, this fracture was caused by a minor trauma in the context of receiving the Basketball ball. WB is a high-impact sport, so its practice by athletes with OI must be duly considered.
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Pham, Dinh The, and Hoang Van Hai Le. "Treatment of distal radius fracture by MIPO technique at Thu Duc City Hospital." Ministry of Science and Technology, Vietnam 65, no. 3DB (2023): 53–57. http://dx.doi.org/10.31276/vjst.65(3db).53-57.
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Objective: To assess the possibility of anatomical correction when treating fractures of the distal radius fracture with a locking plate through a minimally invasive incision and evaluate the possibility of early recovery of wrist function after treatment of the distal radius fracture with minimally invasive incision preserving the pronator quadratus (PQ) muscle. Subject and method: Acute distal radius fracture patients aged 18 to 65 years old, who came for examination and treatment at the Orthopedic and Trauma Department of Thu Duc City Hospital from October 2020 to May 2021. Classification of the distal radius fracture according to AO: A2, A3, B3, C1 and C2. Result: The result of anatomical reduction included VT 6.22o, RI 22.0o, and UV 0.81 mm. X-ray grading gave 75.0% excellent and 25.0% good results, with 100% bone healing after 12 weeks. At 12 weeks, the mean GRIP Strength score was 71.3%, the VAS score was 1.7 points, the Q-DASH score was 18.1 good function points, and the MAYO score was 74. The average time to return to normal activities was 7 weeks. Conclusion: minimally invasive plate osteosynthesis (MIPO) is a method that gives good results for some fracture types in treating distal radius fractures, by indirect reduction with small incisions to help preserve the PQ muscle and early return the wrist function.
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SRIPADA, S., D. I. ROWLEY, M. SAITO, K. SHIMADA, T. NAKASHIMA, and C. A. WIGDEROWITZ. "Biomechanical Testing of the Fractured Distal Radius Treated with A New Bone Cement–Is it Strong Enough?" Journal of Hand Surgery 31, no. 4 (2006): 385–89. http://dx.doi.org/10.1016/j.jhsb.2006.04.005.
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This study evaluates the in vitro ability of CAP, a bone graft substitute with osteointegration and osteoconductive properties, to restore the anatomy and strength of fractured distal radii. Ten pairs of cadaveric radii were imaged and tested to failure, simulating a fracture. The radii were reconstructed using CAP and were re-fractured and sequentially imaged. The deformities of the bones were determined through computerised evaluation of the radiographs. Radiographic analysis showed that CAP is capable of restoring the anatomy of the distal radius. The load and work required to fracture intact radii were compared to those required to fracture the reconstructed radii. The load to fracture was similar in the two situations. The work to fracture, however, was higher with reconstructed radii, suggesting that these are stronger than the original bones. Our study supports the hypothesis that CAP is capable of restoring the original anatomy and dimensions of the distal radius and re-establishing its mechanical strength.
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Oak, Nikhil R., John R. Lien, Alexander Brunfeldt, and Jeffrey N. Lawton. "Biomechanics of the Proximal Radius Following Drilling of the Bicipital Tuberosity to Mimic Cortical Button Distal Biceps Repair Technique." HAND 13, no. 3 (2017): 331–35. http://dx.doi.org/10.1177/1558944717701236.
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Background: A fracture through the proximal radius is a theoretical concern after cortical button distal biceps fixation in an active patient. The permanent, nonossified cortical defect and medullary tunnel is at risk during a fall eliciting rotational and compressive forces. We hypothesized that during simulated torsion and compression, in comparison with unaltered specimens, the cortical button distal biceps repair model would have decreased torsional and compressive strength and would fracture in the vicinity of the bicipital tuberosity bone tunnel. Methods: Sixteen fourth-generation composite radius Sawbones models were used in this controlled laboratory study. A bone tunnel was created through the bicipital tuberosity to mimic the exact bone tunnel, 8 mm near cortex and 3.2 mm far cortex, made for the BicepsButton distal biceps tendon repair. The radius was then prepared and mounted on either a torsional or compression testing device and compared with undrilled control specimens. Results: Compression tests resulted in average failure loads of 9015.2 N in controls versus 8253.25 N in drilled specimens ( P = .074). Torsional testing resulted in an average failure torque of 27.3 Nm in controls and 19.3 Nm in drilled specimens ( P = .024). Average fracture angle was 35.1° in controls versus 21.1° in drilled. Gross fracture patterns were similar in compression testing; however, in torsional testing all fractures occurred through the bone tunnel in the drilled group. Conclusion: There are weaknesses in the vicinity of the bone tunnel in the proximal radius during biomechanical stress testing which may not be clinically relevant in nature. Clinical Relevance: In cortical button fixation, distal biceps repairs creates a permanent, nonossified cortical defect with tendon interposed in the bone tunnel, which can alter the biomechanical properties of the proximal radius during compressive and torsional loading.
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FINSEN, V., and P. BENUM. "Regional Bone Mineral Density Changes after Colles’ and Forehand Fractures." Journal of Hand Surgery 11, no. 3 (1986): 357–59. http://dx.doi.org/10.1016/0266-7681_86_90157-9.
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Patients who sustain a second Colles’ fracture only in one of five instances refracture the previously injured wrist. In those who have sustained fractures of the metacarpals or phalanges of the hand (forehand) subsequent fractures of the forehand are twice as likely to be ipsilateral. We investigated whether persisting regional bone mineral changes could be the mechanism underlying these observations. Bilateral bone mineral density measurements were performed on twenty patients who had sustained a Colles’ fracture and twenty-nine who had sustained forehand fractures more than one year previously. Among Colles’ fracture patients there was an increase in bone mineral density in the distal radius of the fractured side when compared to the uninjured side of thirty-nine percent. The protection of these patients from subsequent ipsilateral Colles’ fracture seems to be due to increased bone strength induced by the healing process. Among patients with forehand fractures no significant bone mineral changes could be demonstrated.
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Francis, Jonathan L., Joseph M. Battle, John Hardman, and Raymond E. Anakwe. "Patterns of injury and treatment for distal radius fractures at a major trauma centre." Bone & Joint Open 3, no. 8 (2022): 623–27. http://dx.doi.org/10.1302/2633-1462.38.bjo-2022-0027.r1.
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Aims Fractures of the distal radius are common, and form a considerable proportion of the trauma workload. We conducted a study to examine the patterns of injury and treatment for adult patients presenting with distal radius fractures to a major trauma centre serving an urban population. Methods We undertook a retrospective cohort study to identify all patients treated at our major trauma centre for a distal radius fracture between 1 June 2018 and 1 May 2021. We reviewed the medical records and imaging for each patient to examine patterns of injury and treatment. We undertook a binomial logistic regression to produce a predictive model for operative fixation or inpatient admission. Results Overall, 571 fractures of the distal radius were treated at our centre during the study period. A total of 146 (26%) patients required an inpatient admission, and 385 surgical procedures for fractures of the distal radius were recorded between June 2018 and May 2021. The most common mechanism of injury was a fall from a height of one metre or less. Of the total fractures, 59% (n = 337) were treated nonoperatively, and of those patients treated with surgery, locked anterior-plate fixation was the preferred technique (79%; n = 180). Conclusion The epidemiology of distal radius fractures treated at our major trauma centre replicated the classical bimodal distribution described in the literature. Patient age, open fractures, and fracture classification were factors correlated with the decision to treat the fracture operatively. While most fractures were treated nonoperatively, locked anterior-plate fixation remains the predominant method of fixation for fractures of the distal radius; this is despite questions and continued debate about the best method of surgical fixation for these injuries. Cite this article: Bone Jt Open 2022;3(8):623–627.
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Goto, Kenji, Kiyohito Naito, Yoichi Sugiyama, et al. "Corrective Osteotomy with Autogenous Bone Graft with Callus after Malunion of Distal Radius Fracture." Journal of Hand Surgery (Asian-Pacific Volume) 23, no. 04 (2018): 571–76. http://dx.doi.org/10.1142/s2424835518720323.
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Corrective osteotomy with callus filling at fracture site for malunion after distal radius fracture is a rare technique, but it achieved a favorable postoperative outcome. The patient, 66-year-old female, visited our hospital 4 months after distal radius fracture. Corrective osteotomy of the distal radius was planned aiming at improving the wrist joint function, and was performed using a volar locking plate, then the bone defect was filled with callus as autogenous bone grafting. At 12 months after surgery, left wrist joint pain and the range of motion have improved, and the Mayo wrist score was excellent. To our knowledge, there has been no study on the treatment of bone defects by filling with callus. Since favorable bone fusion was achieved with callus, this treatment method may overcome the disadvantages of autogenous bone graft, such as pain at the donor region.
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Abrego, M. O., F. L. De Cicco, J. G. Boretto, G. L. Gallucci, and P. De Carli. "Extensor Tendons Rupture after Volar Plating of Distal Radius Fracture Related to a Dorsal Radial Metaphyseal Bone Spur." Case Reports in Orthopedics 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/8351205.
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Extensor tendon ruptures due to volar plating in distal radius fractures have mostly been described in relation with technique failures such as screw prominence and drill penetration. We report the case of a 71-year-old female with a C2 distal radius fracture with severe dorsal metaphyseal comminution. The patient underwent surgical treatment with reduction of the large fragments and fixation with a volar locking plate; the small dorsal metaphyseal nonarticular fragments were not reduced. Six months later, the patient developed extensor digitorum communis (EDC) rupture and extensor indicis proprius (EIP) laceration in coincidence with the dorsal comminution turned into a bony spur. The possible association between the extensor tendon injury and the dorsal residual metaphyseal bony spur in the distal radius fractures is unusual but should be taken into account in fracture patterns presenting dorsal comminution.
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Piotrowski, Maciej. "Results of the treatment of distal radius fractures with a proprietary implant, the DRONes nail plate – preliminary report." Chirurgia Narządów Ruchu i Ortopedia Polska 86, no. 2 (2020): 66–72. http://dx.doi.org/10.31139/chnriop.2020.86.2.6.
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Introduction. Distal radius fractures are one of the most common bone injuries. Modern treatment methods are needed not only to reduce the time needed to heal, but also allow the wrist the full range of motion as soon as possible. The solution should provide stable bone fixation with the least possible damage to soft tissues, which will allow quick recovery of extremity function. The method meeting these criteria is intramedullary fixation. Aim of the study. To evaluate the treatment results of distal radius fractures with the DRONes® hybrid nail plate. Material and methods. The study group consists of patients with distal radius fracture treated with open reduction and intramedullary fixation. Patients aged 24 to 69 years (average 54 years) were operated on after a failed attempt to adjust the fracture using the closed reduction method. 40 distal fractures of the distal radius qualified for the following 5 types according to AO: 2 fractures -A2, 5 -A3, 8 -C1, 14 -C2, 11 -C3. Two weeks after the surgery, X-rays were performed to check the position of the bone fragments and implant. After a further 6-7 weeks, the union and wrist function were evaluated. Results. Bone union was achieved in all patients within 8-9 weeks, and the range of wrist mobility was only slightly limited. The most common complication was the neurapraxia of the superficial branch of the radial nerve disappearing after 6-8 weeks. Conclusions. Patients treated with the DRONes® hybrid nail plate achieve good functional results after 8-9 weeks and can return to work and their preinjury lifestyle. An additional advantage is the simple surgical technique.
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Popov, A. A., M. V. Strunina, and M. V. Telyushchenko. "ABSOLUTE FRACTURE RISK ASSESSMENT IN OUTPATIENTS WITH DISTAL RADIUS OSTEOPOROSIS." Osteoporosis and Bone Diseases 15, no. 3 (2012): 3–6. http://dx.doi.org/10.14341/osteo201233-6.
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Objectives: to assess the absolute fracture risk in outpatients with osteoporosis (OP) at distant radius. Methods: individual absolute fracture risk was assessed using FRAX tool without hip neck bone mineral density (BMD) input in 3082 subsequent subjects (2911 females and 171 males) aged from 40 to 95 (median age 60), calculated by Finnish population data. Distant radius BMD was estimated in all patients by DTX200. Results: 774 (25.1 %) patients had had history of low traumatic fractures. BMD≤- .5 SD was detected in 1659 cases, fracture history in 558 (33.6%) of them (OR = 2.21; 95 % CI 1.93-2.55). Median 10-year probability of a major osteoporotic fracture was 4.90 % (25- 75 %; 1.10 - 55.0) and 10-year probability of a hip fracture was 0.8 % (0 - 46), absolute risk 10 % and higher was detected in 434 (64,3 %) patients. Calculated 10-year probability of a major osteoporotic fracture > 10 % was associated with previous low traumatic fractures: OR = 4,55; 95 % CI 4,06- 5,10, test sensitivity being 56.1 % with specificity 89.6 % . The same association was found for 10-year probability of hip fracture >3 %: OR = 3.57 (3.19 - 4.00), test sensitivity being 51,6 % with specificity 86,7 %. Conclusion: FRAX tool for individual absolute fracture risk assessment should be introduced into general practice for clinical decision making in prophylaxis of OP associated fractures.
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Costa, Matt L., Andy Appelboam, Nick A. Johnson, Inger Mechlenburg, and Per H. Gundtoft. "Do patients with minimally displaced distal radial fractures need a plaster cast?" Bone & Joint Journal 107-B, no. 1 (2025): 7–9. https://doi.org/10.1302/0301-620x.107b1.bjj-2024-0634.r1.
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Traditionally, patients with a fracture of the distal radius are treated in a cast if they do not require surgery. If the fracture requires manipulation, the cast is moulded to hold the reduction and maintain normal anatomical alignment during healing. However, is a cast necessary for patients whose fracture does not require manipulation? Removable splints are an alternative treatment option. Such splints have the advantage that they can be adjusted to improve fit around the wrist as swelling reduces, and can be removed and reapplied for the purpose of washing or, in some cases, exercise. However, evidence for their safety and effectiveness in the management of distal radius fractures is lacking. DRAFT3 is a multicentre randomized non-inferiority trial and economic analysis designed to determine the safety and effectiveness of removable splints as an alternative to casts in the treatment of distal radius fractures that do not require manipulation.Cite this article: Bone Joint J 2025;107-B(1):7–9.
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Freeland, Alan E., and William B. Geissler. "THE ARTHROSCOPIC MANAGEMENT OF INTRA-ARTICULAR DISTAL RADIUS FRACTURES." Hand Surgery 05, no. 02 (2000): 93–102. http://dx.doi.org/10.1142/s021881040000020x.
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Intra-operative arthroscopy and fluoroscopy provide improved visualisation and guide the restoration of intra-articular distal radial fractures while minimising the operative dissection required for their stabilisation. Radial styloid fractures, distal radial fractures with dorsal, palmar or combined ulnar-sided "die punch" fragments, palmar and dorsal Barton's fractures, and various three- and four-part intra-articular fractures without significant bone loss or defect are especially suited for this technique. The experienced arthroscopist may wish to apply the technique to more severely comminuted intra-articular fractures. Bone defects may be approached through a limited dorsal incision traversing the 3rd dorsal wrist compartment. Arthroscopy and fluoroscopy may be used adjunctively to assess fracture reduction and fixation. Arthoscopy further facilitates initial treatment by allowing direct joint visualisation, debridement, the removal of small free intra-articular fragments, and the recognition and early treatment of wrist ligament injuries, particularly those not appreciated by X-ray evaluation.
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Daniels, Anne M., Luuk M. A. Theelen, Caroline E. Wyers, et al. "Bone Microarchitecture and Distal Radius Fracture Pattern Complexity." Journal of Orthopaedic Research 37, no. 8 (2019): 1690–97. http://dx.doi.org/10.1002/jor.24306.
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Dhoju, D., D. Shrestha, N. Parajuli, G. Dhakal, and R. Shrestha. "Ipsilateral Supracondylar Fracture and Forearm Bone Injury in Children: A Retrospective Review of Thirty one Cases." Kathmandu University Medical Journal 9, no. 2 (2012): 11–16. http://dx.doi.org/10.3126/kumj.v9i2.6280.
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Background Supracondylar fracture and forearm bone fracture in isolation is common musculoskeletal injury in pediatric age group But combined supracondylar fracture with ipsilateral forearm bone fracture, also known as floating elbow is not common injury. The incidence of this association varies between 3% and 13%. Since the injury is rare and only limited literatures are available, choosing best management options for floating elbow is challenging. Method In retrospective review of 759 consecutive supracondylar fracture managed in between July 2005 to June 2011, children with combined supracondylar fracture with forearm bone injuries were identified and their demographic profiles, mode of injury, fracture types, treatment procedures, outcome and complications were analyzed. Result Thirty one patients (mean age 8.91 yrs, range 2-14 yrs; male 26; left side 18) had combined supracondylar fracture and ipsilateral forearm bone injury including four open fractures. There were 20 (64.51%) Gartland type III (13 type IIIA and 7 type III B), seven (22.58 %) type II, three (9.67 %) type I and one (3.22 %) flexion type supracondylar fracture. Nine patients had distal radius fracture, six had distal third both bone fracture, three had distal ulna fracture, two had mid shaft both bone injury and one with segmental ulna with distal radius fracture. There were Monteggia fracture dislocation, proximal ulna fracture, olecranon process fracture, undisplaced radial head fracture of one each and two undisplaced coronoid process fracture. Type I supracondylar fracture with undisplaced forearm were treated with closed reduction and long arm back slab or long arm cast. Displaced forearm fracture required closed reduction and fixation with Kirschner wires or intramedullary nailing. Nineteen patients with Gartland type III fracture underwent operative intervention. Among them nine had closed reduction and K wire fixation for both supracondylar fracture and forearm bone injury. One patient with closed reduction and long arm cast application for both type III supracondylar fracture and distal third radius fracture developed impending compartment syndrome and required splitting of cast, remanipulation and Kirschner wire fixation. There were three radial nerve, one ulnar nerve and one median nerve injury and two postoperative ulnar nerve palsy. Three patients had pin tract related complications. Among type III, 16 (80%) patients had good to excellent, two had fair and one gad poor result in terms of Flynn’s criteria in three months follow up ConclusionDisplaced supracondylar fracture with ipsilateral displaced forearm bone injuries need early operative management in the form of closed reduction and percutaneous pinning which provides not only stable fixation but also allows close observation for early sign and symptom of development of any compartment syndrome.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6280 Kathmandu Univ Med J 2011;9(2):11-16
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Dipak, Suthar. "Evaluating the Effectiveness of Radius Bone Plates in Fracture Repair." International Journal of Toxicological and Pharmacological Research 14, no. 9 (2024): 191–94. https://doi.org/10.5281/zenodo.14205736.
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<strong>Background and Aim: </strong>Clinically, resection and reduction-based palmar internal fixation using locking plates is commonly utilized to address AO-C type distal radius fractures. This study seeks to evaluate the safety and effectiveness of radius bone plates in the fixation of fractures associated with the radius bone. <strong>Material and Methods:</strong> This research took place within an Orthopedics Department in India, examining a cohort of 80 patients over the span of one year. In cases of fractures that exhibit instability or significant fragmentation, surgical intervention becomes essential, as relying solely on casting may prove inadequate in preserving the proper alignment of the fracture. All patients underwent monitoring through radiographs, physical examinations, and assessments using the ASA and VAS scoring systems. <strong>Results: </strong>The findings indicate that at each follow-up, there was a noticeable difference in the VAS score, with a consistent reduction in pain intensity suggesting improved outcomes for radius fractures treated with radius plates. Patients undergoing postoperative care were recommended to engage in rehabilitation exercises during the initial six months, followed by physiotherapy sessions. Assessing the advancements at each follow-up revealed positive post-operative outcomes throughout the first year of the follow-up period. <strong>Conclusion:</strong> Employing radius plates for the management of unstable distal end radius fractures demonstrates a strong correlation with favourable functional results and a low incidence of complications.
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Alomran, Ammar, Abdulaziz Alhawas, Ahmed Almulhim, et al. "A Retrospective Analysis from A Single Center Perspective On Complications After Fixing Distal Radius Fracture In Pediatric Population." Medical Archives 77, no. 5 (2023): 384. http://dx.doi.org/10.5455/medarh.2023.77.384-390.
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Background: The Distal radius fractures in the pediatric age group have similar complications to any other fracture. One interpretation of the high fracture incidence in the distal third of the radius is the relative weakness of the metaphyseal part. Objective: The aim of this study is to provide an evaluation of Surgical complications of distal radius through satisfactory reduction and proper fixation by K-wires through bone growth plates. Methods: A retrospective single-center study in a tertiary hospital in Eastern Saudi Arabia from 2000 to 2021, using the hospital’s electronic records system. The Inclusion criteria of this study involve all distal radius fracture cases who underwent surgical fixation by k-wire or plating system and are up to 14 years old. The exclusion criteria include loss of follow-up, incomplete data, and age of more than 14 years. Results: the study included 103 patients. The side of injury was almost equally distributed between the left and right sides. The odds of having at least one complication increase by 2.5 folds if the site of fracture is at the diaphysis. Further, if the distance of the fracture line to the epiphysis is more than 20 mm, the odds of reporting at least one complication post-procedure is 4.4 times higher than if it was at the level of the epiphysis. The majority of diaphyseal fractures required less than 6 weeks for radiological healing, which is significantly different from other sites which were evaluated. Conclusion: Complications of distal radius fracture due to Surgical intervention could be confounded by the complexity of the fracture itself. In our study, we found the distance of the fracture from the physis was inversely proportional to the likelihood of complications. For a comprehensive appreciation of physeal plate, we recommend extended follow-up for those who present with signs of severe distal radius fracture, especially in case of associated ulnar fracture.
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Solari, Mario G., Emily Spangler, Andrew Lee, and Ronit Wollstein. "FIXATION OF COMMINUTED DISTAL RADIUS FRACTURES WITH A MIXTURE OF CALCIUM PHOSPHATE AND CALCIUM SULFATE CEMENT." Hand Surgery 16, no. 02 (2011): 223–28. http://dx.doi.org/10.1142/s0218810411005412.
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Distal radius fracture alignment and stabilization can be a surgical challenge in the face of severe comminution and bone loss. We describe a technique using a calcium phosphate/sulfate bone cement, as an adjunct to internal fixation. This bone cement is biocompatible, osteoconductive, and sets quickly with an isothermic reaction. The use of bone cement eliminates the need for primary autologous bone grafting and allows for easier reduction and retention of reduction at the time of surgery. Bone cement is employed for the following purposes in comminuted fractures: (1) to fill a void due to lost or crushed cancellous bone, (2) to hold larger unstable fragments while hardware is placed, and (3) to retain fragments too small to take hardware. Available bone cements, studies involving the use of bone cement for distal radius fractures, indications, and surgical technique will be reviewed.
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Larsen, LJ, JK Roush, and RM McLaughlin. "Bone plate fixation of distal radius and ulna fractures in small- and miniature-breed dogs." Journal of the American Animal Hospital Association 35, no. 3 (1999): 243–50. http://dx.doi.org/10.5326/15473317-35-3-243.
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Bone plate fixation was reviewed in 29 distal radial fractures of small- and miniature-breed dogs. Twenty-two fractures in 18 dogs were available for follow-up. Number of complications and return to function were evaluated. Complications occurred in 54% of the fractures. Catastrophic complications occurred in 18% of fracture repairs with follow-up, while minor complications occurred in 36%. Sixteen (89%) of 18 dogs had a successful return to function. Bone plate fixation is a successful repair method for distal radius and ulna fractures in small-breed dogs, compared to previously reported methods.
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Murillo, Bernardo, Christian Antonio Allende Nores, and Orlando Rodríguez. "Incidencia de diagnóstico y tratamiento de la osteoporosis en pacientes con fractura de radio distal. [Diagnosis and treatment incidence of osteoporosis in patients with distal radius fractures]." Revista de la Asociación Argentina de Ortopedia y Traumatología 84, no. 2 (2019): 99–104. http://dx.doi.org/10.15417/issn.1852-7434.2019.84.2.664.
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Introducción: Las fracturas de radio distal en pacientes mayores son un indicador de osteoporosis. El objetivo de este estudio fue determinar el diagnóstico y el tratamiento de la osteoporosis en pacientes con fractura de radio distal, operados en nuestra institución, entre 2012 y 2014.Materiales y Métodos: Los datos se obtuvieron de entrevistas telefónicas a 41 pacientes mayores, operados por fracturas de radio distal. Las variables evaluadas fueron: sexo, edad, enfermedades asociadas, tabaquismo, fracturas previas, tratamiento antiosteoporótico previo o posterior a la fractura en cuestión, especialidad del médico que solicitó el tratamiento y realización o no de densitometría mineral ósea.Resultados: La muestra incluyó a 41 pacientes (32 mujeres). Veintiséis contaban con una densitometría antes de la fractura (15 con osteoporosis), 11 habían sufrido una fractura por osteoporosis, y sólo 7 recibían tratamiento antiosteoporótico cuando ocurrió la fractura. Luego de la cirugía, solo 4 de ellos continuó con el tratamiento. Se encontró cierta asociación entre una densitometría patológica y la presencia de diabetes tipo 2, no así con otras comorbilidades. La tasa de incidencia anual de osteoporosis, calculada entre todos los pacientes que se atendieron en nuestra institución, en 2014, fue alrededor del 1%. Los traumatólogos solicitaron el 1,5% de todas las densitometrías prescritas dicho año.Conclusiones: Este estudio sugiere que los traumatólogos que se desempeñan en nuestra institución tienen nula o poca participación en la prevención secundaria de la osteoporosis; por esta razón, se consideraría necesario un protocolo de prevención de fracturas secundarias a la osteoporosis. Abstract Introduction: Distal radius fractures in elderly patients are an indicator of osteoporosis. The aim of this study was to determine osteoporosis diagnosis and treatment in patients with distal radius fractures treated surgically at our institution between 2012 and 2014.Methods:Information of 41 patients who had surgical intervention for distal radius fracture was obtained through telephones interviews. Several variables evaluated: age, sex, smoking, associated pathologies, previous fractures, preoperative and postoperative anti-osteoporotic treatments, specialty of the physicians that indicated antiosteoporotic treatment, and bone mineral density (BMD) studies performed.Results: The study included 41 patients (32 female).Twenty-six had a BMD performed before the fracture (15 evidenced osteoporosis), 11 had had previous fractures secondary to osteoporosis. Only 7patients were under anti-osteoporotic treatment to the moment of the fracture. After surgery, only 4 of the patients continued with the treatment. Pathological BMD had certain degree of associationwith the presence of Diabetes (type 2), but not with other comorbidities. The annual incidence rate of osteoporosis, calculated using all patients attended at our institution in 2014, was about 1%. Orthopedic surgeons indicated only 1.5% of the total number of BMDs prescribed that year.Conclusion: Our study suggests that there is poor prevention by orthopedic surgeons of secondary osteoporotic fractures, which is why a national prevention protocol for fractures secondary to osteoporosis would be considered necessary.
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Mc Colgan, R., David M. Dalton, Adrian J. Cassar-Gheiti, Ciara M. Fox, and Michael E. O’Sullivan. "Trends in the management of fractures of the distal radius in Ireland." Bone & Joint Journal 101-B, no. 12 (2019): 1550–56. http://dx.doi.org/10.1302/0301-620x.101b12.bjj-2018-1615.r3.
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Aims The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT). Patients and Methods Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were included Results In 2008 Kirschner-wire (K-wire) fixation accounted for 59% of operations for fractures of the distal radius, and plate fixation for 21%. In 2017, the rate of K-wire fixation had fallen to 30%, and the proportion of patients who underwent plate fixation had risen to 62%. Conclusion There is an increasing trend towards open reduction and internal fixation for fractures of the distal radius in Ireland. This has been accompanied by a decrease in popularity for K-wire fixation. DRAFFT did not appear to influence trends in the management of fractures of the distal radius in Ireland. Cite this article: Bone Joint J 2019;101-B:1550–1556
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Metcalfe, David, and Daniel C. Perry. "Surgically reducing displaced distal radial fractures in children." Bone & Joint Journal 106-B, no. 1 (2024): 16–18. http://dx.doi.org/10.1302/0301-620x.106b1.bjj-2023-1112.
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Displaced fractures of the distal radius in children are usually reduced under sedation or general anaesthesia to restore anatomical alignment before the limb is immobilized. However, there is growing evidence of the ability of the distal radius to remodel rapidly, raising doubts over the benefit to these children of restoring alignment. There is now clinical equipoise concerning whether or not young children with displaced distal radial fractures benefit from reduction, as they have the greatest ability to remodel. The Children’s Radius Acute Fracture Fixation Trial (CRAFFT), funded by the National Institute for Health and Care Research, aims to definitively answer this question and determine how best to manage severely displaced distal radial fractures in children aged up to ten years.Cite this article: Bone Joint J 2024;106-B(1):16–18.
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Ferracini, Riccardo, Alessandro Bistolfi, Claudio Guidotti, et al. "Bone Loss in Distal Radial Fractures Treated with A Composite Xenohybrid Bone Substitute: A Two Years Follow-Up Retrospective Study." Materials 13, no. 18 (2020): 4040. http://dx.doi.org/10.3390/ma13184040.
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(1) Background: Recently, surgical treatment of distal radius fractures has increased exponentially. Many locking plates’ fixation systems have been developed allowing a more stable reduction and early mobilization. Sometimes, open reduction and fixation of distal radius fractures may leave a residual bone loss requiring grafting. This retrospective study reports clinical and radiologic outcomes of distal radius fractures treated with xenohybrid bone grafting in order to assess (i) the safety of the investigated bone graft; (ii) its radiological integration and biomechanical performances, and (iii) clinical outcomes of the patients; (2) Methods: We performed a retrospective study on a cohort of 19 patients. Preoperative X-ray and CT scan were performed. The mean clinical and radiographical follow-up was two years. Safety of the xenohybrid bone graft was constantly evaluated. Clinical results were assessed through the DASH score and Mayo wrist score; (3) Results: No adverse reactions, infections, and local or general complication were related to the use of xenohybrid bone graft. The radiolucency of the xenografts suggested progressive osteointegration. No evidence of bone graft resorption was detected. All the patients reached consolidation with good to excellent clinical results; and (4) Conclusions: Clinical and radiological data demonstrated that xenohybrid bone grafting promotes new bone formation and healing in osteopenic areas caused by fracture reduction.
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Knopp, B., and M. Harris. "RADIOLOGIC FEATURES AS A PROGNOSTIC INDICATOR OF FOREARM FRACTURES." Orthopaedic Proceedings 105-B, SUPP_7 (2023): 45. http://dx.doi.org/10.1302/1358-992x.2023.7.045.
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This study was conducted to investigate the characteristics, complications, radiologic features and clinical course of patients undergoing reduction of forearm fractures in order to better inform patient prognosis and postoperative management.We conducted a retrospective cohort study of 1079 pediatric patients treated for forearm fractures between January 2014 and September 2021 in a 327 bed regional medical center. A preoperative radiological assessment and chart review was performed. Percent fracture displacement, location, orientation, comonution, fracture line visibility and angle of angulation were determined by AP and lateral radiographs. Percent fracture displacement was derived by: (Displacement of Bone Shafts / Diameter) x 100% = %Fracture Displacement. Angle of angulation and percent fracture displacement were calculated by averaging AP and lateral radiograph measurements.80 cases, averaging 13.5±8.3 years, were identified as having a complete fracture of the radius and/or ulna with 69 receiving closed reduction and 11 receiving fixation via an intramedullary device or percutaneous pinning. Eight patients (10%) experienced complications with four resulting in a refracture and four resulting in significant loss of reduction (LOR) without refracture. Fractures in the proximal ⅔s of the radius were associated with a significant increase in complications compared to fractures in the distal ⅓ of the radius (31.6% vs 3.4%) (P=.000428). Likewise, a higher percent fracture displacement was associated with a decreased risk of complications (28.7% vs 5.9% displacement)(P=0.0403). No elevated risk of complications was found based on fracture orientation, angulation, fracture line visibility, forearm bone(s) fractured, sex, age or arm affected.Our result highlights radius fracture location and percent fracture displacement as markers with prognostic value following forearm fracture. These measurements are simply calculated via pre-reduction radiographs, providing an efficient method of informing risk of complications following forearm fracture.
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Kurozumi, Taketo, Hideaki Miyamoto, Takashi Suzuki, and Yoshinobu Watanabe. "Does Simultaneous Fixation of Both Distal Radius and Distal Ulnar Fractures Improve Outcomes? A Retrospective Cohort Study." Geriatric Orthopaedic Surgery & Rehabilitation 12 (January 2021): 215145932110380. http://dx.doi.org/10.1177/21514593211038089.
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Introduction: Distal metaphyseal ulnar fractures are often found in conjunction with distal radius fractures. However, there is no consensus on optimal management. The purpose of this study was to determine whether simultaneous fixation of both distal radius and distal ulnar fractures would improve outcomes. Materials and Methods: Patients treated for distal radial fractures over a 4-year period at our trauma center were identified, and their medical records were analyzed. Twenty-three patients met the inclusion criteria for this study. All radius fractures were fixed using a volar locking plate. Fourteen ulnar fractures were treated with surgical fixation, and nine were treated conservatively. Data were collected on patient demographics, mechanism of injury, whether it was a closed or open fracture, Gustilo classification, AO/OTA classification, immobilization period, follow-up period, and type of treatment. Physical findings comprising the active range of motion and grip strength and radiological findings, including the ulnar variance compared to the healthy side and bone union, were evaluated. Clinical outcomes were assessed using the quick Disabilities of the Arm, Shoulder, and Hand scores. Results: There was no significant difference between the groups in the quick Disabilities of the Arm, Shoulder, and Hand scores, but the arc of dorsi-palmar flexion was more restricted in the operative group than in the conservative group. Other results were not significantly different between the two groups. Discussion: Fixation of distal metaphyseal ulnar fractures can be challenging, and several studies have shown the validity of conservative treatments. This supports the view that if the distal radius fracture is anatomically and rigidly fixed, distal metaphyseal ulnar fractures can be successfully managed conservatively. Conclusion: Our results did not show any merit in the simultaneous fixation of both distal radius and distal ulnar fractures. Thus, needless surgery should be avoided.
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Dewanto, Clement, and Zulkarnain Muslim. "The Effectiveness of Closed Reduction Method Using Chinese Finger Trap and Immobilization of Circular Casts in the Management of Distal Radius Closed Fractures." Sriwijaya Journal of Surgery 1, no. 2 (2018): 46–53. http://dx.doi.org/10.37275/sjs.v1i2.10.
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ABSTRACT
 Introduction. Distal radius fractures are one of the most common fractures encountered by bone surgeons in the emergency room. In America, accounting for about 8% to 17% of all fracture cases that have been treated and around 75% of fractures in the forearm. In Palembang, especially in Dr. Moh Hoesin general hospital there was no data yet about the number of incidents of distal radius fractures, how to treat (conservatively or operatively) and success rates. For this reason it is difficult to measure accurately, how likely is it that a distal radius fracture can be successfully treated conservatively.
 Methods. This study was an observational analytic study with a longitudinal design to determine the effectiveness of closed reduction measures by immobilization casting through radiological examination in the management of cases of distal radius fractures at dr Moh Hoesin general hospital in Palembang
 Result. Based on the subject based on the type of fracture, there were 43.8% of subjects with Frykman-1; 6.3% of subjects with Frykman-2; 18.8% of subjects with Frykman-3; 12.5% subjects with Frykman-4; 6.3% of subjects with Frykman-5; 0% of subjects with Frykman-6; 6.3% of subjects with Frykman-7; 6.3% of subjects with Frykman-8. Based on the analysis between the Fracture Type and X-Ray parameters in the form of Radial Length, Radial Inclination, Radial Tilt and Ulnar Variance, only Ulnar Variance has a significant relationship with p = 0.001
 Conclusion. The effectiveness of closed reduction is significantly related to the type of Frykman fracture and the most fracture type that has been successfully closed closed is the type of Frykman I fracture with the highest number of samples and 100% success rate.
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Kandel, Manoj, Sarik Kumar Shrestha, Krishna Prasad Paudel, et al. "Prevalence of Osteoporosis in Patients with Distal Radius Fracture from Low-energy Trauma: An Observational Study." Journal of Nepal Medical Association 63, no. 282 (2025): 93–97. https://doi.org/10.31729/jnma.8884.
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Introduction: Osteoporosis is characterized by low bone mass, leading to enhanced bone fragility. Low-energy fractures of distal radius are related to osteoporosis and is therefore related to increased risk of subsequent hip fractures. The objective of this study was to study the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma. This will emphasise the need to investigate these patients for osteoporosis and make practitioners should be aware of the possibility of osteoporosis in such patients. Methods: This observational cross-section study evaluated the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma among patients presenting to tertiary level hospital of Nepal from October 2022 to September 2023.The participants’ demographic data, mechanism of injury, BMD values and T-score values were recorded and diagnosis of osteoporosis and osteopenia was made according to WHO diagnostic criteria. Ethical approval was taken from Institutional Review Committee (Reference Number: 079/80-015).Results: The study involved 96 patients with mean age of 68.27±4.09 years. The mean BMD among the participants was 0.69±0.02 and the mean T-score was -2.75±0.23. Diagnosis of osteoporosis was made in 88 (91.67%) patients and diagnosis of osteopenia was made in 8 (8.33%) patients based on the T-score using the WHO criteria. Of the 88n(%) patients who met the diagnosis of osteoporosis, only 45 (46.88%) patients had started treatment with bisphosphonates for osteoporosis.Conclusions: We have found a high prevalence of osteoporosis among patients with low-energy distal radius fracture.