Assessment of Clinico - Radiological Outcomes of Operated Cases of Intra : Articular Lower End Radius Fractures (original) (raw)
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International Journal of Research in Medical Sciences, 2015
Distal radius fractures account for 17% of all fractures in adults. Thousands of articles were published after Abraham Colles described a very common fracture of the distal end radius in 1814 in the Edinburgh Medical and Surgical Journal, have not yet created a consensus as a treatment programme. 1 The fracture of the lower end of radius crush the mechanical foundation of man's most elegant tool, the hand. No other fracture has a greater potential to devastate hand function. 2 A thorough understanding of the pathophysiology and treatment of distal end radius is important as high energy trauma to distal end radius in adults is becoming more common and ABSTRACT Background: Distal radius fractures account for 17% of all fractures in adults. The fracture of the lower end of radius crushes the mechanical foundation of man's most elegant tool, the hand. No other fracture has a greater potential to devastate hand function. Extra-articular fractures (type A in the AO classification) require avoidance of malunion with angulation and shortening. Malalignment results in limitation of movement, changes in load distribution, midcarpal instability and an increased risk of osteoarthritis of the radiocarpal joint. Aims and objectives: Treatment of extraarticular fractures of distal end radius by cross K wire fixation and cast immobilisation and its comparison with Kapandji's method of intrafocal pinning anatomically and functionally. Methods: Total 50 cases were included in the study. First 25 cases were treated by Kapandji's method and next 25 cases were treated by cross K wire fixation and all cases were given below elbow cast after internal fixation. Patients were followed up at regular intervals and Anatomical and functional outcomes were evaluated in all the patients. Results: In our study anatomical end results were satisfactory in 96% and unsatisfactory in 4% of the subjects treated with cross K wire fixation and 72% and 28% in cases treated by Kapandji's method whereas Functional end results were excellent in 28% cases, good in 68% cases, fair in 4% case and poor in 0% cases treated with cross k wire fixation and 12%, 60%, 24% and 4% in cases treated by Kapandji's method. Conclusion: Cross K wire method proved to be better than Kapandji's method of intrafocal K wire fixation both functionally and anatomically.
Journal of Medical Science And clinical Research, 2018
Distal end radius fractures represent one of the commonest fractures treated in emergency department. Though management of distal end radius fractures has changed over the period of time from cast immobilization to operative intervention, there are conflicting data about long term relationship regarding radiographic parameters and patient report outcome. We compared the outcome of fractures of the lower end radius treated with closed reduction and cast immobilization and those treated with percutaneous K wire fixation and immobilization in cast in neutral position. Aims and Objectives: To study postoperative functional outcome and complications in patients treated for extra articular fracture of distal end of radius and to compare the role of closed reduction and cast and percutaneous K wire fixation and cast application in management of fracture distal end of radius. Materials and Methods: 40 cases of extraarticular lower end of radius fracture were treated. These 40 cases were divided randomly in two equal groups consisting of 20 patients each. One group was treated with closed reduction and below elbow cast and other group by percutaneous K wire fixation and below elbow cast.In both the groups radiological and clinical evaluation was done by taking serial AP and lateral view of wrist joint at 4 weeks, 8weeks and finally at 12 weeks. The assessment of results were made using the demerit score system of Gartland and Werley based on objective and subjective criteria, residual deformity and complications. Results: Our results showed excellent outcome in 8 patients treated by percutaneous K wire fixation and in 6 patients treated by closed reduction and cast alone. When compared both groups anatomical reduction was maintained better in K wire group. Patients in cast group developed progressive dorsal angulation, loss of radial length and radial inclination. K wire group had statistically significant better radiological outcome except for ulnar variance and bone healing than cast group. However functional outcome was similar in both groups
External fixator and K wire- A versatile tool in distal end radius fractures
Indian Journal of Orthopaedics Surgery, 2018
Introduction: Distal end of the radius fractures are common injuries and are the commonest bony injury around the wrist. The logical treatment need to be planned based on specific fracture configuration, the extent of displacement, degree of articular disruption, stability and many other factors. The present study is intended to assess results of closed reduction, K wiring and external fixator in Fractures of Lower end Radius/ulna in 40 patients classified according to Frykman's classification. Materials and Methods: This is a retrospective study of 40 cases of distal end radius fractures selected randomly over a period one year from March 2016 to March 2017. Observation and Results: Out of 40 patients in the study most of them were male with the mean age of patients being 44.72.Injury was commonly due to fall on out stretched hand with no associated injuries signifying it is caused by low energy trauma. Most of the patients were of Frykman type III and IV. The average period for intermittent mobilization is between 6 to 7 weeks. 90% patients have 10-22 degrees of range of radial inclination. Most patients developed a good range of movement postop. Few complications were reported with pin tract infection being present in 5% cases. Conclusion: We have studied 40 patients of distal end radial fracture treated with external fixator and K wires. It is simple and inexpensive implant. Technique is less demanding for surgery. It causes minimal soft tissue interference. Elbow and fingers can be mobilized immediate post operatively. It maintains reduction and provides stability to fracture fixation. Period of immobilization was short. Complication rates are comparatively low in our study. Most patients had excellent to good results. Its ease of use and successful results make external fixator and K wire versatile tool for treatment of these fractures.
International Journal of Orthopaedics Sciences, 2017
This is very common injury faced by Orthopaedic surgeons. It accounts 15-16% of the total percentage trauma. The restoration of normal congruency of distal radius is essential, otherwise the secondary osteoarthritis of wrist joint sets in at a faster pace. The modalities of treatment available are a) Closed reduction, b) crossed K-wires, c) External fixator, d) volar locking compression plate. There are various parameters to assess the displacement which are a) ulnar variance, b) radial length, c) radial inclination, d) palmar tilt, e) dorsal angle. The results of fixation depend entirely on all these factors aforementioned, which can judge whether the normal anatomy of the joint is restored. 15 cases of fracture distal radius are treated with volar LCP, 33 cases are treated with crossed k wires with or without external fixator frame. The results of both the techniques were more or less similar. But volar LCP require more precison & soft tissue dissection. The operating time & the hospitalization, is more along with the risk of infection. The other technique i.e. fixation with crossed K-wires is user friendly technique, where there is no need of open surgery, results are comparable with those fixed with volar LCP. But when there is involvement of partial articular surface, AO type B, volar LCP is the treatment of choice.
National journal of clinical orthopaedics, 2020
Introduction: The fracture of distal end of radius was before known for being common in old with low functional demand who sustained a low energy trauma. But the rate of this fracture has increased due to more number of old populations along with increasing number of road traffic accidents and other high energy traumas in all age groups who end up suffering this fracture [1]. This joined with ever increasing demand for perfect reduction and a decreased difficulty in treatment of this fracture among the patients has brought greater importance to the way these fractures are managed Method: This randomized comparative study was performed at
Closed reduction and percutaneous k-wire fixation for distal end radius fractures
International Journal of Research in Medical Sciences, 2020
Background: To evaluate radiological and functional outcome in fractures of the distal radius treated by K-wire fixation.Methods: Forty patients (16 males, 24 females) with different types of fractures of distal radius were treated. K-wire fixation was performed under axillary bolock or general anaesthesia. Anatomical restoration was evaluated by postero-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate Radial Height (RH), Radial Inclination (RI) and Volar Tilt (VT). Functional outcome was evaluated using Mayo scoring system.Results: According to Mayo score 72.5% (n=29) of our patients had excellent to good outcome while as 17.5% (n=7) had fair outcome and 10% (n=4) patients had poor outcome.Conclusions: Kirschner wire fixation is an inexpensive procedure that provides anatomic reduction, fracture fixation, and maintenance of reduction with an adequate method of immobilization.
Journal of clinical and diagnostic research : JCDR, 2016
In extra-articular distal radius fractures closed reduction and casting has been the mainstay of treatment, difficulty lies in predicting and maintaining the proper reduction at final union. Percutaneous K-wire stabilization is also a widely accepted treatment option, but there is no consensus on its outcome in comparison to closed reduction and casting. To evaluate the results of closed reduction and casting versus closed reduction with percutaneous K wire fixation and casting in the treatment of the distal radius extra-articular fracture with reference to the restoration of radial height, radial inclination, volar tilt of the distal articular surface and to assess the functional outcome of the same measured by the Gartland and Werley demerit scoring system. Prospective study was conducted on 60 patients attending the Department of Orthopaedics, from December 2013 to May 2015 with extra-articular fractures (AO type 23-A2 and 23-A3) of distal radius and fulfilling all the inclusion ...
European Journal of Trauma, 2005
Purpose: The objective of this retrospective study was to compare the results of two operative techniques used for the treatment of distal radius fractures classified as AO type A3. Patients and Methods: Patients were treated with either fixed-angle volar plates or intrafocal Kirschner wires (K-wires) using a Kapandji-like technique. The functional results were determined with the Gartland & Werley Score as well as the DASH Score after an average follow-up of 28 months. Results: 55 patients were included in the study. Of these, 33 were female and 22 male, with an average age of 59 years. In patients < 60 years, the Gartland Score was 1.4 points in the fixed-angle volar plate group, and 4.6 points in the Kapandji group. In patients ≥ 60 years, no significant difference between the therapy groups could be ascertained. The DASH Score measured 17 points in each group. In all cases, a satisfactory reduction was obtained. The Kapandji group experienced significantly more loss of reduction position at follow-up in terms of volar tilt and radioulnar inclination than the fixed-angle volar plate group. Conclusion: These results show that intrafocal K-wire fixation in older patients is a suitable method to attain and hold sufficient bony reduction. However, younger patients achieve better radiologic and functional results when treated with open reduction using the 3.5-mm LCP fixed-angle volar plate.
Acta Orthopaedica et Traumatologica Turcica, 2010
This study was designed to compare the results of palmar locking plate and K-wire augmented external fixation in the treatment of intra-articular comminuted distal radius fractures. Methods: The study included 30 patients with intra-articular comminuted distal radius fractures. Sixteen patients (11 men, 5 women; mean age 49±16 years) underwent open reduction and palmar locking plate fixation, and 14 patients (11 men, 3 women; mean age 35±10 years) underwent closed reduction and K-wire augmented external fixation. In both groups, eight patients had accompanying injuries. According to the AO/ASIF classification, there were four C1, 10 C2, and two C3 fractures in the locking plate group, and three C1, eight C2, and three C3 fractures in the external fixation group. For functional assessment, joint range of motion and grip strength were measured. The patients were assessed using the Gartland-Werley scale. Subjective functional assessment was made using the QuickDASH scale. On final radiographs, the presence of osteoarthrosis in the radiocarpal joint was assessed according to the Broberg-Morrey criteria. The follow-up period was at least 12 months (26.1±6.1 months in the locking plate group, and 62.7±16.8 months in the external fixation group). Results: Wrist flexion (p=0.012) and supination (p=0.003) degrees at final follow-up were significantly greater in the locking plate group. Other range of motion parameters were similar in the two groups. On final radiographic measurements, there were no significant differences between the two groups with respect to losses in palmar angulation, radial length, and radial inclination, and change in ulnar variance. The mean Gartland-Werley scores did not differ significantly (2.4±2.4 with plate fixation, and 2.0±2.8 with external fixation; p>0.05). The results were excellent in 11 patients (68.8%) and good in five patients (31.3%) with plate fixation. The results of external fixation were excellent in 11 patients (78.6%), good in two patients (14.3%), and moderate in one patient (7.1%). The mean QuickDASH scores and time to return to work were similar in patients treated with a locking plate and external fixator (QuickDASH score 2.4±3.0 and 2.9±5.4; 1.9±0.5 months and 2.1±0.7 months, respectively; p>0.05). The mean loss of strength compared to the healthy side at final follow-up was 3% in the locking plate group, and 5% in the external fixation group. Radiographic findings of stage 1 osteoarthrosis were observed in four patients (25%) in the plate group, and in 11 patients (78.6%) in the external fixation group. There were no complications in the locking plate group. In the external fixation group, two patients (14.3%) had regional pain syndrome, three patients (21.4%) had superficial pin and wire tract infections, and one patient complained of adherence at entry sites of the fixator. Overall, nine patients (64.3%) expressed dissatisfaction with the external fixator. Conclusion: Our results showed no superiority between the two treatment methods with respect to objective and subjective tools of evaluation. Palmar locking plate fixation was associated with full patient satisfaction. K-wire augmented external fixation can be used as a safe method in selected cases in which the severity of distal radius fracture would not allow palmar locking plate fixation.
International Journal of Research in Orthopaedics, 2018
Background: Distal end radius fractures are the most common fractures seen among all orthopaedic injuries, accounts for nearly 20% of all fractures coming to the emergency department.There are various treatment modalities for distal end radius fracture which includes closed reduction and casting, closed reduction with external fixation and closed reduction with internal fixation.Methods: This retrospective study was done on patients who underwent distal end radius fracture surgery in the Department of Orthopaedics at MGM Hospital Kamothe in the last 2 years from May 2015 to May 2017. Total of 108 patients were included in the study, out of which 62 were males and 46 were females undergoing distal end radius fracture surgery. The mean age was 34.5 (28-75 years age group). All patients were assessed with wrist radiograph to see the collapse post-operatively and after 4-6 weeks.Results: The mean age was 34.5 (28-75 years age group). Out of 108, three females treated with cast lost for ...