The Profile of Distal Radius Fracture Colles\u27 Type at Dr. Soetomo Hospital in 2013

The fracture cases become increase because the rapid development of transportation and human mobility today is not offset by good vigilance in conducting the activity. One of the most common location is in the hand and involves distal radius part, named Colles\u27 fracture. Colles\u27 fracture is the most common wrist fracture (almost 80% of the forearm fractures and the incidence rise in elderly people especially woman. The adequate distribution data of Colles\u27 Fracture is not available yet. If this situation keeps going, it will have impacts on the lack of preventive measures and recovery methods. The study was design as descriptive and used secondary data from medical records in Orthopedics and Traumatology Department of Dr. Soetomo Hospital Surabaya. Total 37 patients that included in inclusion criteria. Distal radius fracture Colles\u27 type was common in woman. The most common age was 45-64 years old. Most common causes of fracture was traffic accidents. Left forearm become major affected side. The incidence dominantly occurred at the street. The incidence often occurred at 12.00-18.00. The onset of admission from the incidence place to hospital was less than 8 hours

Functional Outcome after Treatment of Aggressive Tumours in the Distal Radius: Comparison between Reconstruction using Proximal Fibular Graft and Wrist Fusion

Introduction: Restoration of a functional hand is the ultimate goal following a distal radius tumour resection. The early outcomes of mobile wrist reconstruction are satisfactory; however, long-term results are unpredictable due to late wrist instability and degenerative arthritis. Our aim is to compare mobile wrist reconstruction with wrist fusion (pan-carpal fusion) in our cohort of patients. Materials and Methods: A retrospective cohort study was performed for functional outcomes of all patients who underwent resection for distal radius tumour and treated with either fusion or reconstruction of the wrist in a single institution from years 2000-2013 with a minimum of three years follow-up. Results: Eleven patients were included in the study, six of whom had wrist reconstruction with proximal fibula graft and the remaining five wrist fusion, with a mean follow-up of 6.3 years. The mean Musculoskeletal Tumour Society (MSTS) score was 82.78%, ranging from 70% to 93.3%. Average grip strength compared to the normal contralateral hand was 60.0% for total wrist fusion, which was better than wrist reconstruction with 58.07%. There was no difference in the functional outcome between fusion and mobile reconstruction in our study. Osteoarthritis changes and subluxation of the wrist joint were the most common findings in the long-term follow-up for this group. Conclusion: There was no difference in the functional outcome of the long-term follow-up between the two groups

Management of distal unstable radius fractures with locking distal radius plates: a retrospective study

Background: Distal radius fractures that are unstable are challenging to treat. The locking distal radius plate screws is a superior alternative to the other forms of treatment (external fixator and K pin). The purpose of this study was to provide the radiographic and functional clinical outcomes of patients who had locking distal radius plate screws treatment. This study's objective was to clinically assess the results of using a locking distal radius plate system to treat radius fractures.Methods: 31 patients with radius fractures are included in this retrospective clinical trial. They are all treated with a locking distal radius system made by Kaulmed Private Limited in Sonipat, Haryana, India. The patients were treated with variable angle locking distal radius plates that includes 2.4 mm KL-8 variable angle two column volar distal radius plates and 2.4 mm KL-8 variable angle volar rim distal radius plates. There were 31 patients consisting of 24 male and 07 female, with an average age of 44 years. The fractures were categorized based on AO classification and pre-operative fitness was assessed using American society of anaesthesiologist (ASA grade). The patients were assessed clinically, radiologically and functionally using visual analogue scale (VAS), post-operative radiographs and measuring grip strength and weight bearing respectively.Results: Surgery was performed on 31 patients with at-least three post-operative follow-up visits in 180 days. No patient in any group complained after the final follow up about any major complications or hardware problems, and every patient's bone union was achieved successfully. Radiological outcomes also showed proper union in 6-7 weeks.Conclusions: Distal radius volar locking plates provide effective results in correcting distal radius anatomy

DRUJ instability after distal radius fracture: A comparison between cases with and without ulnar styloid fracture

AbstractBackgroundBecause of the importance of the DRUJ in upper extremity function and the prevalence of distal radius fractures, either with or without ulnar styloid fracture, this study was designed to assess the relationship between ulnar styloid fracture and the incidence of DRUJ instability after treatment of distal radius fractures treated with ORIF (volar plate).Methods112 patients suffering from type two and three distal radius fractures (Fernandez classification), were evaluated. Depending on the presence of ulnar styloid avulsion fracture, patients were divided into two groups: 86 cases with isolated radial fracture and 26 cases with a distal radius fracture accompanied by ulnar styloid fracture. All patients underwent distal radius fracture ORIF. CT scanning was done both immediately after surgery and 3 months post-op. DRUJ stability was examined using the modified radioulnar line method and the incidence of DRUJ instability was compared between the two groups.ResultsImmediate instability was seen in 11 patients. Three of these patients had concomitant ulnar styloid fracture and were excluded for further fixation. Three months later, another 9 cases were diagnosed with DRUJ instability, 2 of whom had concomitant ulnar styloid fracture and the other 7 suffered from isolated distal radius fracture. Chi-square test revealed no significant difference (p < 0.05). There were no cases of delayed union or non-union distal radius fracture.ConclusionOur study demonstrated that untreated stable or minimally displaced ulnar styloid fracture accompanied by distal radius fracture, has no adverse effect on DRUJ stability following ORIF of the radius

Correlation between obesity and severity of distal radius fractures

Introduction: The incidence of obesity has increased significantly worldwide. Our hypothesis was that patients with obesity have a more severe distal radius fracture and we realized a study to evaluate this correlation between obesity and severity of distal radius fractures caused by low-energy injuries. Materials and methods: A total of 114 patients with distal radius fracture were examined in

Ipsilateral olecranon and distal radius fracture: A case report

WOS: 000397094300056PubMed ID: 25544490INTRODUCTION: Concomitant ipsilateral olecranon and distal radius fracture are rare injuries. Their clinical presentation is unusual and investigation and management is poorly described. PRESENTATION OF CASE: We present a 55-year-old woman patient who fell off sustaining a concomitant distal radius and olecranon fracture in the same extremity. On examination, there was gross swelling of the proximal and distal forearm and no neurovascular deficit. Radiographs confirmed distal radius and olecranon fracture. Patient was treated with open reduction and anatomic locking plate for olecranon and a closed reduction percuteneous K wire fixation with penning fixator for distal radius fracture. After physical therapy program, functional results were good and DASH score was 60. DISCUSSION: Several different combinations of fracture with dislocation have been described, but, to our knowledge, concurrent ipsilateral olecranon and distal radius fracture has not been reported before. In the literature review there are two similar cases in the English literature. CONCLUSION: Ipsilateral olecranon and distal radius fracture is a very rare injury due to different trauma mechanisms. However we should keep in mind that there may be adjacent joints and structures for concomitant injuries

A Biomechanical Investigation of Load Sharing at the Distal Forearm

Loading at the distal forearm has been previously examined under static loads, however there remains no consensus on how loading is affected by active wrist and forearm motion. This work examines load magnitudes and load sharing at the distal radius and ulna during of active wrist and forearm motion. Two instrumented implants were designed to measure in vitro loading in cadaveric specimen. The implants were evaluated and found reliable for use in further biomechanical studies. An in vitro study investigated the effect of joint angle and direction of joint motion on loads in the distal radius and ulna during active flexion-extension, radioulnar deviation and dart throw motion. Loads through the distal radius and ulna were significantly greater in extension and reverse dart throw motion than in flexion and forward dart throw motion. A subsequent study examined the effect of radial length changes, joint angle and direction of motion on distal radius and ulna loading during active forearm rotation. Load magnitudes through the distal radius were greater in supination than in pronation. Radial lengthening found to increase radial loading and decrease ulnar loading and radial shortening decreased distal radius loading and increased distal ulna loading throughout forearm rotation, in a quasilinear fashion. This work improves the understanding of forearm bone loading and will assist clinicians in the development of rehabilitation techniques, surgical protocols and implant designs

A three-dimensional analysis of the sigmoid notch

Fractures of the distal radius are among the most common injuries of the upper extremity, though treatment has traditionally focused on restoration of the radiocarpal joint and late sequelae may persist. X-ray imaging underestimates sigmoid notch involvement following distal radius fractures. No classification system exists for disruption patterns of the sigmoid notch of the radius associated with distal radius fractures. This study quantifies the anatomy of the sigmoid notch and identifies the landmarks of the articular surface and proximal boundaries of the distal radioulnar joint (DRUJ) capsule. Computed tomography scans of freshly frozen cadaveric hands were used - followed by dissection, and three-dimensional reconstruction of the distal radius and sigmoid notch. The sigmoid notch surface was divided into two surfaces and measured. The Anterior Posterior (AP) and Proximal Distal (PD) widths of the articulating surface were reviewed, along with the radius of curvature, version angle and depth. The study showed that the sigmoid notch is flatter than previously believed - and only the distal 69% of its surface is covered by cartilage. On average, it has about nine degrees of retroversion, and its average inclination is almost parallel to the anatomical axis of the radius. Clinical implications exist for evaluation of the DRUJ involvement in distal radius fractures or degenerative diseases and for future development and evaluation of hemiarthroplasty replacement of the distal radius

Biomechanics of the Upper Extremity in Response to Dynamic Impact Loading Indicative of a Forward Fall: An Experimental and Numerical Investigation.

The distal radius is one of the most common fracture sites in humans, often resulting from a forward fall with more than 60 % of all fractures to the wrist requiring some form of surgical intervention. Although there is a general consensus regarding the risk factors for distal radius fractures resulting from forward falling, prevention of these injuries requires a more thorough understanding of the injury mechanisms. Therefore the overall purpose of this dissertation was to assess the response of the upper extremity to impact loading to improve the understanding of distal radius fracture mechanisms and the effectiveness of joint kinematic strategies for reducing the impact effects. Three main studies were conducted that utilized in vivo, in vitro and numerical techniques. In vitro impact testing of the distal radius revealed that fracture will occur at a mean (SD) resultant impact force and velocity of 2142.1(1228.7) N and 3.4 (0.7) m/s, respectively. Based on the failure data, multi-variate injury criteria models were produced, highlighting the dynamic and multidirectional nature of distal radius fractures The in vitro investigation was also used to develop and validate a finite element model of the distal radius. Dynamic impacts were simulated in LS-DYNA and the resulting z-axis force validation metrics (0.23-0.54) suggest that this is a valid model. A comparison of the experimental fracture patterns to those predicted numerically (i.e. von-Mises stress criteria) shows the finite element model is capable of accurately predicting bone failure