Combined ligamentotaxis and kirchner wires fixation for intraarticular fractures of the distal radius

Forty-two unstable intra-articular distal radius fractures were treated with primary external fixator augmented with Kirschner wires fixation. An external fixator was inserted between the radius and the second metacarpal, and ligamentotaxis was maintained for 4 weeks. A supervised physiotherapy regimen was started from day one postoperative. The external fixation was removed at 4 weeks and Kirschner wires were removed at an average of 7.1 weeks. Seventy patients were females and 25 were males, with an average age of 47.3 years. In 39 patients [92.9%] the anatomical result was good or excellent, but three fractures healed with malunion. All patients made a satisfactory functional recovery, at a mean follow-up of 28 months after injury. None had pain in the wrist and all were satisfied with the result. The average grip strength was 96% of normal. External fixation supplemented with Kirschner wires fixation with early removal of the external fixator and mobilization is an effective method for the treatment of unstable intra-articular distal radius fractures. It could give better functional results than the use of an external fixator alone

Treatment of chronic rotator-cuff impingement with arthroscopic subacromial decompression

We made a prospective study on 29 patients who had arthroscopic subacromial decompression for chronic rotator-cuff impingement. All patients were diagnosed as having chronic rotator-cuff impingement on the basis of clinical and sonographic examination. All patients were assessed pre-operatively and at 3, 6 and 12 months post-operatively using the shoulder-rating scale of the University of California at Los Angeles [UCLA]. The dominant arm was affected in 24 patients. There were 26 males and only three females. Before operation, the UCLA shoulder score was poor or fair in all patients. After three months of the operation 48% of patients had satisfactory relief of symptoms but at one year 93% of patients examined had a good or excellent result We concluded that arthroscopic subacromial decompression is an effective form of treatment, but full recovery of function and relief of symptoms could take long time