ABSTRACT
Background and Aims: Metaphysical distal radius fractures are common fractures account for almost half of the fractures in Orthopaedic Emergencies. According to different studies, 1-6 weeks cast immobilization after distal radius surgery has been recommended. The aim of this study was to compare outcomes and complications of short-term and long-term immobilization treatment methods
Methods: In a randomized clinical trial, 50 patients with metaphysical distal radius fractures and extra joint or intra joint fractures without comminution referred to the Emergency Unit of Shohada Hospital in Tabriz, Iran who were treated by percutaneous pinning were selected and divided into two groups of immobility for one week [group 1] and immobility for four weeks [group 2]
Results: Loosing of pins was not seen in any of the groups. There were no significant differences in intensity of pain, infection at the site of pins and range of motion improvement between the two groups. Most of the patients in group two like group one have gained their ability in three months, but 1.5 month after the treatment return of motions in the early motion group was significantly faster
Conclusion: According to these findings, there is no difference in final therapeutic and functional outcomes between 1- and 4- week post operative immobility. Earlier initiation of movements after one week is not associated with more complications in comparison to late initiation of movements, but patients return to their daily activities earlier
ABSTRACT
Delayed diagnosis of musculoskeletal injury in multitrauma patients may potentially cause functional or cosmetic sequelae remaining for the rest of survivors life. Identification of factors which hide injuries from early diagnosis in multitrauma patients will decrease their occurrence and prevent many functional disabilities and cosmetic sequelae. We planned this study to assess the reasons for injury concealment in multitrauma patients and provide resolutions to reduce them. This cross-sectional study on 487 patients was carried out in Tabriz Shohada Hospital from February 2004 to February 2005. After collection of needed data, a questionnaire was filled for every multitrauma patient who had a missed injury. The relative frequency of multitrauma was 18.51% among all studied trauma patients [487 cases], but 7.6% of included patients [28 from 367 trauma cases] had missed injury [ies]. 32 missed injuries were found in 28 patients. Most injuries were musculoskeletal, involving the distal part of the limbs [feet, hands, wrists and ankles]. Fracture was the most common type of musculoskeletal injury [19 out of 32 missed injuries]. Causes that lead to concealment of injuries were founded to be inadequate physical and / or, radiographic examinations, commonly after severe penetrating injuries which are mostly due to motorcycle accident. Most of the missed injuries have been ultimately diagnosed upon the patient's complaints in hospital wards, within 1 to 30 days after trauma. We can prevent missing of injuries by complete and accurate physical examination and perfect radiographic evaluation according to the standard protocols. Repetitive serial examinations during admissions and after discharge can reveal missed injuries