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@#Introduction: The aim of this study was to evaluate the clinical outcomes following treatment of distal radial fractures using intramedullary elastic wires with a combination of either cast immobilisation or external fixation. Materials and methods: A total of 42 patients (24 females and 18 males) aged 40 to 78 years who presented with displaced and unstable, closed or grade I open, extra- and/or intra-articular fractures of the distal radius were included in the study. Twenty-seven fractures were AO/OTA Type A2- A3 and 15 Type C1-C2. Twenty-four patients were treated with antegrade intramedullary (IM) fixation with elastic wires followed by cast immobilisation and 18 required an external fixator in lieu of casting. Results: Final follow-up evaluation was conducted 12 months post-surgery using Sarmiento's modification of Lindstrom criteria and the demerit point system of Gartland and Werley. Successful fracture union was observed in all patients between eight to 14 weeks. Using Sarmiento's modification of Lindstrom criteria, 12 patients (28.6%) had excellent, 23 (54.8%) had good and 7 (16.6 %) had fair results. Based on the functional evaluation using the demerit point system of Gartland and Werley, 13 patients (31%) had excellent, 25 (59.5%) had good and four (9.5%) had fair results. None of the patients had a poor outcome using either of these criteria. Although a fracture union rate of 100% was confirmed clinically and radiographically, eight out of the 42 patients had minor complications in our study. One patient had uneventful IM migration of the wires, one patient reported a feeling of wire loosening, three patients complained of joint stiffness and soft tissue irritation, and three others reported on-going pain. The total cost of all implants used per case was less than INR 1,000. Conclusions: Good to excellent functional and radiographic outcomes with easy to manage complications are achieved with the techniques described. Patient selection is key to determining which particular method should be prescribed in a given case.
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Objective: To compare the effectiveness of minimally invasive percutaneous internal fixation and traditional open reduction via Henry approach and internal fixation in the treatment of unstable distal radial fractures.
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PURPOSE: The purpose of this study was to evaluate and compare the clinical & radiological outcome between LCP and conventional T-plate fixation in the treatment of distal radial fracture. MATERIALS AND METHODS: From January 2000 to October 2006, 26 patients were treated by LCP fixation and 20 patients were treated by conventional T-plate fixation for distal radial fracture. We used the X-ray to calculate the radial inclination, radial length and volar tilting, then compared the loss of correction after the operation between both groups. We also evaluated the clinical functional outcome by Mayo wrist score. RESULTS: The average follow-up since operation was ten months in both LCP and conventional T-plate fixation group. According to Frykmann classification, there were 1 case of type 1 (4%), 2 of type 2 (8%), 5 of type 3 (19%), 14 of type 4 (54%), 1 of type 5 (4%), 2 of type 7 (8%), 1 of type 8 (4%), and to AO classification, 4 of type A (15%), 22 of type C (85%) in LCP group. In conventional T-plate group, according to Frykmann classification, there were 12 cases of type 3 (60%), 4 of type 4 (20%), 3 of type 7 (15%), 1 of type 8 (5%), and to AO classification, 6 of type B (30%), 14 of type C (70%). In LCP group, the loss of correction between immediate post-operation and last follow-up was about 1.03 degrees in radial inclination, -1.09 mm in radial length, -2.08 degrees in volar tilting at each, and in conventional T-plate group, 2.4 degrees in radial inclination, -0.82 mm in radial length, -2.11 degrees in volar tilting at each. There was no statistical significance (p>0.05) in two groups. In the clinical functional outcome (according to Mayo wrist score), 92% of patient showed above good result in LCP group and 85% of patient showed above good result in conventional T-plate group. There was no infection, delayed union. CONCLUSION: Treatment by Interposition of fragments and shortening in the intractable nonunion of humerus with a bony defect can achieve not only good functional result, shortened bone union time and improved in shoulder and elbow motion.
Subject(s)
Humans , Elbow , Follow-Up Studies , Humerus , Shoulder , WristABSTRACT
Ruptures of extensor pollicis longus tendon after distal radial fractures are well-known. However, delayed flexor tendon rupture of finger as a complication of the fracture are less common. We report the case of delayed rupture of flexor digitorum profundus tendon to middle and ring fingers and flexor digitorum superficialis to ring finger in 72 year old female patient. She was treated by free tendon graft with palmaris longus tendon. After 1 year follow-up, range of motion and flexion power were recovered to nearly normal.