Evaluación de resultados calificada por el paciente en el análisis la diferencia de resultado funcional entre Fijación distal del segundo y tercer metacarpiano de placa de distracción dorsal en conminutivo distal fractura de radio / Patient-rated outcomes evaluation in analyzing the difference of functional outcome between second and third metacarpal distal fixation of dorsal distraction plating in comminutive distal radius fracture

Introduction: Comminuted distal radius fracture is one of the fractures that difficult to reduce. This study aimed to compare Patient-Rated Wrist Evaluation (PRWE) score between plating on second and third metacarpal groups. Methods: This study used a retrospective analytic research design with a sample of twenty seven cases of distal radius comminutive fractures that have been treated using dorsal distraction plating. Fifthteen cases with distal fixation in second metacarpal and twelve cases in third metacarpal. Data were then analyzed using the Mann-Whitney test. Results: The mean Pain scores in the second metacarpal and third metacarpal groups, respectively were 5.73 compared to 6.17. While the mean score of Function in the second metacarpal group and the third metacarpal group, respectively 12.67 compared to 13.83. The total PRWE score in the second metacarpal group was 18.40 compared to the third metacarpal group which was 20.0 (p>0.05). Conclusions: Patients with distal radius comminuted fracture treated using dorsal distraction plating with distal fixation in second metacarpal showed higher mean Pain, Function and total PRWE compared to third metacarpal, but there were no significant differences

Functional outcomes of conservatively treated clavicle fractures

OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique. RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion). CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.

El tratamiento incruento de las fracturas multifragmentarias mediante fijadores externos / Conservative treatment of comminuted fractures by external fixators

Se presenta una serie de 20 pacientes con fracturas multifragmentarias en 5 casos del húmero, en 8 del fémur y en 7 de la tibia. Todos se trataron con fijadores externos tipo Ortofix. Se obtuvo consolidación primaria en 18 casos (90 por ciento) en un promedio de 13 semanas, mientras que 2 requirieron medios masivos de osteosíntesis y aplicación de injerto óseo por haber sufrido severo retardo de consolidación

Extra-articular displaced fracture distal radius-comparative study

Study was made on 19 patients with displaced extra-articular fractures of the distal radius [A3 2] comparing three methods of treatment. The three treatment groups were closed reduction and dynacast fixation, primary external fixation and open reduction with buttress plate fixation. All the patients had clinical and radiological review at 6 months and at one year. The functional result according Demerit point system and radial shortening were assessed. Statistical analysis was applied to comparison with the normal opposite wrist, patients treated by open reduction with buttress plate fixation had a good functional and anatomical results, also there is correlation between final functional outcome and radial shortening