ABSTRACT
Various plating systems are available to fix distal radius fractures, each with a specific design. The purpose of this study was to compare radiological outcome and complications of the Variable Angle LCP Plate 2.4-mm (DePuy Synthes) with the VariAx volar locking plate (Stryker). One hundred patients (103 wrists) operated on for a distal radius fracture were retrospectively reviewed with a mean follow-up of 3.5 years. Seventy-three wrists were treated with a DePuy Synthes plate and 30 with a VariAx plate. The overall complication rate was 32%. Nineteen cases underwent revision surgery, 18 had malunion and 3 complex regional pain syndrome. Complicaton rate was 43% with DePuy Synthes plates and 27% with Variax plates, but the difference was not significant.
Subject(s)
Bone Plates , Fracture Fixation, Internal , Fractures, Malunited , Pain, Postoperative , Postoperative Complications , Radius Fractures/surgery , Wrist Injuries , Bone Plates/adverse effects , Bone Plates/classification , Bone Plates/statistics & numerical data , Bone Screws , Comparative Effectiveness Research , Female , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/instrumentation , Fracture Fixation, Internal/methods , Fractures, Malunited/diagnostic imaging , Fractures, Malunited/etiology , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Pain, Postoperative/diagnosis , Pain, Postoperative/etiology , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/physiopathology , Postoperative Complications/surgery , Radiography/methods , Radius Fractures/diagnosis , Radius Fractures/etiology , Reoperation/methods , Wrist Injuries/diagnosis , Wrist Injuries/surgeryABSTRACT
The authors present a case of monoarticular localized pigmented villonodular synovitis (PVNS) in a 7-year old girl. PVNS is a rare benign disease of the synovial tissue. It is especially rare in ankles of children, with only 15 cases reported in literature. The girl presented with swelling and pain in the left ankle since 4 weeks. The tentative diagnosis was made after a joint puncture and a MRI scan. A synovial mass with a brown-yellowish appearance was seen during the excisional biopsy. After removing the entire mass and without adjuvant therapy, no recurrence was detected after 12 months. As it is very rare in children, PVNS is easily misdiagnosed. Early diagnosis is important to prevent bone and cartilage damage. A review of the clinical, radiological and therapeutical features of PVNS are presented.
Subject(s)
Ankle Joint , Arthrodesis/methods , Dissection/methods , Edema , Synovial Membrane/pathology , Synovitis, Pigmented Villonodular , Ankle Joint/diagnostic imaging , Ankle Joint/pathology , Ankle Joint/physiopathology , Ankle Joint/surgery , Arthralgia/diagnosis , Arthralgia/etiology , Biopsy/methods , Child , Diagnosis, Differential , Diagnostic Errors/prevention & control , Early Diagnosis , Edema/diagnosis , Edema/etiology , Female , Humans , Magnetic Resonance Imaging/methods , Synovitis, Pigmented Villonodular/diagnosis , Synovitis, Pigmented Villonodular/physiopathology , Synovitis, Pigmented Villonodular/surgery , Treatment OutcomeABSTRACT
The aim of the study was to find out if ulnar shortening is effective to treat ulnar wrist pain and which factors influence outcome. Thirty-seven patients were evalua- ted with a mean follow-up of 4.5 years. Thirty patients (81%) would undergo the same operation again although 21 (57%) had residual ulnar wrist pain. Mean disabilities of arm, shoulder and hand (DASH) score was 22 and mean patient rated wrist evaluation score (PRWE) was 33. DASH and PRWE scores were better in smokers, in patients operated on the non- dominant side and when follow-up was longer. PRWE score was worse in posttraumatic cases. Age, gender and type of osteotomy did not influence outcome. Three patients (8%) needed an additional operation for nonunion and in 17 (46%) plate and screws had to be removed. It can be concluded that ulnar shortening can be proposed to treat ulnocarpal wrist pain, but complete pain relief cannot be guaranteed and additional surgery may be required.