AHD<6 mm is a sign of rotator-cuff rupture almost systematically involving longstanding total infraspinatus tear, not always amenable to suture repair due to advanced fatty degeneration. AHD equal to or greater than 6mm is of no diagnostic relevance and in no way indicates whether there is subscapularis tear and, if so, whether suture repair is feasible.

We performed a prospective randomized study on 60 patients with dorsally displaced extra-articular or noncomminuted intraarticular fractures of the distal radius. All 60 fractures were treated by closed reduction and Kirchner wire trans-styloid fixation. 30 patients had 1 weeks' postoperative immobilization and 30 patients had 6 weeks' immobilization. All patients had a clinical and radiographic review at 6 weeks and at 1 year after the operation. Pain, range of movement and grip strength were tested clinically, and changes in dorsal tilt, frontal radial deviation, ulnar variance, and radial shortening were assessed radiographically. Rates of complications were the same in both groups. At follow-up, pain was similar in both groups and range of motion and grip strength were somewhat better after early mobilization--in comparison with the opposite wrist--but this was statistically significant only for ulnar deviation. The postoperative radiographic reductions were similar in both groups, with no differences in loss of reduction after bone healing. Therefore, in Colles' fractures, trans-styloid fixation with two K-wires seems to give a stable osteosynthesis, which does not need additional immobilization with a plaster cast.

Since the Constant scores obtained after trapezius transfer correlate those estimated when not combining a subscapularis repair and taking into account the very frequent lack of improvement regarding the preoperative anterior subluxation of the humeral head, the trapezius transfer does not appear as a recommendable treatment option.

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