A Comparative Study of Clinical and Radiologic Outcomes of Unstable Colles Type Distal Radius Fractures in Patients Older Than 70 Years: Nonoperative Treatment Versus Volar Locking Plating

Arora, Rohit; Gabl, M.; Gschwentner, Martin; Deml, Christian; Krappinger, Dietmar; Lutz, M.

doi:10.1097/bot.0b013e31819b24e9

Cited by 245 publications

(241 citation statements)

References 28 publications

(35 reference statements)

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“…Do these patients require more pain medications, more recovery room time, and/or have functional outcomes or patient satisfaction differences? In addition, we currently have little understanding regarding how to advise patients about optimal pain control after distal radius fracture fixation [1,2,9,12]. We therefore decided to conduct a randomized study comparing pain control after distal radius fracture fixation in patients who received either general anesthesia or brachial plexus blockade to better understand this.…”

Section: Introductionmentioning

confidence: 99%

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Galos

Taormina

Crespo

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Distal radius fractures are very common injuries and surgical treatment for them can be painful. Achieving early pain control may help improve patient satisfaction and improve functional outcomes. Little is known about which anesthesia technique (general anesthesia versus brachial plexus blockade) is most beneficial for pain control after distal radius fixation which could significantly affect patients' postoperative course and experience. Questions/Purposes We asked: (1) Did patients receiving general anesthesia or brachial plexus blockade have worse pain scores at 2, 12, and 24 hours after surgery? (2) Was there a difference in operative suite time between patients who had general anesthesia or brachial plexus blockade, and was there a difference in recovery room time? (3) Did patients receiving general anesthesia or brachial plexus blockade have higher narcotic use after surgery? (4) Do patients receiving general anesthesia or brachial plexus blockade have higher functional assessment scores after distal radius fracture repair at 6 weeks and 12 weeks after surgery? Methods A randomized controlled study was performed between February, 2013 and April, 2014 at a multicenter metropolitan tertiary-care referral center. Patients who presented with acute closed distal radius fractures (Orthopaedic Trauma Association 23A-C) were potentially eligible for inclusion. During the study period, 40 patients with closed, displaced, and unstable distal radius fractures were identified as meeting inclusion criteria and offered enrollment and randomization. Three patients (7.5%), all with concomitant injuries, declined to participate at the time of randomization as did one additional patient (2.5%) who chose not to participate, leaving a final sample of 36 participants. There were no dropouts after randomization, and analyses were performed according to an intention-totreat model. Patients were randomly assigned to one of two groups, general anesthesia or brachial plexus blockade, and among the 36 patients included, 18 were randomized to each group. Medications administered in the postanesthesia care unit were recorded. Patients were discharged receiving oxycodone and acetaminophen 5/325 mg for pain control, and VAS forms were provided. Patients were called at predetermined intervals postoperatively (2 hours, 4 hours, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours) to gather pain scores, using the VAS, and to document the doses of analgesics consumed. In addition, patients had regular followups at 2 weeks, 6 weeks, and 12 weeks. Pain scores were again recorded using the VAS at these visits.Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are...

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Section: Introductionmentioning

confidence: 99%

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Galos

Taormina

Crespo

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Incidence of distal radius fractures increase in two distinct age groups in which the injury occurs by two distinct mechanisms: high energy falls during sports activities in young and low energy falls in elderly patients with various risk factors. Closed reduction and cast stabilization is the accepted treatment in most cases, especially in lowdemand elderly patients [2][3][4], whereas operative treatment provides better anatomical stabilization of the wrist and earlier improvement of functions in patients who had professional expectations.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary repair device against volar plating in the reconstruction of extra-articular and simple articular distal radius fractures; a randomized pilot study

Zehir

Çalbıyık

Zehi̇r³

et al. 2014

International Orthopaedics (SICOT)

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Purpose This prospective randomized pilot study reports our institutional experience and early results using Sonoma Wrx (Sonoma Orthopedic Products, Santa Rosa, CA) in the treatment of extra-articular and simple intra-articular distal radius fractures. Material and methods A total of 64 patients, were enrolled in the study. They were considered eligible if they had; unstable extra-articular distal radius fractures and simple intraarticular distal radius fractures suitable for closed reduction (AO types; A2.2, A2.3, A3

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“…11,14 The results of this retrospective study are comparable with those reported by various authors in terms of early functional recovery and acceptable radiological parameters. 3,6,11 The modified Green and O'Brien Score showed 5(21 Percent) excellent, 13(54 Percent) good, 5(21 Percent) fair, and 1(4 Percent) poor results at the latest follow-up. Arora, et al 3 reported 31(27%) excellent, 54(47%) good, 23(20%) fair, and 6(5%) poor results in their multicenter study.…”

Section: Modified Clinical-scoring System Of Green and O'brienmentioning

confidence: 99%

“…Although cast treatment gives good functional outcome in geriatric patients, 2,3 it has given way to operative methods for better outcome in high-demand younger patients. A multiple array of surgical techniques for fixation of distal radius fracture are available which include pins and plaster, spanning external fixator, percutaneous pinning and various types of plates and screws.…”

Section: Introductionmentioning

confidence: 99%

Vol Ar Plating of Distal Radius Fracture : A Retrospective Analysis

Moirangthem¹,

J²,

R³

et al. 2015

jemds

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BACKGROUND: Treatment of distal radius has undergone remarkable changes since the time of Abraham colles. Conservative treatment with cast application has given way to operative techniques for better outcome in high demand young individuals. Volar plating for distal end radius fractures is an effective technique which allows early mobilisation with restoration of radial inclination, radial length, articular congruity and palmar tilt. MATERIALS AND METHODS: This study was performed in chettinad hospital and research institute between January 2013 and March 2014. 24 patients with closed isolated distal end radius fractures treated with open reduction and internal fixation with plates and screws by volar approach were followed up retrospectively for a minimum period of one year. There were 17 men and 7 women. Mean age was 44 years (Range, 22-75 years). The fractures were classified based on the AO system. There were 4 A2, 12 B3, 5 C1, 3 C2 fracture types. RESULTS: All the patients were evaluated with standard anteroposterior and lateral radiographs and CT scans in case of intraarticular fractures. In all patients plating of distal end radius done by volar approach. Patients were followed postoperatively for one year radiologically and clinically by modified clinical scoring system by Green and O Brien. Five patients had excellent results, thirteen patients had good results with twenty five percent restriction of wrist function .Five patients had fair results. One patient had postop wound infection which required implant removal and external fixator application. CONCLUSION: With proper patient selection and accurate surgical techniques, volar plating continues to be a useful method of treatment for distal end radius fractures with minimal complications and allowing early return of patients to normal activities.

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A Comparative Study of Clinical and Radiologic Outcomes of Unstable Colles Type Distal Radius Fractures in Patients Older Than 70 Years: Nonoperative Treatment Versus Volar Locking Plating

Cited by 245 publications

References 28 publications

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Intramedullary repair device against volar plating in the reconstruction of extra-articular and simple articular distal radius fractures; a randomized pilot study

Vol Ar Plating of Distal Radius Fracture : A Retrospective Analysis

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