A revolution in the management of fractures of the distal radius?

Downing, N. D.; Karantana, Alexia

doi:10.1302/0301-620x.90b10.21293

Cited by 124 publications

(89 citation statements)

References 67 publications

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“…After the introduction of the volar plate in the early 1990s locking plates are currently gaining popularity because of their high stability and improved fixation in osteoporotic bone [12,13]. In 2008, there were already more than 30 different volar plating systems [14]. However, to date there is no level 1 evidence of improved performance and there are considerable drawbacks including the high costs [15].…”

Section: Introductionmentioning

confidence: 99%

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Twigt

Bemelman

Lansink

et al. 2013

International Orthopaedics (SICOT)

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Purpose C-type distal radial fractures remain challenging fractures. Currently locking plates are very popular because of their length preserving, stability. A considerable drawback is the high cost. Since 2003 we have been using mini AO plates (2.7 mm) as an alternative. We analysed our results and performed a cost analysis. Methods Retrospective analysis was performed of all patients operated upon between 2003 and 2008 for C type distal radius fractures. Reduction was achieved with mini AO plates, applied in a buttress fashion, with ligamentotaxis. Rehabilitation consisted of immediate mobilisation. Pre-and postoperative X-rays, operative results and patient charts were reviewed. Furthermore, we prospectively evaluated the functional results using VAS, DASH and Mayo wrist scores. Lastly, we assessed the implant costs and compared them to locking plates. Results Thirty-four patients were treated with a mean age of 49 years. Mean radial shortening improved 2 mm; dorsal and radial angulation improved 23 and 4°, respectively. At consolidation (eight weeks) the average radial shortening was 0.75 mm, a volar angulation of 3°, and 21°of radial angulation. Functional results were excellent, demonstrated by a mean VAS score less than 1, a DASH score of 12 and a Mayo wrist score of 87. Compared to locking plates, there was an overall reduction in material costs of 15,300 Euro.Conclusions Our technique has excellent biomechanical stability, enabling immediate functional rehabilitation, good anatomical and functional outcome with significantly lower costs.

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Section: Introductionmentioning

confidence: 99%

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Twigt

Bemelman

Lansink

et al. 2013

International Orthopaedics (SICOT)

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“…12 We have used both patient derived functional outcome measures as well as range of motions to have both objective as well as subjective assessments. Radiological parameters were also assessed at various intervals to notice the effect of various parameters on change in functional outcome.…”

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confidence: 99%

Comparison of outcome of extra articular lower end radius fracture with percutaneous pinning and volar locking plate

et al. 2017

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INTRODUCTIONFractures of the distal radius are common fractures seen in orthopedics outpatient and trauma care. Data suggests that around 6% of women by age of 80 years will sustain such fracture and 9% women by age of 90.1 As the population continues to age, these figures are likely to increase still further. Its growing incidence may be attributed to a parallel rise of osteoporosis and high energy accidents.2,3 The epidemiology has changed from the times of Colle's fracture to present date due to increased life expectancy and increased in high energy trauma. Various authors have stated the age specific incidence, that ranged from 9 to 100 per 10,000 per year. [4][5][6] Various operative and non-operative treatment options are available, without there being a consensus as to an optimal method according to the patients demographics and fracture pattern. 7,8 Despite this being a topic of discussion there have been very few studies focusing on the functional outcomes following percutaneous K wiring and volar plating in extra articular fractures. Each having their own merits and demerits.Percutaneous wire fixation being a relatively quick and minimally invasive procedure that could be carried out in limited operative environment. However, since the ABSTRACT Background: As fractures of the distal radius are the most common fractures of the upper extremity with no clear guidelines for mode of intervention it was decided to compare two of the most common methods of treatment. The aim of this study was to review a group of patients sustaining extra articular lower end radius fracture treated with percutaneous wiring and volar plating and compare their functional outcome at a significant follow up time. Methods: A prospective study was conducted at tertiary care center. A sample of 45 patients who had a displaced extra articular distal radius fracture and were subjected to treatment with either a plate (n =24) or k wiring (n =21). Outcome assessments were conducted at 6 months. Outcomes were measured on the basis of scores on the DASH questionnaire, wrist range of motion, and radiographic parameters. Results: Patients in the plate group had significantly better DASH scores (p=0.0431) and range of motion at six months compared with patients in the k wiring group. Collapse in radial length was observed in 2 patients with percutaneous wiring which led to suboptimal range of motion and increased DASH scores. Significance arc of motion at 6months in dorsiflexion and palmar flexion were p=0.0038 and when compared with opposite limb were significant in all three planes p=0.0217, p=0.0126 and p=0.0029. Conclusions: Based on our observation we found that treatment of dorsally displaced, unstable extra articular radius fractures across all age groups, volar-locked plates achieve a superior radiological and functional outcome with minimal complications.

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“…When the quality of the pronator quadratus muscle is good, the volar-placed plates are almost covered with the pronator quadratus, except at the distal edge of the plate (17,18). Volar scars are better tolerated and less obvious, and the blood supply to the radius is less likely to be disrupted (17).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, fixed-angle distal radius volar locking plates are systems that are angled to fit the palmar surface anatomically and have locking screws to fit the subchondral area at a fixed angle. These features facilitate the reduction, and fixation becomes more stable (17). This is crucial for an older population that encounters such fractures due to osteoporotic bone formation (2,9).…”

Section: Introductionmentioning

confidence: 99%

Distal radius measurements and efficacy of fixed-angle locking volar plates

Nouman

Siddiqui²,

Basra³

2014

Turk J Med Sci

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Dairy and meat production are very complex in dry regions due to shortages and the low quality of fodder, especially in dry months. Livestock scientists are enthusiastic to explore and investigate good quality fodder that can boost milk and meat production in an economical way. Moringa oleifera is known as one of the best fodder crops for dry regions with scanty amounts of water. Hence, the present study was designed to evaluate the potential of Moringa oleifera as a field crop by harvesting at different cutting heights (30, 90, and 150 cm). The nutritional quality (minerals like P, K, Ca, and Mg, and crude protein) was determined along with antioxidant (SOD, CAT, POD, total phenolic contents) activities. The findings show that a Moringa crop gave maximum biomass (472 g plant -1 ) with higher mineral content in its leaves when harvested at 30-cm cutting height in August, while the minimum biomass (113.54 g plant -1 ) was recorded when plants were harvested at 150-cm cutting height. Higher antioxidants, total phenolics content, and photosynthetic pigments were recorded in the hot rainy season (July and August). The seasonal variability affects mineral content in moringa leaves. The highest mineral content was found in August, followed by July. It is concluded that the moringa tree, due to its higher mineral content and antioxidant activities, can be cultivated as a field crop as a good alternate for livestock fodder.

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A revolution in the management of fractures of the distal radius?

Cited by 124 publications

References 67 publications

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Comparison of outcome of extra articular lower end radius fracture with percutaneous pinning and volar locking plate

Distal radius measurements and efficacy of fixed-angle locking volar plates

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