Distale Radiusfraktur

Unglaub, Frank; Langer, Martin; Hohendorff, B.; Müller, Lars Peter; Unglaub, Julia M.; Hahn, Peter; Krimmer, H.; Spies, Claudia

doi:10.1007/s00132-016-3347-5

Cited by 18 publications

(5 citation statements)

References 43 publications

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“…The dorsal fragments could not be accessed via the palmar exposure. Previous classifications were only descriptive and did not indicate a specific surgical approach [27]. In a recent article, Hintringer et al highlighted the relevance of considering the traumamechanism to determine the surgical approach, which can be in conflict with the standardized palmar acess for PSI use [28].…”

Section: Discussionmentioning

confidence: 99%

Computer-assisted open reduction internal fixation of intraarticular radius fractures navigated with patient-specific instrumentation, a prospective case series

Casari

Roner

Fürnstahl

et al. 2021

Arch Orthop Trauma Surg

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Background Intra-articular fractures are associated with posttraumatic arthritis if inappropriately treated. Exact reduction of the joint congruency is the main factor to avoid the development of arthrosis. Aim of this study was to evaluate feasibility of computer-assisted surgical planning and 3D-printed patient-specific instrumentation (PSI) for treatment of distal intraarticular radius fractures. Method 7 Patients who suffered a distal intraarticular radius fracture were enrolled in this prospective case series. Preoperative CT-scan was recorded, whereupon a 3D model was computed for surgical planning and design of PSI for surgical navigation. Postoperative accuracy and joint congruency were assessed. Patients were followed-up 3, 6 and 12 months postoperatively. Results Mean follow-up was 16 months. Over all range of motion was restored and flexion, extension and pronation showed significant recovery, p < 0.05. Biggest intraarticular joint step-off and gap reduced from average 2.49 (± 1.04) to 0.8 mm (± 0.44), p < 0.05 and 6.12 mm (± 1.04) to 2.21 mm (± 1.16), p < 0.05. Average grip strength restored (3–16 months) from 20.33 kg (± 7.12) to 39.3 kg (± 19.55) p < 0.05, 100% of the healthy contralateral side. 3D-accuracy for guided fragments was 2.07 mm (± 0.64) and 8.59° (± 2.9) and 2.33 mm (± 0.69) and 12.86° (± 7.13), p > 0.05 for fragments reduced with ligamentotaxis. Conclusion Computer-assisted and PSI navigated intraarticular radius fracture treatment is feasible, safe and accurate. The benefits of this method, however, do not outstand the additional effort. Level of evidence IV.

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Section: Discussionmentioning

confidence: 99%

Computer-assisted open reduction internal fixation of intraarticular radius fractures navigated with patient-specific instrumentation, a prospective case series

Casari

Roner

Fürnstahl

et al. 2021

Arch Orthop Trauma Surg

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“…This situation is attributed to the more frequent occurrence of osteoporosis. Fractures in young men are caused by severe trauma [14].…”

Section: Discussionmentioning

confidence: 99%

Early and mid-term efficacy of volar titanium lock plate applications in radial distal intraarticular fractures

et al. 2019

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Amaç: Erişkin distal radius kırıklarında titanyum volar kilitli plak uygulanan olgularımıza ait fonksiyonel ve radyolojik sonuçların erken ve orta dönem analizinin yapılarak etkinliğinin ortaya konulmasıdır. Hastalar ve Yöntemler: Distal Radius kırığı nedeniyle volar kilitli plak uygulanan 64 hasta (67 kırık ekstremite) retrospektif olarak incelendi. 36 kadın, 31 erkek, yaş ortalaması 53.31(18-75) idi. Frkyman sınıflamasına göre ve AO sınıflamasına göre sınıflandırıldı. Modifiye Gartlant Werley Skoru, Disabilities of the Arm, Shoulder and Hand (DASH) scoru, Modifiye Stewart skorlama sistemine göre değerlendirildi. Bulgular: Modifiye Gartland-Werley Skoruna göre 35(%52.2)'i mükemmel, 27(%39.7)'si iyi, 4(%5.9)'u orta ve 1'i kötü (%1.5) olarak değerlendirildi. DASH skoru ortalama değeri 9,5±8.8(0-35). Palmar eğim ameliyat öncesi-5.58±14.9 [(-50)-(30)], ameliyat sonrası 3.65±10.88[(-30)-(+45)] olarak değerlendirildi. İstatistiksel olarak radial yükseklik, radial inklinasyon ve palmar eğimin anlamlı düzeyde düzeldiği görüldü(p=0.001). Stewart radyolojik skoru değerlendirildiğinde 37(%54.4)'si mükemmel, 26(%38.8)'i iyi, 4(%5.9)'ü orta olarak değerlendirildi. Sonuç: Erişkin distal radius kırıklarında iyi sonuçların elde edilebilmesi kırığın iyi değerlendirilmesi, uygun tedavi şeklinin seçilmesi, uygun cerrahi tekniğin kullanılması, Anatominin iyi oluşturulması ve sağlam fiksasyon ile mümkün olabilir. Titanyum voler kilitli plak ile kırık tesbiti etkili bir tedavi yöntemi olup erken harekete izin vererek iyileşmeyi hızlandırdığı ve sonuça olumlu katkı sağlamaktadır.

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“…Trümmerfrakturen, Begleitverletzungen und fehlende PatientInnen-Compliance erfordern manchmal eine postoperative Immobilisierung. Eine Ruhigstellung in einer abnehmbaren Unterarmschiene bis zur 3. postoperativen Woche wird empfohlen, wobei jedoch sofortige aktive Beübungen der Fingergelenke und des Handgelenks, je nach Stabilität der Frakturversorgung, aus der Schiene heraus angestrebt werden sollen [ 34 ].…”

Section: Operative Therapieunclassified

Grundprinzipien der operativen Versorgung der distalen Radiusfraktur

Seeher,

Bode,

Arora

2024

Unfallchirurgie

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ZusammenfassungDie distale Radiusfraktur ist eine der häufigsten Frakturen der oberen Extremität. Nach entsprechender Diagnostik mithilfe von nativradiologischen und meist computertomographischen bildgebenden Untersuchungen fällt die Entscheidung zur konservativen oder zur operativen Therapie. Ist die Indikation zur operativen Versorgung gegeben, stehen diverse Möglichkeiten der Reposition und Fixation zur Verfügung. Das Spektrum reicht von geschlossenen über offene Verfahren bis hin zur unterstützenden begleitenden Arthroskopie. Eine entsprechende präoperative Aufklärung der PatientInnen über den Eingriff sowie die geplante Nachbehandlung ist essenziell. Ziel der Versorgung ist die Wiederherstellung der Handgelenkfunktion unter Erhalt von Beweglichkeit und Kraft bei niedrigem Komplikationsrisiko. Allen operativen Verfahren ist das Prinzip der Reposition zur Wiederherstellung der anatomischen Verhältnisse und anschließender Fixation gemeinsam. Als geschlossene Verfahren stehen die Fixation mit Kirschner-Drähten sowie der Aufbau eines Fixateur externe zur Verfügung. Die palmare winkelstabile Plattenosteosynthese hat sich in den letzten Jahren als Methode der Wahl für einen Großteil der zu versorgenden Frakturen etabliert. Für spezielle Frakturmuster und zur Behandlung von Begleitverletzungen kann eine arthroskopische Unterstützung indiziert sein. Ein einheitlicher Konsensus über die beste Verfahrenswahl besteht nicht. In diesem Beitrag werden die möglichen Verfahren, einschließlich ihrer Zugänge, Fixationstechniken und spezifischer Nachbehandlung, beleuchtet.

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Distale Radiusfraktur

Cited by 18 publications

References 43 publications

Computer-assisted open reduction internal fixation of intraarticular radius fractures navigated with patient-specific instrumentation, a prospective case series

Computer-assisted open reduction internal fixation of intraarticular radius fractures navigated with patient-specific instrumentation, a prospective case series

Early and mid-term efficacy of volar titanium lock plate applications in radial distal intraarticular fractures

Grundprinzipien der operativen Versorgung der distalen Radiusfraktur

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