Effects of distal radius fracture malunion on wrist joint mechanics

Pogue, David J.; Viegas, Steven F.; Patterson, Rita M.; Peterson, Pamela D.; Jenkins, David K.; Sweo, Timothy D.; Hokanson, Jim

doi:10.1016/0363-5023(90)90143-f

Cited by 283 publications

(145 citation statements)

References 19 publications

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“…Fractures were considered radiographically displaced if they contained one or more radiographic parameters in the bounds for dorsal tilt, volar tilt, radial shortening, articular gap, and articular stepoff ( Table 2; Fig. 2) [8,11,24,36,38,39]. Moreover, comminution was assessed by categorizing as having two, three, and four or more parts.…”

Section: Methodsmentioning

confidence: 99%

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

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The relationship between radiographic and functional outcomes in older patients with distal radius fractures is controversial. We explored this relationship by assessing the influence of radiographic displacement and fracture comminution on the functional outcomes of these fractures. We also asked whether operative intervention and demographic factors (age, gender, duration of followup) influenced outcome. We examined 53 patients older than 55 years with distal radius fractures with various functional assessments: range of motion (ROM) and strength measurements, three subjective surveys (Disabilities of the Arm, Shoulder, and Hand; Patient-rated Wrist Evaluation; Modernized Activity Subjective Survey of 2007), a Gartland and Werley score, and an objective, standardized hand performance test (Jebsen-Taylor). We measured angulation, articular gap/stepoff, and radial shortening on final radiographs and fracture comminution of preoperative radiographs. We observed no effect of radiographic displacement on subjective or objective outcome assessments, including standardized hand performance timed testing. Surgically treated fractures were less likely to display residual dorsal angulation and radial shortening, but surgical intervention did not independently predict functional outcome. Fracture comminution, patient gender, and months of followup similarly had no effect on outcome. We found no relationship between anatomic reduction as evidenced by radiographic outcomes and subjective or objective functional outcomes in this older patient cohort.

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Section: Methodsmentioning

confidence: 99%

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

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“…According to the literature reviewed, the three main anatomical measurements considered in correcting deformed distal radii are the ulnar variance, dorsal tilt, and radial tilt [8,7,6,11]. It was therefore not surprising to find that there was a large standard deviation in the other geometric variables, which were translation along the lateral and A/P axes, and rotation about the pronation/supination axis.…”

Section: Discussionmentioning

confidence: 99%

“…Fractures of the distal radius constitute about 15% of all fractures seen in the emergency room [4,6]. The distal bone fragment may fail to realign to its proper anatomical position during healing, which can affect the alignment, kinematics, and load transfer across the wrist.…”

Section: Rationale and Objectivesmentioning

confidence: 99%

Fixation-Based Surgery: A New Technique for Distal Radius Osteotomy

Croitoru

Ellis

Small

et al. 2000

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2000

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Abstract. Fixation-based surgery is a new technique for achieving difficult corrections in some orthopedic procedures. The method is premised on using a fixation device, such as a fracture-fixation plate, during the alignment and distration phases of an open-wedge osteotomy. The basic idea is similar to assembly of manufactured components: pilot holes are drilled in the bone fragments, the fixation plate is attached to one fragment and, when the fragment is moved, the alignment has been achieved when the pilot holes in one fragment line up with predetermined through holes in the fixation plate. The method has been specifically developed to address osteotomy of the distal radius to correct a malunited fracture. The method has been validated in laboratory studies. Clinical trials suggest that the method is no slower than the conventional technique, there is almost no intraoperative X-ray exposure, and that exceptionally large corrections can easily be achieved.

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“…So far, only minor associations and contradictory results have been described for the predictive significance of the factors of initial dislocation [22], degree of radial shortening 1 week after reduction [15,16,19], loss of radial angle [15,16], ulnar shortening [16], radial shortening [12] and dorsal angulation of the radial joint surface [14,16] for the function after distal radius fractures. The low association and the contradictory results can be partly explained by the influence of other factors on the functional outcome such as age, osteoporosis [3], osteoarthritis and pre-existing degenerative changes in the radiocarpal joint [17].…”

Section: Introductionmentioning

confidence: 99%

Can the displacement of a conservatively treated distal radius fracture be predicted at the beginning of treatment?

Einsiedel¹,

Freund

Sander

et al. 2008

International Orthopaedics (SICOT)

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The aim of this study was to investigate whether the final displacement of conservatively treated distal radius fractures can be predicted after primary reduction. We analysed the radiographic documents of 311 patients with a conservatively treated distal radius fracture at the time of injury, after reduction and after bony consolidation. We measured the dorsal angulation (DA), the radial angle (RA) and the radial shortening (RS) at each time point. The parameters were analysed separately for metaphyseally "stable" (A2, C1) and "unstable" (A3, C2, C3) fractures, according to the AO classification system. Spearman's rank correlations and regression functions were determined for the analysis. The highest correlations were found for the DA between the time points 'reduction' and 'complete healing' (r=0.75) and for the RA between the time points

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Effects of distal radius fracture malunion on wrist joint mechanics

Cited by 283 publications

References 19 publications

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Fixation-Based Surgery: A New Technique for Distal Radius Osteotomy

Can the displacement of a conservatively treated distal radius fracture be predicted at the beginning of treatment?

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