Incidence of Anti-osteoporosis Diagnosis and Treatment After Distal Radius Fractures

Abstract

coverage, and the hand reconstruction is made with secondary procedures, with poor functional results and lengthy hospital stays. Materials and Methods: We present our series of 25 cases of catastrophic hand injuries in pediatric patients aged 2 to 17 years with grade II to IV of the Hand Injury Severity Scoring System, which were managed by our team between 2010 and 2014. The main cause of injury was motor vehicle accident, followed by mangling by a machine. In all these patients, an attempt was made to repair or reconstruct all damaged structures in 1 surgical sitting, to avoid lengthy hospital stays, move the hand and fingers as quickly as possible, and diminish the psychological damage these injuries cause. Free flaps were used in 19 of the patients. No pedicled flaps were done in any of the patients, in order to be able to start the therapy program very early, sometimes on the first postoperative day. The range of surgical procedures performed in these patients was 1 to 3 surgeries. The initial reconstruction surgery was complemented in these cases with other 2 procedures such as flap thinning, hardware removal, secondary tendon grafting, etc. Results: Patients were assessed at least 1 year after the initial surgery with the Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) disability instrument (which has been validated to use on older children). In average, all patients scored 18 or better. The patients and their parents also evaluated cosmetic appearance. Conclusions: It is very important to consider special factors in the pediatric population, such as the size of anatomical structures, compliance with treatment, rehabilitation of the patient, and the psychological and emotional complications for the child and their families. We show the importance of the initial total hand reconstruction in the pediatric population in the treatment of catastrophic injuries of the hand; this approach gives the child the opportunity to have an aesthetically acceptable and functional hand in the shortest time possible.