Intra-articular fractures of the distal end of the radius in young adults.

Knirk, J.; Jupiter, Jesse B.

doi:10.2106/00004623-198668050-00003

Cited by 1,253 publications

(675 citation statements)

References 19 publications

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“…In patients not meeting these criteria, the radial head was replaced. Patient charts and radiographs were reviewed to assess details of initial injury, radial head fracture management (ORIF versus arthroplasty), stability intraoperatively and postoperatively, radiographic signs of arthrosis using the scale of Knirk and Jupiter [12], joint incongruency, complications, reoperations, and ROM. At the 18-month visit, prospectively gathered patient response data were used to calculate DASH scores and Broberg-Morrey indexes.…”

Section: Methodsmentioning

confidence: 99%

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Watters

Garrigues

Ring

et al. 2014

Clinical Orthopaedics &Amp; Related Research

111

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Background Surgical treatment for terrible triad injuries of the elbow (defined as elbow dislocations with concomitant fractures of the radial head and coronoid) remains a challenging clinical problem. Specifically, the question of whether to repair or replace the radial head remains controversial. Questions/purposes We compared patients with terrible triad injuries of the elbow whose radial head fracture was treated with either internal fixation and internal fixation (ORIF) or radial head arthroplasty in terms of (1) clinical outcome measures (DASH and Broberg-Morrey scores, ROM), (2) elbow stability and radiographic signs of arthrosis, and (3) complications and reoperation rates. Methods Retrospective review identified 39 patients with terrible triad injuries and minimum 18-month complete clinical and radiographic followup (mean, 24 months; range, 18-53 months). Patients were managed with a standard algorithm consisting of (1) repair (n = 9) or replacement (n = 30) of the radial head, (2) repair of the lateral ulnar collateral ligament, and (3) repair of the coronoid fracture. During the study period, the radial head generally was internally fixed when there were fewer than four articular fragments; otherwise, it was replaced. Evaluation included the DASH score, the Broberg-Morrey index, measurements of elbow stability and motion, and radiographic assessment for signs of arthrosis; chart review was performed for complications and reoperations. Complete followup was available on 87% (39 of 45 patients).

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Section: Methodsmentioning

confidence: 99%

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Watters

Garrigues

Ring

et al. 2014

Clinical Orthopaedics &Amp; Related Research

111

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“…Twenty-six patients had wrist radiographs performed and wrist arthrosis was assessed according to the grading scale of Knirk and Jupiter [20]. This system designates for Grade 1 as slight joint space narrowing, Grade 2 as marked narrowing with osteophyte formation, and Grade 3 as bone-on-bone narrowing with osteophyte and cyst formation.…”

Section: Description Of Experiment Treatment or Surgerymentioning

confidence: 99%

“…Review of radiographs at final followup revealed no patients with nonunion, hardware complications, or adjacent arthritis in the arthrodesis cohort. Of the patients who had osteoarticular allograft, radiographs were available at final followup for two, both of whom had Grade II arthrosis [20]. Of the 11 patients with available radiographs in the intralesional excision cohort who did not have conversion to arthrodesis at the time of final followup, five (45%) had radiographic signs of radiocarpal arthrosis, which was Grade I in two patients and Grade II in three patients.…”

Section: Other Complications After Intralesional Curettage and Resectionmentioning

confidence: 99%

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

Wysocki

Soni

Virkus

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background A giant cell tumor is a benign locally aggressive tumor commonly seen in the distal radius with reported recurrence rates higher than tumors at other sites. The dilemma for the treating surgeon is deciding whether intralesional treatment is adequate compared with resection of the primary tumor for oncologic and functional outcomes. More information would be helpful to guide shared decision-making. Questions/purposes We asked: (1) How will validated functional scores, ROM, and strength differ between resection versus intralesional excision for a giant cell tumor of the distal radius? (2) How will recurrence rate and reoperation differ between these types of treatments? (3) What are the complications resulting in reoperation after intralesional excision and resection procedures? (4) Is there a difference in functional outcome in treating a primary versus recurrent giant cell tumor with a resection arthrodesis? Methods Between 1985 and 2008, 39 patients (39 wrists) were treated for primary giant cell tumor of the distal radius at two academic centers. Twenty patients underwent primary intralesional excision, typically in cases where bony architecture and cortical thickness were preserved, 15 underwent resection with radiocarpal arthrodesis, and four had resection with osteoarticular allograft. Resection regardless of reconstruction type was favored in cases with marked cortical expansion. A specific evaluation for purposes of the study with radiographs, ROM, grip strength, and pain and functional scores was performed at a minimum of 1 year for 21 patients (54%) and an additional 11 patients (28%) were available only by phone. We also assessed reoperations for recurrence and other complications via chart review.

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“…The study shows that wrist motion was significantly influenced by the presence of a residual step of the joint surface but not by its size. To highlight this matter I will like to remind the reader that previous clinical studies support the opinion that a step-off of more than 2 mm in the radiocarpal joint is associated with increased arthritic changes (Knirk and Jupiter, 1986), while steps of 1 mm cause pain and decreased range of motion and grip strength (Fernandez and Geissler, 1991;Trumble et al, 1994). Furthermore, biomechanical studies (Wagner et al, 1996) have shown that 1 mm steps cause significant pressure changes.…”

mentioning

confidence: 96%

Should Anatomic Reduction be Pursued in Distal Radial Fractures?

Fernández

2000

Journal of Hand Surgery

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Two articles on distal radial fractures in young adults are published in this issue of the journal. One reports the results of open reduction and internal fixation with the p-plate in a group of patients in which the majority of fractures were complex and intraarticular. The other retrospectively assessed 169 fractures with an average follow-up of 4.9 years, based on the radiographic evaluation of the patient's X-rays until discharge and on the answers provided by a patient-based subjective outcome questionnaire. My task has been to comment, criticise and analyse the findings and results reported in both articles, in order to highlight areas of uncertainty and controversy regarding the current management of fractures of the distal radius in the younger age group.

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Intra-articular fractures of the distal end of the radius in young adults.

Cited by 1,253 publications

References 19 publications

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

Should Anatomic Reduction be Pursued in Distal Radial Fractures?

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