“PAF” analysis of acute distal radius fractures in adults. Preliminary results

Herzberg, Guillaume; Izem, Yadar; Saati, M. Al; Plotard, F.

doi:10.1016/j.main.2010.07.005

Cited by 31 publications

(6 citation statements)

References 21 publications

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“…The follow-up duration had to be greater than 2 years. Fractures were considered as irreparable if they displayed a combination of six criteria, which are included in the criteria related to the patient/energy of the accident/characteristics of the fracture (PAF) chart: 8,9 AO type "C" complete intra-articular fracture, high extra-and intra-articular displacement scores exceeding 6/12, main fracture line distal to the watershed line, impaction, and circumferential comminution (►Fig. 1 and ►Fig.…”

Section: Methodsmentioning

confidence: 99%

Primary Wrist Hemiarthroplasty for Irreparable Distal Radius Fracture in the Independent Elderly

et al. 2015

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Background?Volar plating for acute distal radius fractures (DRF) in the elderly has been recommended. Some studies have suggested that open reduction with internal fixation (ORIF) in this situation results in frequent complications. Our purposes were to provide a definition of irreparable DRF in independent elderly patients and to review the results of a preliminary retrospective series of wrist hemiarthroplasty (WHA) in this patient population. Materials?Between 2011 and 2014, 11 consecutive independent elderly patients (12 wrists) with irreparable intra-articular DRF were treated with primary WHA at the acute stage. A resection of the ulnar head was associated in nine wrists. A total of 11 wrists with more than 2 years of follow-up form the basis of this paper. Description of Technique?The approach was dorsal longitudinal. An osteotome longitudinally entered the dorsal aspect of the fracture medial to the Lister tubercle. Two thick osteoperiosteal flaps were elevated radially and ulnarly in a fashion similar to opening a book. The distal radius articular surface was excised. The implant was pressed into the radial canal with attention to restoring distal radius length. The two osteoperiosteal flaps were brought back together and sutured so as to close, again like a book, the osseous and soft tissues around the implant. Results?At mean follow-up of 30 months, average visual analog scale (VAS) pain was 1/10. Mean QuickDASH (Disabilities of the Arm, Shoulder and Hand) score was 32, and mean Patient-Rated Wrist Evaluation (PRWE) score was 24. Mean forearm rotation arc was 151?. Mean active flexion-extension arc was 60?. Mean active extension was 34?. Mean grip strength was 14?kg (64% of contralateral wrist). Mean Lyon wrist score was 73%. Bone healing around the implants was satisfactory in all but one case. Conclusions?Out data suggest that treatment of irreparable DRF in the independent elderly patient with a bone-preserving WHA may be a viable option. Longer-term follow-up and comparative studies are needed to confirm the validity of this concept.

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Section: Methodsmentioning

confidence: 99%

Primary Wrist Hemiarthroplasty for Irreparable Distal Radius Fracture in the Independent Elderly

et al. 2015

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“…Activities of daily living and quality of life were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Patient-Rated Wrist Evaluation (PRWE) Score at the last follow-up. 34,35 Fracture assessment was performed using the Patient, Accident and Fracture documentation by Herzberg et al 36 Plain radiographs and, if available, computed tomography (CT) scans of the wrist at specific time points (injury, 4, 8, and 16 weeks after surgery, before and after implant removal and last follow-up in May or June 2017) were analyzed retrospectively by 3 independent observers (1 senior consultant of hand surgery, 1 consultant, and 1 resident with 2 years of experience in hand surgery) using the digital radiologic viewing software Intelli-Space PACS Enterprise (Philips). To assess the complex fracture characteristics in detail and guide a suitable treatment strategy, we used, in most cases, preoperative multislice CT or cone-beam CT. Conebeam CT has good sensitivity, fast availability, low radiation dose, and lower costs.…”

Section: Data Collectionmentioning

confidence: 99%

Radiological, Clinical, and Functional Outcomes of Combined Dorsal and Volar Locking Plate Osteosynthesis for Complex Distal Radius Fractures

Lüdi¹,

Kurz²,

Deforth³

et al. 2023

The Journal of Hand Surgery

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“…Our experience-AARIF for displaced LVRF in AO B3 or C DRF Between 2009 and 2019, we had 1861 DRFs into our PAF database. 15,16 There were 112 partial AO B and 1179 complete AO C fractures.…”

Section: Surgical Technique-aarif For Displaced Lvrf In Ao B3 or C Drfmentioning

confidence: 99%

Arthroscopically Assisted Treatment of Volar Rim Fractures

Herzberg¹,

Burnier

2021

J Wrist Surg

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Background Arthroscopically-assisted reduction and internal fixation (AARIF) for distal radius fractures (DRF) has been extensively described. Little information is available about AARIF in AO “B3” and “C” DRF with displaced lunate facet volar rim fragment (VRF) and volar carpal subluxation. However, lunate volar rim fragment (LVRF) may be very difficult to reduce and fix under arthroscopic control using the flexor carpi radialis (FCR) or FCR extended approaches while traction is applied. Purposes The aims were to describe our surgical technique of AARIF of partial or complete DRF with VRF and provide information about how often this technique may be necessary, based on a large DRF database. Methods The dual-window volar approach for complete articular AO C DRF with volar medial fragment was described in 2012 for performing open reduction internal fixation (ORIF). Since 2015, we have used the dual-window approach for AARIF of “B3” or “C” DRF with volar carpal subluxation. We analyzed our PAF database, searching for patients treated with AARIF in “B3” and “C” fractures. Results The dual-window volar approach is very useful when using AARIF for AO “B3” and “C” DRF with displaced VRF and volar carpal subluxation. The anteromedial part of the exposure allows a direct access to reduction and fixation of the LVRF under traction and arthroscopic control. Overall, 1% of all articular DRF in this series showed a displaced LVRF amenable to the dual-window volar approach. Conclusion It is almost impossible to access and properly fix a VRF using traction and arthroscopic control through the FCR or FCR extended FCR approach because of the stretched flexor tendon mass. The use of the dual-window approach during AARIF of AO “B3” or “C” DRF has not previously been reported. Displaced VRF are rare whether they were part of “B3” or “C” fractures. If AARIF is chosen, we strongly recommend the use of the dual-window volar approach for AO “B3” and “C” fractures with VRF. A single anteromedial approach can also be used for isolated “B3” anteromedial DRF.

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“PAF” analysis of acute distal radius fractures in adults. Preliminary results

Cited by 31 publications

References 21 publications

Primary Wrist Hemiarthroplasty for Irreparable Distal Radius Fracture in the Independent Elderly

Primary Wrist Hemiarthroplasty for Irreparable Distal Radius Fracture in the Independent Elderly

Radiological, Clinical, and Functional Outcomes of Combined Dorsal and Volar Locking Plate Osteosynthesis for Complex Distal Radius Fractures

Arthroscopically Assisted Treatment of Volar Rim Fractures

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