Salvage procedure after malunited distal radius fractures and management of pain and stiffness

Keuchel-Strobl, Tina; Quadlbauer, S.; Jurkowitsch, J.; Rosenauer, Rudolf; Hausner, T.; Leixnering, M.; Pezzei, Ch.

doi:10.1007/s00402-020-03369-8

Cited by 21 publications

(17 citation statements)

References 70 publications

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“…They were partly used in combination with external fixation. However, secondary dislocation still occurred [9][10][11][12][13][14], that necessitated correction and salvage procedures [15][16][17][18][19][20][21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Hintringer¹,

Rosenauer

Pezzei

et al. 2020

Arch Orthop Trauma Surg

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A wide range of different classifications exist for distal radius fractures (DRF). Most of them are based on plane X-rays and do not give us any information on how to treat these fractures. A biomechanical understanding of the mechanical forces underlying each fracture type is important to treat each injury specifically and ensure the optimal choice for stabilization. The main cause of DRFs are forces acting on the carpus and the radius as well as the position of the wrist in relation to the radius. Reconstructing the mechanism of the injury gives insight into which structures are involved, such as ruptured ligaments, bone fragments as well as the dislocated osteoligamentous units. This article attempts to define certain key fragments, which seem crucial to reduce and stabilize each type of DRF. Once the definition is established, an ideal implant can be selected to sufficiently maintain reduction of these key fragments. Additionally, the perfect approach is selected. By applying the following principles, the surgeon may be assisted in choosing the ideal form of treatment approach and implant selection.

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Section: Introductionmentioning

confidence: 99%

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Hintringer¹,

Rosenauer

Pezzei

et al. 2020

Arch Orthop Trauma Surg

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“…Currently, debridement appears to be the only available option, although micro fracturing may be attempted without adequate proof of its benefit [10]. Yet, severely comminuted radius fractures with destroyed cartilage may even need, or benefit from, partial wrist fusion or hemi-arthroplasty instead of arthroscopically assisted open reduction and internal fixation [10,36,[38][39][40][41].…”

Section: Assisted Fracture Reductionmentioning

confidence: 99%

Arthroscopic assisted treatment of distal radius fractures and concomitant injuries

Kastenberger

Kaiser

Schmidle

et al. 2020

Arch Orthop Trauma Surg

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Wrist arthroscopy is mainly used to assist fracture reduction and fixation and to diagnose and treat concomitant injuries mainly to the scapholunate (SL), lunotriquetral (LT) ligament and the triangular fibrocartilage complex (TFCC). Arthroscopy is beneficial in improving anatomical reduction of fracture steps and gaps in intra-articular distal radius fractures (DRFs). Yet, the literature that the functional outcome correlates with the use of arthroscopy, is limited. Non-surgical treatment and immobilization is recommended for Geissler grade I-III Sl-ligament injuries, while open reduction, ligament suture and/ or K-wire pinning is mandatory for complete ligament tears according to Geissler grade IV. This manuscript describes the current literature and gives insight into the authors' opinions and practice.

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“…The main goal of treatment is obtaining sufficient pain-free motion, allowing early return to activities and minimizing the risk for future degenerative changes or disability. However, even with surgical treatment, radiocarpal joint stiffness (RJS) is a common postoperative complication following DRFs, which greatly influence patients' normal function [11,12]. Previous studies have investigated many postoperative complications following DRFs, such as tendon spontaneous rupture [13,14], loss of reduction [15,16], injury of triangular fibrocartilage complex [17], or wrist pain [18,19].…”

Section: Introductionmentioning

confidence: 99%

Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors

et al. 2020

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Background: Postoperative radiocarpal joint stiffness (RJS) is common in patients with distal radius fractures (DRFs). The purpose of this study was to record the incidence of RJS and to determine potential risk factors that may be associated with it. Methods: We retrospectively included a series of patients who suffered from DRFs and underwent volar plate fixation. Patients' basic data, radiographic data, and postoperative data were collected. The incidence of RJS during follow-up was recorded, and both univariate analyses and multivariate logistic regression were used to determine factors associated with it. Results: A total of 119 patients were included in this study. After surgical procedures, there were 42 (35.3%) patients with RJS and 77 (64.7%) patients without. The incidence of RJS after surgical treatment is 35.3%. Multivariate analysis showed that intra-articular fracture (OR, 1.43; 95% CI, 1.13-1.81), pre-operative severe swelling (OR, 1.35; 95% CI, 1.05-1.74), post-operative unsatisfied volar tile (OR, 1.38; 95% CI, 1.01-1.89), and improper rehabilitation exercise (OR, 1.72; 95% CI, 1.18-2.51) were correlated with the incidence of RJS during follow-up. Conclusions: Patients with intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile, and improper rehabilitation exercise were factors associated with the incidence of wrist stiffness. Preoperative risk notification and postoperative precautions are necessary for relevant patients.

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Salvage procedure after malunited distal radius fractures and management of pain and stiffness

Cited by 21 publications

References 70 publications

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Arthroscopic assisted treatment of distal radius fractures and concomitant injuries

Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors

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