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Distal radius osteoporotic features
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
Donato Perretta, Jesse B. Jupiter
There are no absolute indications for the operative treatment of osteoporotic distal radius fractures. In the authors’ opinion, the most important factor in decision-making is the preinjury activity level of the elderly patient with osteoporosis. Chronological age alone should not dictate treatment. With advances in medical care, there is significant variability in functional ability and demands among patients older than 65 years. Accordingly, in 2002 Jupiter et al. (7) retrospectively reviewed 20 patients who underwent open reduction and internal fixation of a distal radius fracture after initial reduction was lost. All patients had significant preinjury functional demands due to work, hobbies, or independent living. The radiographic parameters that signified unacceptable alignment were volar radiocarpal subluxation, articular incongruity greater than 2 mm, or greater than 20° of dorsal tilt. If one of these radiographic parameters is present in an active patient, we recommend surgery regardless of the chronological age. In addition, operative treatment is indicated in cases of acute carpal tunnel syndrome and multiply injured patient.
Single Best Answer Questions
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Which nerve is damaged in the scenario below? A 65-year-old woman is referred with a loss of sensation over her thumb index and middle finger. Her radiograph confirms a distal radius fracture.Axillary nerveLateral pectoral nerveMedian nerveMusculocutaneous nerveRadial nerve
R
Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Radius Fracture Fracture of the distal radius of the forearm is known as Colles fracture and was described by Abraham Colles (1773–1843), professor of surgery at Berlin in 1814. John Rhea Barton (1794–1871) described a fracture of the posterior articular margin of the lower end of the radius (Barton fracture) in 1838. Moore fracture involving the lower end of the radius with dislocation of the head of ulna and entrapment of the styloid process within the annular ligaments was described by American surgeon, Edward Mott Moore (1814–1902).
Non-union of the ulnar styloid process in children is common but long-term morbidity is rare: a population-based study with mean 11 years (9–15) follow-up
Published in Acta Orthopaedica, 2019
Linda Korhonen, Sarita Victorzon, Willy Serlo, Juha-Jaakko Sinikumpu
There are several potential complications in USP non-union. The triangular fibrocartilage complex (TFCC) and anatomic bone congruity are the main factors contributing to the stability of the distal radioulnar joint (DRUJ) (Kazemian et al. 2011) and even minor changes in ulnar length can change the axial loads on the TFCC (Bae and Waters 2006). Growth arrest resulting from distal radius fracture appears as ulnar lengthening (ulna plus) (Schuurman et al. 2001, Waters et al. 2002). Respectively, ulnar shortening is a result of growth arrest of ulna and it may result in TFCC degeneration and rupture (Nelson et al. 1984). Thus, one of the most disabling complications after distal radius fracture is instability in DRUJ (Daneshvar et al. 2014, Gogna et al. 2014). In addition, chronic ulnar sided wrist pain (Yuan et al. 2017) and higher Disabilities of the Arm, Shoulder and Hand (DASH) scoring have been reported; nevertheless, they are still slight enough to fall outside clinical importance in short-term follow-up (Kazemian et al. 2011, Kramer et al. 2013, Wijffels et al. 2014, Mulders et al. 2018).
20-Year outcome of TFCC repairs
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Maria Moloney, Simon Farnebo, Lars Adolfsson
Forty-nine patients consented to participate in the study and completed the PRWE, resulting in an answering frequency of 77%. Two patients were excluded because repeated examination of the medical records revealed that it could not be ascertained that their respective index operation had been performed according to the inclusion criteria. Forty-seven patients remained, out of which 41 agreed to a radiographic examination during 2014. Two additional patients had X-rays taken previously, at least 10 years after the index operation, and these images were therefore used and the radiographic analysis based on 43 patients. Patient data are displayed in Table 1. The average age at the time of the operation was 32 years and there were 29 women and 18 men. The median delay from the onset of symptoms until operation was one year (range 1 day–12 years). Four patients had been operated within two weeks of the trauma. Twenty patients had sustained a distal radius fracture. All of these had healed without apparent malunion as compared with the uninjured wrist. Twenty-seven had sustained an injury without a concomitant fracture. Patient data are shown in Table 1.
The impact of regional anesthesia on opioid demand in distal radius fracture surgery
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Daniel Cunningham, Micaela LaRose, Tori Kinamon, Elle MacAlpine, Sandra Au, Ariana Paniagua, Christopher Klifto, Mark J. Gage
Distal radius fractures are one of the most commonly encountered fractures and RA is frequently used during operative treatment [22]. Moreover, the incidence of distal radius fractures is on the rise worldwide [23–25]. While prognosis after distal radius fracture is overall favorable, continued pain and disability up to a year after injury is not uncommon [26]. While distal radius fractures are particularly common in the elderly, a high-risk group for the negative outcomes of opioid medications, little research has evaluated the risk of chronic opioid use or the effect of RA in reducing opioid misuse after these fractures. Additionally, the effect of RA on opioid use after distal radius fracture in the perioperative period has been mixed [27–32].