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Distal radius and ulnar fractures
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
There are three basic constructs for percutaneous pinning: Distal radius pinning where pins are placed across the fracture in the distal radius. These may be only radial styloid pins or may also include a pin from the dorsal ulnar aspect to the volar aspect of the radius.Ulnar radial pinning where the pins are placed from the radius across the ulna.Intra-focal pinning or the Kapandji technique where the pins are inserted into the fracture, used as reduction tools and then driven into the proximal radius (Figure 26.7).
Paediatric upper limb trauma
Published in Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou, Orthopaedic Trauma, 2014
Chethan Jayadev, Tanvir Khan, Manoj Ramachandran
Closed reduction may be attempted under general anaesthesia for stage II injuries, by supinating the forearm extending the elbow. Additional varus stress allows space for manual manipulation of the distal fragment. Percutaneous pinning is performed for unstable reductions. Evaluation of articular reduction can be difficult and may require an arthrogram. Residual displacement and articular incongruence are indications for open reduction.
Complications of Treatment of the Hand
Published in Stephen M. Cohn, Matthew O. Dolich, Complications in Surgery and Trauma, 2014
Operative treatments include external fixation, percutaneous pinning, open reduction, and any combination of these. Poor final outcome is more likely when the fracture is initially very displaced, when the distal radioulnar joint is involved, when the radiocarpal joint is comminuted, when there is residual shortening of >2 mm, or when there is dorsal angulation of >15°. Redisplacement will occur with about one of three closed reductions, and the final outcome when redisplacement occurs and repeated closed manipulations are required will be good or excellent for only one of three fractures [2]. This is due to dorsal comminution in which there is no supporting posterior cortex. Pinning, plating, and posterior grafting can help prevent recurrent dorsal tilt (apex volar angulation).
Pedobarographic, Clinic, and Radiologic Evaluation after Surgically Treated Lisfranc Injury
Published in Journal of Investigative Surgery, 2021
Engin Eceviz, Hüseyin Bilgehan Çevik, Orhan Öztürk, Tuğçe Özen, Tuğba Kuru Çolak, İlker Çolak, Mine Gülden Polat
In a pedobarographic study of patients with Lisfranc injury by Schepers et al., there was shown to be an increase in the contact surface of the midfoot and forefoot, and increased pressure in the midfoot [16]. However, in the current study, there was found to be decreased contact surface of the midfoot. Consequently, the patients in the Schepers et al.’s study had pes planus, while the current study patients had cavus after Lisfranc injury. A possible reason for the difference between the two studies could be due to patient population characteristics. In the previous study, half of the 26 patients were treated surgically (n = 13; 9 open reduction and internal fixation, and 4 closed reduction and percutaneous pinning) and the other half (n = 13) with cast only. In the present study, all 68 patients were treated with open reduction and internal fixation. This was provided us more homogeneous population for the present study.
Is there a reason to challenge our current practice in children’s forearm fractures?
Published in Acta Orthopaedica, 2021
L Stefan Lohmander, Ian A Harris
The findings of Laaksonen and colleagues should provide a stimulus for low-risk-of-bias comparative studies in this area so that practice can be narrowed to a range that targets the best patient outcomes with the least harm and cost. One such trial was planned and a protocol published (Adrian et al. 2015), but no results appear to have been published. We are encouraged to note that the authors of the survey discussed here have initiated a randomized trial of “Casting Versus Percutaneous Pinning Treatment of Pediatric Overriding Distal Forearm Fractures” (https://clinicaltrials.gov/ct2/show/NCT04323410).
Interosseous wiring for fragmented proximal phalangeal fractures
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Hidetoshi Teraura, Hideki Sakanaka, Hiroyuki Gotani
Ethical approval was obtained from the institutional review board and informed consent was obtained from all participants included in the study. We conducted surgery on patients for whom conservative therapy was unsuccessful. Manual reduction was attempted under local anesthesia. If closed reduction was successful and proper alignment was achieved, percutaneous pinning or screw fixation via a small incision was performed. IOW was performed only if closed reduction could not be achieved.