Bridging external fixation and supplementary Kirschner-wire fixation <i>versus</i> volar locked plating for unstable fractures of the distal radius

Egol, Kenneth A.; Walsh, Michael; Tejwani, Nirmal C.; McLaurin, Toni M; Wynn, C.; Paksima, Nader

doi:10.1302/0301-620x.90b9.20521

Cited by 170 publications

(116 citation statements)

References 33 publications

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“…Different authors have described good results in treating these fractures using very different modalities, e.g. Kirschner wires, external fixators, volar (locking) or dorsal (locking) plates [16,[18][19][20]. K-wires are still a popular method, unfortunately they may fail to maintain fracture position, are associated with a high incidence of pin site infection and require additional cast immobilisation [21].…”

Section: Discussionmentioning

confidence: 99%

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Twigt

Bemelman

Lansink

et al. 2013

International Orthopaedics (SICOT)

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Purpose C-type distal radial fractures remain challenging fractures. Currently locking plates are very popular because of their length preserving, stability. A considerable drawback is the high cost. Since 2003 we have been using mini AO plates (2.7 mm) as an alternative. We analysed our results and performed a cost analysis. Methods Retrospective analysis was performed of all patients operated upon between 2003 and 2008 for C type distal radius fractures. Reduction was achieved with mini AO plates, applied in a buttress fashion, with ligamentotaxis. Rehabilitation consisted of immediate mobilisation. Pre-and postoperative X-rays, operative results and patient charts were reviewed. Furthermore, we prospectively evaluated the functional results using VAS, DASH and Mayo wrist scores. Lastly, we assessed the implant costs and compared them to locking plates. Results Thirty-four patients were treated with a mean age of 49 years. Mean radial shortening improved 2 mm; dorsal and radial angulation improved 23 and 4°, respectively. At consolidation (eight weeks) the average radial shortening was 0.75 mm, a volar angulation of 3°, and 21°of radial angulation. Functional results were excellent, demonstrated by a mean VAS score less than 1, a DASH score of 12 and a Mayo wrist score of 87. Compared to locking plates, there was an overall reduction in material costs of 15,300 Euro.Conclusions Our technique has excellent biomechanical stability, enabling immediate functional rehabilitation, good anatomical and functional outcome with significantly lower costs.

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Section: Discussionmentioning

confidence: 99%

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Twigt

Bemelman

Lansink

et al. 2013

International Orthopaedics (SICOT)

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“…Do these patients require more pain medications, more recovery room time, and/or have functional outcomes or patient satisfaction differences? In addition, we currently have little understanding regarding how to advise patients about optimal pain control after distal radius fracture fixation [1,2,9,12]. We therefore decided to conduct a randomized study comparing pain control after distal radius fracture fixation in patients who received either general anesthesia or brachial plexus blockade to better understand this.…”

Section: Introductionmentioning

confidence: 99%

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Galos

Taormina

Crespo

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Distal radius fractures are very common injuries and surgical treatment for them can be painful. Achieving early pain control may help improve patient satisfaction and improve functional outcomes. Little is known about which anesthesia technique (general anesthesia versus brachial plexus blockade) is most beneficial for pain control after distal radius fixation which could significantly affect patients' postoperative course and experience. Questions/Purposes We asked: (1) Did patients receiving general anesthesia or brachial plexus blockade have worse pain scores at 2, 12, and 24 hours after surgery? (2) Was there a difference in operative suite time between patients who had general anesthesia or brachial plexus blockade, and was there a difference in recovery room time? (3) Did patients receiving general anesthesia or brachial plexus blockade have higher narcotic use after surgery? (4) Do patients receiving general anesthesia or brachial plexus blockade have higher functional assessment scores after distal radius fracture repair at 6 weeks and 12 weeks after surgery? Methods A randomized controlled study was performed between February, 2013 and April, 2014 at a multicenter metropolitan tertiary-care referral center. Patients who presented with acute closed distal radius fractures (Orthopaedic Trauma Association 23A-C) were potentially eligible for inclusion. During the study period, 40 patients with closed, displaced, and unstable distal radius fractures were identified as meeting inclusion criteria and offered enrollment and randomization. Three patients (7.5%), all with concomitant injuries, declined to participate at the time of randomization as did one additional patient (2.5%) who chose not to participate, leaving a final sample of 36 participants. There were no dropouts after randomization, and analyses were performed according to an intention-totreat model. Patients were randomly assigned to one of two groups, general anesthesia or brachial plexus blockade, and among the 36 patients included, 18 were randomized to each group. Medications administered in the postanesthesia care unit were recorded. Patients were discharged receiving oxycodone and acetaminophen 5/325 mg for pain control, and VAS forms were provided. Patients were called at predetermined intervals postoperatively (2 hours, 4 hours, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours) to gather pain scores, using the VAS, and to document the doses of analgesics consumed. In addition, patients had regular followups at 2 weeks, 6 weeks, and 12 weeks. Pain scores were again recorded using the VAS at these visits.Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are...

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“…In this study right side involvement were more than left side. K. Egol, M. Walsh, w. Tejwani [4] and others in their prospective trial of bridging external fixation and supplementary Kirschner wirefixation got the following functional results in volar plate group at end of 12 weeks. Dorsiflexion -72%, palmarflexion -67%, radial deviation -69%, ulnar deviation -67%, supination -81%, pronation -94%.…”

Section: Discussionmentioning

confidence: 89%

Functional outcome of fixation of unstable distal end radius fracture with volar buttress plating, A prospective study

Bhavi¹,

Naikwadi²

2017

Int. J. Orthop. Sci.

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Background: Distal end of radius fracture accounts for 17% of all fractures in adults. The primary goal of treatment is to return the patient to his or her pre fracture functional status and to independent to carry out there daily needs. There are multiple options for distal end radius treatment, CRIF with K wire / external fixator, But there are disadvantages like malunion, pin tract infection, which may results in poor range of movement. Hence ORIF with volar plating is commonly done for unstable distal end radius.

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Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius

Cited by 170 publications

References 33 publications

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial

Functional outcome of fixation of unstable distal end radius fracture with volar buttress plating, A prospective study

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