External and internal fixation for comminuted intra-articular fractures of distal radius

Pradhan, Rabindra Lal; Lakhey, S; Pandey, BK; Manandhar, Rajeev Raj; Rijal, K P; Sharma, S

doi:10.3126/kumj.v7i4.2756

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…Similar findings were also stated by other researchers having more male patients in their study. 18 Regarding complications we observed one case each of pin tract infection, reduced grip strength and finger stiffness, these results verify the studies of other workers who noted the similar complications, but most of these were pin tract infections that result in prolonged hospital stay and early wire removal. [19][20][21] The assessment of movement in our study was excellent, we observe near about normal palmar flexion, dorsiflexion, supination, pronation, ulnar and radial deviation, similar and some better movements were achieved by other studies depending upon the duration of follow up time and better physiotherapy facilities.…”

Section: Discussionsupporting

confidence: 89%

Comminuted intra articular fracture of distal radius: Outcome of Management with closed reduction and percutaneous pinning.

Shah

Soomro

et al. 2019

TPMJ

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Objectives: To determine the outcome and various complications in the management of comminuted intra articular fractures of distal radius in adults treated with closed reduction associated with Percutaneous Pinning. Study Design: Observational study. Setting: Department of Orthopaedic PUMHS, Nawabshah. Period: January 2017 to December 2018. Material and Methods: 45 consecutive cases of closed comminuted intra articular fractures of distal radius matching the inclusion criteria, all patients were adult aged between 23 – 38 years having Gartland and Werly type II and III fractures of 6 to 7 days duration. After initial resuscitation, thorough clinical examination done and all base line laboratory investigations and x-rays were obtained. The demographic and clinical data was recorded on a proforma. The patients were informed about the study and surgery and a written consent was taken and all of the patients were gone for closed reduction with percutaneous K – wiring. Functional outcome like union, healing and any complication were assessed. Patients were also checked for the range of movements. After 6 weeks, the K – wires and cast were removed and the procedure of physiotherapy started. After six weeks all the patients were advised for follow up at an interval of 3 months and 6 months. The data collected was statistically analysed and the results were tabulated. Results: 45 cases of closed intra articular fractures of distal radius were assessed, out of these 20 cases have Gartland type II and 25 cases have Gartland type III fractures. The age of patient was ranged between 23 – 38 years (mean 34+ 4.63), majority (55.6%) of patients were male. The left side of fractures were present in 66.3% of cases. All the patients checked for complications and that were seen in only 07 cases consisting of pin tract infection, reduced grip strength and finger stiffness. At the end of study period the range of movements in different directed were checked and evaluation was done according to modified Demerit scoring system. Conclusion: Closed reduction of distal radius with percutaneous pinning in comminuted intra articular fractures gives promising excellent results, it is a simple and minimal procedure providing anatomic reduction, fixation of fracture and maintenance of reduction with an suitable technique of immobilization.

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Section: Discussionsupporting

confidence: 89%

Comminuted intra articular fracture of distal radius: Outcome of Management with closed reduction and percutaneous pinning.

Shah

Soomro

et al. 2019

TPMJ

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“…A removable plaster of Paris (POP) splint was applied to the volar plating group postoperatively and started on range of motion (ROM) and grip strength exercises as per the tolerance of the patient. Bone healing was determined radiographically by the appearance of bridging trabeculae across the fracture and clinically by the fracture site being non-tender to palpation [8]. The fixator was removed at a mean interval of 7.2 weeks (6 weeks to 8 weeks).…”

Section: Follow-up Evaluationmentioning

confidence: 99%

Prospective Randomized Study Comparing the External Fixator and Volar Locking Plate in Intraarticular Distal Radius Fractures: Which Is Better?

Sharma

Pathak

Sandhu

et al. 2020

Cureus

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Introduction Various treatment options for patients with an intraarticular distal radius fracture are available, but in cases of comminuted fractures, these narrow down to either a volar locking plate, an external fixator, or a combination of these two. We conducted this prospective study to compare the external fixation and internal fixation of intraarticular fractures of the distal radius in terms of clinical/functional outcome and complications and with the available literature. Material and method This prospective randomized study consisted of a total number of 30 patients with intraarticular fractures of the distal end of the radius divided randomly into two groups (A and B), treated by external fixation (Group A) and volar plating (Group B), in a tertiary care institute during the study period. Result The most patients were males >50 years of age, with injury to the right dominant hand most commonly caused by a fall on an outstretched hand. As per the modified Green & O'Brien scoring system, the volar plating group showed the final result as excellent in two (13.33%), good in seven (46.6%), fair in four (26.6%), and poor in two (13.3%) whereas an excellent outcome was seen in one (6.66%), good and fair in five patients each (33.3%), and poor in four (26.66%) patients at the six months follow-up. Conclusion Overall, both fixation techniques seem to apply sufficient stabilization to restore function and retain anatomy; however, volar locking plates have certain advantages over external fixator in the early postop period in terms of earlier recovery and mobilization.

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“…2 Although good to excellent results have been shown with plate and external fixation for these unstable fractures, the need for prolonged immobilization is a concern. 3,4,5 The advantages of plate osteosynthesis are direct fracture reduction, stable rigid fixation, and the possibility of immediate postoperative motion. 6,7 Open reduction of the fracture allows reduction of the fracture under direct vision and leads to accurate restoration of anatomy.…”

Section: Introductionmentioning

confidence: 99%

Osteosynthesis of Unstable Fractures of Distal Radius with Volar Locking Plate

Pradhan

Sharma

Pandey

et al. 2013

Nepal Ortho. Assoc. J.

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BACkGROUND: Various surgical treatment methods are available for unstable distal radius fractures. Clinical and radiological outcome with volar locking plate has been very satisfactory. The purpose of this prospective study is to evaluate the results of the treatment of unstable fractures with the volar locking plate with regard to loss of reduction, functional outcome and complications. METHODS:Unstable distal radius fractures were enrolled for the study from May 2008 until July 2010. All patients were treated with 3.5 mm distal radius volar locking plate and assessed by clinical and radiological examination. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome.RESULTS: eighteen male and 12 female patients with the average age of 42.53 (range 30-64years) were followed up for a period of 9 to 34 months (average.23 months). There were fourteen A3 fractures, nine C1 fractures, six C2 fractures, and one C3 fracture, whereas one had a Gustilo grade I open wound on the volar aspect. Seven of the fractures had associate fracture of the ulnar styloid. The functional outcome was excellent in 23 (76%), good in 6 (20%), fair in 1 (4%) and none had poor outcome. There were very few complications in our series. CONCLUSION:Unstable fractures of distal radius treated by open reduction with volar locking plate provides adequate fixation with no collapse in reduction and also have satisfactory functional outcome with minimal complications.

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External and internal fixation for comminuted intra-articular fractures of distal radius

Cited by 8 publications

References 11 publications

Comminuted intra articular fracture of distal radius: Outcome of Management with closed reduction and percutaneous pinning.

Comminuted intra articular fracture of distal radius: Outcome of Management with closed reduction and percutaneous pinning.

Prospective Randomized Study Comparing the External Fixator and Volar Locking Plate in Intraarticular Distal Radius Fractures: Which Is Better?

Osteosynthesis of Unstable Fractures of Distal Radius with Volar Locking Plate

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