Fractures of the Distal Radius Treated With Cross-Pin Fixation and a Nonbridging External Fixator, the CPX System: A Preliminary Report

Mirza, Ather; Jupiter, Jesse B.; Reinhart, Mary Kate; Meyer, Patricia G

doi:10.1016/j.jhsa.2008.12.020

Cited by 15 publications

(7 citation statements)

References 70 publications

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“…The goal of surgical treatment is to achieve an anatomical reduction and promote early resumption of usual activities. Fixed-angle volar-locking plates and some nonbridging external fixators, give enough three dimension support for most distal radius fractures to begin early mobilization, which should justify a better score compared to other fixation techniques [1,5,6]. From a functional point of view in our study we haven't observed differences between both groups, although there is scientific evidence that short-term outcomes in patients undergoing fixed-angle volar-locking plates have earlier recovery [8][9][10].…”

Section: Discussionmentioning

confidence: 52%

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Comparison Between External Fixators and Fixed-Angle Volar-Locking Plates in the Treatment of Distal Radius Fractures

et al. 2016

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Distal radius fractures are a common disorder in industrialized nations associated with osteoporosis, with a reported incidence of two fractures per thousand patients per year. We performed a retrospective study comparing two sets of 40 patients, with fracture of the distal radius treated with Penning external fixator, compared to 40 patients treated with fixed-angle volar-locking plate (Plate Depuy ® DVR), with the objective of finding differences between both treatment methods in anatomical values, functional outcomes and complication rates. All fractures were classified according to the AO classification. Postero-anterior and lateral radiographs of the wrist were taken after fracture, after surgery and at 6 months after surgery. We also assessed functional outcome. Minimum follow up was of 10 months. We compared complications between both groups. In the group of patients treated with fixed-angle volar-locked plate, radiological results are found to be closer to the anatomical references. Final outcomes revealed similar functional scores between both groups. The complications rate was statistically higher in the group of patients who underwent external fixation. In the fixed-angle volar-locked plate group, most of complications were related to patient discomfort due to the volar-locking plate.

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Section: Discussionmentioning

confidence: 52%

“…Functional outcome was evaluated 10 months from the surgery by clinical Lindtröm scale that values function, symptoms, deformity and mobility by a grade scale (Table 2), and with the visual analogical scale (VAS) in both series at the end of follow-up [5]. The minimum follow up period was of 10 months, with an average of 15 months.…”

Section: Methodsmentioning

confidence: 99%

Comparison Between External Fixators and Fixed-Angle Volar-Locking Plates in the Treatment of Distal Radius Fractures

et al. 2016

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“…However, external fixation led to better grip strength and wrist flexion. Given that external fixation is less invasive compared with internal fixation, it is generally agreed that external fixation plays an important role in treating the unstable DRF [2,6,7,9-12]. …”

Section: Introductionmentioning

confidence: 99%

Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable

Chen

Zheng

et al. 2013

BMC Musculoskelet Disord

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BackgroundThe ulnar styloid is an important supportive structure for the triangular fibrocartilage complex. However, it remains inconclusive whether or not a fractured ulnar styloid should be fixed in an unstable distal radius fracture (DRF) with a stable distal radioulnar joint (DRUJ). The purpose of this study is to evaluate the effect of an untreated ulnar styloid fracture on the outcome of unstable DRF treated with transarticular external fixation when the DRUJ is stable.Methods106 patients with an unstable DRF and a stable DRUJ were included in this study following external fixation. The patients were divided into the non-fracture, the tip-fracture and the base-fracture groups according to the location of the ulnar styloid fracture at the time of injury. Postoperative evaluation included the range of wrist motion, the radiological index, the grip strength, the PRWE-HK scores, the wrist pain scores, and the instability of DRUJ at the external fixator removal time, three months postoperatively and the final follow-up visit.ResultsThe patients were followed for 12 to 24 months (15 months in average). Sixty-two of 106 patients (58%) had ulnar styloid fracture and 16 patients (26%) showed radiographic evidence of union of ulnar styloid fractures at the final follow-up visit. No significant difference in the radiological findings, the range of wrist motion, the grip strength, the PRWE-HK scores, and the wrist pain scores among three patient groups was detected at the external fixator removal time, three months postoperatively, or the final follow-up visit. Six of the 106 patients (5.7%) complained of persistent ulnar-side wrist pain during daily activities. One patient (0.9%) showed a positive sign in a stress-test, three patients (2.8%) showed a positive sign in a provocative-test, and five patients (4.7%) showed a positive sign in a press-test. There was no significant difference in the percentages of patients who complained of persistent ulnar-side wrist pain or showed a positive sign in the physical examination of the distal radioulnar joint among the three groups at the final follow-up time points.ConclusionWhen the DRUJ is stable, an untreated ulnar styloid fracture does not affect the wrist outcome of the patient with an unstable DRF treated with external fixation.

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“…[1][2][3][4][5][6] Exposure of the distal radius using a direct radial approach is an infrequently used procedure with limited indications for treating distal radius fractures. [1][2][3][4][5][6] Exposure of the distal radius using a direct radial approach is an infrequently used procedure with limited indications for treating distal radius fractures.…”

Section: Historical Perspectivementioning

confidence: 99%

Exposure of Distal Radius Fractures Using a Direct Radial Approach With Mobilization of the Superficial Branch of the Radial Nerve

Pirela-Cruz

Scher

2010

Techniques in Hand &Amp; Upper Extremity Surgery

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Extraarticular and simple intraarticular fractures and malunions of the distal radius can be addressed through a direct radial approach that entails careful and meticulous handling of the soft tissues. This approach involves mobilization of the superficial branch of the radial nerve (SBRN) and extensor tendons of the first dorsal compartment. A Type I SBRN pattern is when the nerve presents as a single bundle. In Type II pattern, there are 2 major nerve groups present. With Type II branching patterns of the SBRN, careful intraneural dissection is required to mobilize the nerve branches into a safe location during surgery. The primary advantage of this approach is the ease of surgical dissection and avoidance of the flexor tendons of the fingers during surgery.

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Fractures of the Distal Radius Treated With Cross-Pin Fixation and a Nonbridging External Fixator, the CPX System: A Preliminary Report

Cited by 15 publications

References 70 publications

Comparison Between External Fixators and Fixed-Angle Volar-Locking Plates in the Treatment of Distal Radius Fractures

Comparison Between External Fixators and Fixed-Angle Volar-Locking Plates in the Treatment of Distal Radius Fractures

Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable

Exposure of Distal Radius Fractures Using a Direct Radial Approach With Mobilization of the Superficial Branch of the Radial Nerve

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