Fractures of the Dorsal Articular Margin of the Distal Part of the Radius with Dorsal Radiocarpal Subluxation

Lozano-Calderón, Santiago; Doornberg, Job N.; Ring, David

doi:10.2106/jbjs.e.00930

Cited by 38 publications

(27 citation statements)

References 20 publications

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“…[29,30] The method of limb immobilization following pinning is considered controversial among authors studying this topic. [2,31,32] To the best of our knowledge, there has been no previous report in the English literature of an immobilization method as described here for Group I patients of this study.…”

Section: Discussionmentioning

confidence: 85%

Which modality is the best choice in distal radius fractures treated with two different Kirschner wire fixation and immobilization techniques?

Günay

Öken

Yavuz

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 85%

Which modality is the best choice in distal radius fractures treated with two different Kirschner wire fixation and immobilization techniques?

Günay

Öken

Yavuz

et al. 2015

Ulus Travma Acil Cerrahi Derg

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show abstract

“…Although there are publications of biomechanical testing of different plate systems [30–34] and non-randomised case series and so-called expert opinions of using these implants [4, 35–40], in September 2006 there are no scientific relevant studies available showing a superior outcome using the criteria of Handoll and Madhok [27]. …”

Section: Evidence-based Medicine and Meta-analyses Randomised Trialsmentioning

confidence: 99%

“…These fractures are actually fractures of the dorsal articular margin with dorsal radiocarpal subluxation and are therefore unstable [4]. Most of the bony ridges are very small and therefore difficult to refix with implants such as screws or plates and indirect techniques of reduction of the fragment and the carpus (by ligamentotaxis with an external fixator) will reduce the fracture.…”

Section: Classification Based On Ct Data and Operative Strategymentioning

confidence: 99%

The treatment of severely comminuted intra-articular fractures of the distal radius

Mader¹,

Pennig²

2006

Strategies in Trauma and Limb Reconstruction

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Comminuted fractures of the distal end of the radius are caused by high-energy trauma and present as shear and impacted fractures of the articular surface of the distal radius with displacement of the fragments. The force of the impact and the position of the hand and carpal bone determine the pattern of articular fragmentation and their displacement and the amount and the extent of frequent concommitant ligament and carpal bone injury. The result of the osseous lesion in comminuted fractures was termed "pilon radiale", which emphasizes the amount of damage to the distal radius and the difficulties to be expected in restoring the articular congruity. Besides this the additional injury, either strain of disruption of the ligaments and the displacement of the carpus and/ or the triangular fibrocartilage complex will equally influence the functional outcome. This review will expand on the relevant anatomy, correct classification and diagnosis of the fracture, diagnostic tools and operative treatment options. Current treatment concepts are analysed with regard to actual literature using the tools of evidence based medicine criteria. A new classification of severely comminuted distal radius fractures is proposed using CT data of 250 complex intraarticular radius fractures. Finally a standardized treatment protocol using external fixation in combination with minimal invasive internal osteosynthesis is described.

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“…Secondly, minimally invaded sigmoid notch induced by posterior thin cortical fracture of distal radius was observed in 13 cases (12%) among 112 cases of AO type C. Limited extension of wrist joint can be occurred when this fragments are displaced to distal area and healed and ulnar displacement can cause chronic distal radioulnar joint pain induced by the collision to the head of ulnar during rotation. Besides, the accurate judgment during the early stage of radiography is vital because posterior thin cortical fracture is often accompanied with posterior subluxation of distal radioulnar joint 18). Thirdly, precise anatomical reduction was difficult in the comminuted fracture on articular surface of sigmoid notch since it was generated from a high energy impact and accompanied with severe comminuted fracture of distal radius.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Sigmoid Notch Involvement in the Intra-Articular Distal Radius Fractures: The Efficacy of Computed Tomography Compared with Plain X-ray

et al. 2012

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BackgroundThe purpose of this study is to evaluate the efficacy of computed tomography (CT) scans compared with plain radiographs on detecting the involvement of the sigmoid notch.MethodsThis study involved 121 cases diagnosed as the intra-articular distal radius fracture and performed post-reduction CT scans. We determined the presence of the sigmoid notch involvement with both plain radiographs and CT scans and compared findings of plain radiographs with CT scans about the incidence and the pattern of injuries. And the differences of results between arbeitsgemeinschaft für osteosyntheses (AO) type C2 and C3 were compared.ResultsThe incidences of sigmoid notch involvement detected in plain radiographs were 81 cases (66.9%), whereas CT scans were 99 cases (81.9%). The sensitivity of plain radiographs compared with CT scans was 74.7%, the specificity was 68.2%, the positive predictive value was 91.4%, the negative predictive value was 37.5%, the false negative value was 25.3%, and the false positive value was 31.8%. In comparison between AO type C2 and C3, the incidence of sigmoid notch involvement was not a significant difference, but the displacement of fracture fragment showed a significant difference.ConclusionsThe intra-articular distal radius fracture usually accompanies the sigmoid notch involvement. Considering that the evaluation of sigmoid notch involvement by plain radiography often results in misinterpretation or underestimation, performing CT scan in intra-articular distal radius fracture is thought to be beneficial.

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Fractures of the Dorsal Articular Margin of the Distal Part of the Radius with Dorsal Radiocarpal Subluxation

Abstract: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Cited by 38 publications

References 20 publications

Which modality is the best choice in distal radius fractures treated with two different Kirschner wire fixation and immobilization techniques?

Which modality is the best choice in distal radius fractures treated with two different Kirschner wire fixation and immobilization techniques?

The treatment of severely comminuted intra-articular fractures of the distal radius

Evaluation of the Sigmoid Notch Involvement in the Intra-Articular Distal Radius Fractures: The Efficacy of Computed Tomography Compared with Plain X-ray

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