Influence of Cortical Comminution and Intra-articular Involvement in Distal Radius Fractures on Clinical Outcome: A Prospective Multicenter Study

Wadsten, Mats; Buttazzoni, Gunnar G.; Sjödén, Göran O.; Kadum, Bakir; Sayed-Noor, Arkan S.

doi:10.1055/s-0037-1601577

Cited by 14 publications

(13 citation statements)

References 33 publications

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“…Postoperative pain is common in DRF patients even after surgical treatment [17]. The irregular articular surface has been demonstrated to be the main reason to increase the risk of traumatic osteoarthritis and to cause unsatisfactory function recovery [18][19][20], and if it is associated with postoperative pain remains unclear. To clarify this confusion, we made a comparison, and the results showed that patients with gaps or steps on the sigmoid notch have significantly more severe pain during forearm rotation at the 1-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

The effect of distal radius fractures involving the distal radioulnar articular joint on forearm rotation

Kong

et al. 2020

J Orthop Surg Res

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Background The objective of this study was to predict the function of the forearm rotation on the basis of the articular surface of the sigmoid notch from three-dimensional reconstruction images. Methods We retrospectively reviewed patients who underwent volar plate fixation for intra-articular distal radius fractures (DRFs) in our institution between January 2017 and July 2019. The 3D image of the sigmoid notch on the fractured distal radius was reconstructed and looked up from the ulnar view to determine the existence of gaps or steps. Patients with or without gaps/steps on the sigmoid notch were included in the case group or control group, respectively. The patients’ basic data and postoperative data were collected and compared. Results A total of 81 patients were included. There were 33 patients in the case group, and 48 patients in the control group. There was no significant difference between the two groups at baseline. The total range of motion (ROM) of rotation in the case group and control group was 130.3 ± 6.2° and 145.3 ± 6.7°, respectively (P < 0.001). The percentage of rotation ROM of contralateral limb in the case group and control group was 72.3 ± 3.1% and 80.7 ± 3.6%, respectively (P < 0.001). VAS during forearm rotation was 2.1 ± 0.7 in the case group, which is significantly higher than that in the control group (1.5 ± 0.5, P < 0.001). Conclusion This study proposed a new method to assess the articular surface of the sigmoid notch which is based on 3D reconstruction images. With the assistance of this method, we found that gaps or steps on the sigmoid notch not only limit forearm pronation rotation and supination rotation, but also cause apparent wrist pain during forearm rotation movement and poor wrist ability.

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Section: Discussionmentioning

confidence: 99%

The effect of distal radius fractures involving the distal radioulnar articular joint on forearm rotation

Kong

et al. 2020

J Orthop Surg Res

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“…Postoperative pain is common in DRFs patients even after surgical treatment [17]. Irregular articular surface has been demonstrated to be the main reason to increase the risk of traumatic osteoarthritis and to cause unsatisfactory function recovery [18][19][20], and if it is associated with postoperative pain remains unclear. To clarify this confusion, we made a comparison, and the results showed that patients with gaps or steps on sigmoid notch have signi cant more severe pain during forearm rotation at the one-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Distal Radius Fractures Involving Distal Radioulnar Articular Joint on Forearm Rotation

Kong

et al. 2020

Preprint

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Background: The objective of this study was to predict the function of forearm rotation on basis of articular surface of sigmoid notch from three-dimensional reconstruction images. Methods: We retrospectively reviewed patients who underwent volar plate fixation for intra-articular distal radius fractures (DRFs) in our institution between January 2017 and July 2019. The 3D image of sigmoid notch on fractured distal radius was reconstructed and looked up from ulnar view to determine the existence of gaps or steps. Patients with or without gaps/steps on sigmoid notch were included in case group or control group respectively. The patients’ basic data and postoperative data were collected and compared. Results: A total of 81 patients were included. There were 33 patients in case group, and 48 patients in control group. There was no significant difference between the two groups at baseline. Total range of motion (ROM) of rotation in case group and control group were 130.3±6.2 degrees and 145.3±6.7 degrees respectively (P<0.001). Percentage of rotation ROM of contralateral limb in case group and control group were 72.3±3.1% and 80.7±3.6% respectively (P<0.001). VAS during forearm rotation were 2.1±0.7 in case group, which is significantly higher than that in control group (1.5±0.5, P<0.001). Conclusion: This study proposed a new method to assess the articular surface of sigmoid notch which is based on 3D reconstruction images. With the assistance of this method, we found that gaps or steps on sigmoid notch not only limit forearm pronation rotation and supination rotation, but also cause apparent wrist pain during forearm rotation movement.

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“…Clinical examples of each subgroup are depicted in Fig 3 . 1. Volar comminution, with comminution defined as a free-floating piece of cortex > 3 mm [32].…”

Section: Plos Onementioning

confidence: 99%

“…4. Simultaneous presence of dorsal comminution (a free-floating piece of cortex > 3 mm [32]), severe initial displacement (dorsal angulation > 30˚, radial inclination < 10˚, or ulnar variance > 3 mm), and clinical suspicion of physiological osteopenia/osteoporosis � .…”

Section: Plos Onementioning

confidence: 99%

Forecasting effects of “fast-tracks” for surgery in the Swedish national guidelines for distal radius fractures

et al. 2022

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Background and purpose National guidelines for treatment of distal radius fractures (DRFs) were presented in Sweden in 2021. In the guidelines, a fast-track is recommended for 4 subgroups of highly unstable DRFs. Regardless of the results of the closed reduction these are recommended for surgery within 1 week of injury. This study aims to evaluate the potential consequences of the newly presented national guidelines on incidence of surgical interventions. Patients and methods In all, 1,609 patients (1,635 DRFs) with primary radiographs after a DRF between 2014 and 2017 at two Swedish hospitals were included in a retrospective cohort study. An estimation was made of the percentage of patients in the historical pre-guidelines cohort, that would have been recommended early primary surgery according to the new national guidelines compared to treatment implemented without the support of these guidelines. Results On a strict radiological basis, 32% (516 out of 1635) of DRFs were classified into one of the 4 defined subgroups. At 9–13 days follow-up, cast treatment was converted into delayed primary surgery in 201 cases. Out of these, 56% (112 out of 201) fulfilled the fast-track criteria and would with the new guidelines have been subject to early primary surgery. Interpretation The fast-track regimen in the new guidelines, has a high likelihood of identifying the unstable fractures benefitting from early primary surgery. If the proposed Swedish national guidelines for DRF treatment are implemented, a greater proportion of fractures would be treated with early primary surgery, and a delayed surgery avoided in the majority of cases. The potential benefits in relation to possible costs when using the fast-track criteria in every day practice are still unknown.

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Influence of Cortical Comminution and Intra-articular Involvement in Distal Radius Fractures on Clinical Outcome: A Prospective Multicenter Study

Cited by 14 publications

References 33 publications

The effect of distal radius fractures involving the distal radioulnar articular joint on forearm rotation

The effect of distal radius fractures involving the distal radioulnar articular joint on forearm rotation

The Effect of Distal Radius Fractures Involving Distal Radioulnar Articular Joint on Forearm Rotation

Forecasting effects of “fast-tracks” for surgery in the Swedish national guidelines for distal radius fractures

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