Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation

Trumble, Thomas E.; Wagner, William F.; Hanel, Douglas P.; Vedder, Nicholas B.; Gilbert, Mary

doi:10.1016/s0363-5023(05)80455-1

Cited by 102 publications

(69 citation statements)

References 39 publications

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“…In this cohort, age and gender did not influence patient-reported pain and disability at 1 year. This is in keeping with other reports in the literature that analyzed both intra-and extraarticular distal radius fractures together [1,9,11,13] and used either the Gartland and Werley scale [1,11] or another subjective scale for evaluating outcome [13].…”

Section: Discussionsupporting

confidence: 79%

“…Trumble et al, however, found that the greater the number of corticies that are comminuted, the greater the decrease in functional outcome [13]. This suggests that the energy of the injury (assuming increased energy causes increased comminution) is related to functional outcome; however, this cohort consisted primarily of intra-articular (77%) distal radius fractures.…”

Section: Discussionmentioning

confidence: 97%

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Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Grewal

MacDermid

Pope

et al. 2007

Hand (New York, N,Y.)

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Distal radius fractures are common injuries; however, identifying which factors are responsible for predicting outcomes remains an area of controversy. The purpose of this study was to define factors predictive of patient-reported pain and disability at 1 year in a prospective cohort of extra-articular distal radius fractures (n=222). Data were collected at the initial visit and after 3, 6, and 12 months. The primary outcome was the 1-year patientrated wrist evaluation (PRWE) score. The effect of baseline patient and injury characteristics on the 1-year PRWE score was assessed. Univariate and forward stepwise regression analyses both agreed that the most influential predictor of pain and disability at 1 year was injury compensation. The 1-year PRWE score was significantly higher for subjects involved with third-party claims (35.48) compared to those that were not involved in any claims (14.97), p=0.006. The regression model found that three baseline factors -injury compensation, education, and other medical comorbiditiesexplained 16.4% of the variance in PRWE scores at 1 year. No injury characteristic, including the degree of initial fracture displacement, was found to significantly influence the 1-year PRWE score. This study has shown that baseline patient and injury characteristics play a small role in predicting 1-year patient-reported pain and disability in extra-articular distal radius fractures. Conceptual factors outside of this biomedical model should be investigated.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 97%

Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Grewal

MacDermid

Pope

et al. 2007

Hand (New York, N,Y.)

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“…Although the comprehensive classification of fractures includes type C fracture groups with a multifragmented metaphysis, it does not specifically describe fractures with dorsal and volar metaphyseal comminution. Components of volar/dorsal comminution of the metaphysis as the basis for a fracture classification group have been described only by Trumble et al [22].…”

Section: Discussionmentioning

confidence: 99%

“…The dorsal FCR sheath is then incised, and a superficial blunt retainer is used between the incised FCR tendon sheaths. The radial 17 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) FCR sheath protects the radial artery, whereas the ulnar FCR sheath protects the median nerve. Once this is done, blunt dissection is carried down to the pronator quadratus muscle.…”

Section: Surgical Techniquementioning

confidence: 99%

“Sandwich” Plating for Intra-articular Distal Radius Fractures with Volar and Dorsal Metaphyseal Comminution

Day

Kamath

Makhni

et al. 2007

Hand (New York, N,Y.)

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Introduction Intra-articular distal radius fractures with volar and dorsal comminution present a special challenge to the hand surgeon. Methods Ten patients formed the study cohort. All plates were low profile and stainless steel. Radiographic parameters, range of motion, and strength compared to the uninjured side were recorded. Functional outcome was evaluated by Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and Gartland and Werley scoring system. Results Median age at surgery was 58 years (range, 24 to 86). Mean follow-up was 17 months (range, 12 to 28). According to the AO classification system, there were three type C2 and seven type C3 fractures. Median preoperative dorsal angulation was 24 deg; median postoperative dorsal angulation was 3 deg. Eighty percent (8) of the fractures also had an intra-articular step-off or gap, all of which were corrected to neutral by the procedure. Compared with the contralateral side, mean extension and flexion were 73 and 75%, respectively, pronation and supination were 95 and 88%, respectively, and grip strength and thumb pinch were 72 and 87%, respectively. Mean postoperative DASH score was 16 points, and 70% (7) of the patients had Gartland and Werley scores of good or excellent. None of the patients needed to have their plates removed, and no extensor tendon rupture was reported. Conclusions The "sandwich" plating technique is an effective method of regaining near-anatomic reconstruction of intra-articular, volarly and dorsally comminuted distal radius fractures. Results from this study demonstrate that patients can expect to regain about 80% of their range of motion and strength. Moreover, 70% of the patients will have good to excellent functional outcomes. This is the first study to examine range of motion and functional outcome of low-profile "sandwich" plating without plate removal.

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“…2 A wrist with anterior fracture displacement and increased palmar tilt after the pinning of a Colles' fracture ulnar variance from the contralateral wrist, increase in ulnar variance was found to be an important radiological parameter affecting the functional result. [6,20,21,23]. Inadequate correction of palmar tilt with either too much palmar or dorsal tilt will be reflected in an increased ulnar variance.…”

Section: Discussionmentioning

confidence: 99%

Anterior fracture displacement in Colles’ fractures after Kapandji wiring in women over 59 years

Hollevoet

Verdonk

2006

International Orthopaedics (SICOT)

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The aim of this study was to assess the radiological results of Colles' fractures treated with Kapandji wiring and to determine the frequency of postoperative anterior fracture displacement. The X-rays of 89 fractures in women over 59 years of age were evaluated. Five weeks after injury, palmar shift of the distal fracture fragments and/or palmar tilt of more than 20°were observed in 26 patients. In ten wrists dorsal tilt was not sufficiently corrected and measured more than 10°. Increase in ulnar variance was more than 2 mm in 37 wrists and more than 5 mm in six wrists; this was more pronounced when the palmar tilt was not corrected properly or when anterior fracture displacement was present. We conclude that Kapandji wiring may not be able to prevent anterior fracture displacement in almost one-third of Colles' fractures in osteoporotic elderly patients.Résumé Le but de cette étude était d'apprécier le résultat radiologique du traitement par le brochage de Kapandji des fractures de Pouteau-Colles et de déterminer la fréquence des déplacements antérieurs secondaires. Les radiographies de 89 fractures chez des femmes de plus de 59 ans ont été évaluées. 5 semaines après le traumatisme un décalage antérieur et/ou une bascule palmaire de plus de 20 degrés était observé dans 26 cas. Dans 10 cas la bascule postérieure était insuffisamment corrigée et mesurait plus de 10 degrés. L'augmentation de l'index cubital était de plus de 2 mm dans 37 poignets et de plus de 5 mm dans 6 poignets, ceci étant plus prononcé quand la bascule palmaire n'était pas corrigée correctement ou quand un déplacement antérieur de la fracture était présent. Nous concluons que le brochage de Kapandji ne prévient pas le déplacement antérieur dans environ un tiers des fractures de Pouteau-Colles chez la patiente âgée et ostéoporotique.

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Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation

Cited by 102 publications

References 39 publications

Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

“Sandwich” Plating for Intra-articular Distal Radius Fractures with Volar and Dorsal Metaphyseal Comminution

Anterior fracture displacement in Colles’ fractures after Kapandji wiring in women over 59 years

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