Rekonstruktion der tiefen Anteile der distalen radioulnaren Bandstrukturen mit einem Sehnentransplantat – Operation nach Adams

Spies, Christian; Langer, Martin; Müller, Lars Peter; Unglaub, Frank

doi:10.1007/s00064-019-00638-7

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…Although the treatment of DRF with VLP fixation reportedly achieves satisfactory outcomes, several researchers have reported that some patients experience ulnar wrist pain after surgical treatment of DRF [ 29 ]. TFCC injuries are a recognized cause of ulnar side wrist pain, resulting in unsatisfactory outcomes [ 5 , 6 ]. Many authors have recommended surgical repair of the TFCC in distal radius fractures to prevent the adverse effect of instability of the DRUJ and ulnar side wrist pain [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

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Association between imaging parameter changes and triangular fibrocartilage complex injury after distal radius fractures

Tan,

Wang,

2023

J Orthop Surg Res

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Background Triangular fibrocartilage complex (TFCC) injury is a frequent soft tissue injury that has been observed to accompany distal radius fractures (DRFs) with concomitant changes in radiologic parameters. The aim of this study was to investigate the relevance of distal radial radiologic parameters associated with DRF and traumatic TFCC injury. Methods A total of 172 patients with distal radius fractures who underwent X-ray, CT, and MRI before undergoing volar locking plate or external splint fixation between October 2021 and December 2022 were included in this study. An analysis of various radiologic parameters and the classification of fracture type and TFCC injuries by CT and MRI was performed. All patients were divided into the TFCC uninjured group and the injured group. The incidence and relevant radiologic parameters were compared. Results This study included 76 males and 96 females with a mean age of 56.1 years. Among all patients, 33 (19.2%), 40 (23.2%), and 99 (57.6%) had DRF with A, B, and C fractures, respectively, according to the AO/OTA classification. In patients with fractures, the TFCC was found to be injured in 54.1% (93/172) of patients (type 1A in 21, 1B in 46, 1C in 39, and 1D in 35) but uninjured in 45.9% (79/172). There were significant differences between the TFCC injured and uninjured groups regarding the radius length (p = 0.044) and DRUJ distance (p = 0.040) of radiologic parameters that changed with DRF, although there were no differences between the two groups regarding gender, age, injured side, intra- and extra-articular, radius inclination and palmer tilt angle, or sagittal translation. Within the TFCC injured group, the radius length and DRUJ distance were 4.83 mm and 2.95 mm less or wider than 7.19 mm and 1.83 mm of the uninjured group. Moreover, shorter radius length was related to type lB TFCC injury (p = 0.041). Both radius length (AUC = 0.658) and DRUJ distance (AUC = 0.582) had no convincing predictive value for TFCC injury in DRF. Conclusion 1B TFCC injury is most common in patients with DRF and concomitant TFCC injury. Both radius length and DRUJ distance have a significant statistical correlation with TFCC injury, and patients with TFCC injury tend to have a shortened radius and wider DRUJ distance, although they have no predictive value for TFCC injury in DRF. In addition, a shorter radius length was related to type lB TFCC injury.

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Section: Discussionmentioning

confidence: 99%

“…The triangular fibrocartilage complex (TFCC) is one of the most important stabilizing structures of the DRUJ [ 5 ]. Reconstruction of deep fibers of the TFCC is beneficial for stabilizing the wrist joint [ 6 ]. During clinical practice, it is relatively easy for physicians to see distal ulnar radius fractures on wrist X-rays or CT.…”

Section: Introductionmentioning

confidence: 99%

Association between imaging parameter changes and triangular fibrocartilage complex injury after distal radius fractures

Tan,

Wang,

2023

J Orthop Surg Res

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“…Traumatic lesions of the distal radio-ulnar joint (DRUJ) occur in conjunction with fractures of the distal radius in a considerable number of cases and underappreciated injuries are a common cause of ulnar-sided wrist pain and limited range of motion [5][6][7]. Amongst the most common classification systems of distal radius fractures, however, only the Frykman classification [8] takes into account the involvement of the distal radio-ulnar joint.…”

Section: Introductionmentioning

confidence: 99%

Standard radiographic assessments of distal radius fractures miss involvement of the distal radioulnar joint: a diagnostic study

Hruby

Haider

Laggner

et al. 2021

Arch Orthop Trauma Surg

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Introduction Distal radius fractures account for one-fifth of all fractures in the emergency department. Their classification based on standard radiographs is common practice although low inter-observer reliabilities and superiority of computer tomography (CT) scanning in evaluation of joint congruency have been reported. Materials and methods We retrospectively analyzed 96 displaced distal radius fractures scheduled for open reduction and internal fixation using standard radiographic assessment. The radiographs were classified with the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA), Fernandez and Frykman classifications by three observers and inter-rater reliabilities were calculated. Additional CT scanning was performed in all cases and the following parameters were assessed: radiocarpal joint involvement, fracture extent into the radial sigmoid notch, i.e. the distal radio-ulnar joint, comminution of the metaphysis, and concomitant ulnar styloid fracture. The CT scans were used as a reference standard to determine sensitivity and accuracy of standard radiographic assessment in evaluation of distal radius fractures. Results The inter-rater agreement for the AO classification was 35.4%, 68.8% for the Fernandez and 38.5% for the Frykman classification. Fracture extension into the radiocarpal joint was present in 81 cases (84.4%). Sigmoid notch involvement was found in 81 fractures (84.4%). Involvement of both joints was present in 72 cases (75%). The sensitivity of standard radiographs regarding radiocarpal joint involvement was 93.8%. Considering involvement of the distal radio-ulnar joint the false-negative rate using standard radiographs was 61.7% and the test’s accuracy for sigmoid notch involvement was 45.8%. Conclusion This study demonstrates that involvement of the sigmoid notch is frequently missed in standard radiographs. The presented data support the frequent use of CT imaging to allow the holistic illustration of a fracture’s complexion and to ensure optimal pre-operative planning.

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Long-term results of more than 13 years after arthroscopic repair of triangular fibrocartilage complex (TFCC) Palmer 1B tears: a comparison with short- and mid-term results

Unglaub

Brückner

Heyse

et al. 2021

Eur J Trauma Emerg Surg

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Rekonstruktion der tiefen Anteile der distalen radioulnaren Bandstrukturen mit einem Sehnentransplantat – Operation nach Adams

Cited by 8 publications

References 22 publications

Association between imaging parameter changes and triangular fibrocartilage complex injury after distal radius fractures

Association between imaging parameter changes and triangular fibrocartilage complex injury after distal radius fractures

Standard radiographic assessments of distal radius fractures miss involvement of the distal radioulnar joint: a diagnostic study

Long-term results of more than 13 years after arthroscopic repair of triangular fibrocartilage complex (TFCC) Palmer 1B tears: a comparison with short- and mid-term results

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