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David G Dennison - One of the best experts on this subject based on the ideXlab platform.

  • open reduction and internal locked fixation of unstable Distal ulna Fractures with concomitant Distal Radius Fracture
    Journal of Hand Surgery (European Volume), 2007
    Co-Authors: David G Dennison
    Abstract:

    Purpose To evaluate the results following locking plate fixation of unstable Distal ulna Fractures with concomitant Distal Radius Fracture. Methods A retrospective review was conducted to identify patients who had been treated with a locking plate for unstable displaced Fractures of the Distal ulna in which a concomitant ipsilateral Distal Radius Fracture was also treated operatively. Medical records and radiographs were reviewed, and 5 patients were identified with an average age of 52 years (range, 47–61 years) and with follow-up averaging 11.6 months (range, 6–17 months). There were 2 open and 3 closed Fractures. Included was 1 simple neck, 1 comminuted neck, 1 head, and 2 head and neck Fractures of the Distal ulna. All Distal Radius Fracture implants were locked volar plates. Results All Distal ulna and Distal Radius Fractures united, and the average motion was: flexion 59°; extension 59°; pronation 67°; and supination 72°. Average grip strength was 97% of the opposite extremity. Final ulnar variance averaged −0.4 mm (ulnar negative), radial inclination was 20°, and volar tilt was 8°. All Distal radioulnar joints were stable. Two patients had mild, transient paresthesias of the dorsal sensory branch of the ulnar nerve, and both patients recovered completely within 3 months. There were no subsequent surgeries or hardware failures. There were no infections and no wound problems. Based upon the Sarmiento modification of the Gartland and Werley rating score, there were 4 excellent results and 1 good result. Conclusions Locked plating of unstable Distal ulna Fractures, in the setting of an associated Distal Radius Fracture, resulted in union, good to excellent alignment and motion, nearly symmetric grip strength, and minimal transient morbidity. Type of study/level of evidence Therapeutic IV.

Inger B Schipper - One of the best experts on this subject based on the ideXlab platform.

  • ulnar styloid process nonunion and outcome in patients with a Distal Radius Fracture a meta analysis of comparative clinical trials
    Injury-international Journal of The Care of The Injured, 2014
    Co-Authors: M M E Wijffels, J Keizer, G A Buijze, Y Zenke, Pieta Krijnen, Niels W L Schep, Inger B Schipper
    Abstract:

    Abstract Purpose There is no consensus on the relation between ulnar styloid process nonunion and outcome in patients with Distal Radius Fractures. The aim of this study was to analyze whether patient-reported outcome is influenced by the nonunion of the accompanying ulnar styloid Fracture in Distal Radius Fracture patients. Methods A meta-analysis of published studies comparing outcomes after Distal Radius Fractures with a united versus a non-united ulnar styloid process was performed. In addition, if provided by the authors, the raw data of these studies were pooled and analysed as one study. The outcome measures of the analyses included patient-reported outcome, functional outcome, grip-strength, pain, and Distal radioulnar joint (DRUJ) instability. Results Data from six comparative studies were included, concerning 365 patients with a Distal Radius Fracture. One hundred and thirty-five patients with an ulnar styloid union were compared with 230 patients with a nonunion of the ulnar styloid. No significant differences were found between groups regarding any outcome measure. Conclusion Based on this meta-analysis, there is no relation between the nonunion of the ulnar styloid process and function in patients with a Distal Radius Fracture.

Gregory A Merrell - One of the best experts on this subject based on the ideXlab platform.

  • the use of a vascularized Distal ulna autograft for complex Distal Radius Fracture nonunions
    Journal of Hand Surgery (European Volume), 2020
    Co-Authors: Daniel Kokmeye, Gregory A Merrell, William Kleinma, Robe M Altera
    Abstract:

    In patients with segmental nonunion of the Distal Radius, the Distal ulna and Distal radioulnar joint may not be salvageable. As an alternative to a vascularized free fibula, a pedicled Distal ulna vascularized graft is a useful salvage technique. The procedure relies on the vascular bundle of the pronator quadratus and the dorsal oblique arterial anastomosis between the anterior and posterior interosseous arteries running along the interosseous membrane as the pedicle. We present 3 patients who received a Distal ulna vascularized graft with concomitant wrist arthrodesis for Distal Radius segmental nonunion after complex Distal Radius Fracture. This technique provides a local pedicled graft that may be a simpler, more reliable, and less technically demanding alternative.

  • sigmoid notch reconstruction using osteoarticular graft in a severely comminuted Distal Radius Fracture a case report
    Journal of Hand Surgery (European Volume), 2002
    Co-Authors: Gregory A Merrell, Kimberly A Barrie, Scott W Wolfe
    Abstract:

    A case of a young patient with a severely comminuted intra-articular Distal Radius Fracture dislocation and severe injury of the Distal radioulnar joint is presented. Early reconstruction of the sigmoid notch and radioulnar ligaments was performed using the remaining scaphoid facet of the Distal Radius articular surface, an autogenous tendon graft for ligament reconstruction, and radioscapholunate arthrodesis. The patient was able to return to his manual work without limitations. We present additional information on the comparative anatomy of the sigmoid notch and scaphoid facet that may guide surgeons in treating this severe injury.

K H Wong - One of the best experts on this subject based on the ideXlab platform.

  • hand numbness and carpal tunnel syndrome after volar plating of Distal Radius Fracture
    Hand, 2011
    Co-Authors: S C Koo, K H Wong
    Abstract:

    We report the incidence of late onset post-operative carpal tunnel syndrome (late carpal tunnel syndrome) and late median nerve neuropathy after volar plating of Distal Radius Fracture by conducting a retrospective study on volar plating for Distal Radius Fracture performed during 2002 to 2006. Two hundred eighty-two volar plating were performed for acute Distal Radius Fracture after exclusion. Post-operative hand numbness occurred in 24 patients of which nine had carpal tunnel syndrome. Thus, the incidence of late carpal tunnel syndrome was 3.2% (9/282). Of the eight (8/24, 33%) patients with post-operative hand numbness that failed to respond to conservative treatment, five had carpal tunnel release and three had neurolysis of median nerve at Distal forearm. All had clinical improvement except in one patient. The incidence of late carpal tunnel syndrome after volar plating of Distal Radius in the present series is similar to the prevalence of carpal tunnel syndrome in general population. The incidence is low compared with other series, regardless of treatment method (conservative treatment, volar or dorsal plating). The outcome of post-operative hand numbness is generally favourable.

Kristina Åkesson - One of the best experts on this subject based on the ideXlab platform.

  • Disability and Pain are the Best Predictors of Sick Leave After a Distal Radius Fracture in Men
    Journal of Occupational Rehabilitation, 2020
    Co-Authors: Lisa Egund, Karin Önnby, Fiona Mcguigan, Kristina Åkesson
    Abstract:

    Purpose Distal Radius Fracture often compromises working ability, but clinical implications are less studied in men due to its lower incidence. This study therefore describes sick leave in men with Distal Radius Fracture, specifically exploring the impact of patient- and Fracture-related factors. Methods Professionally active men aged 20–65 with Distal Radius Fracture were followed prospectively for 1-year (n = 88). Data included treatment method, radiographic parameters pre/post treatment, complications, health, lifestyle and occupational demand. Patient outcomes were self-reported sick leave; Disability of the Arm, Shoulder and Hand (DASH) score; pain (5 likert scale); SF-36: Physical Component Scale (PCS) and Mental Component Scale (MCS). Results Median sick leave was 4 weeks (IQR 0; 8); almost a third reported taking no sick leave. Categorizing sick leave into 3 groups (0–6, 7–12 and > 12 weeks), men with the longest sick leave had 22 points higher DASH score (p = 0.001) and 5 points lower PCS (p = 0.02) at 1 week and the difference remained over time; they were also older and more often treated surgically. The strongest predictors of length of sick leave were one-week post-Fracture DASH score (rs = 0.4, p