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Asif M. Ilyas - One of the best experts on this subject based on the ideXlab platform.
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Distal Radius Fractures: Emergency Department Evaluation and Management
Orthopedic Clinics of North America, 2015Co-Authors: Eric M. Padegimas, Asif M. IlyasAbstract:: Musculoskeletal injuries are the second most common cause of presentation to emergency departments. Distal Radius fractures are an especially common injury pattern that often require evaluation and fracture management in an emergency department. This article reviews the evaluation of Distal Radius fractures including physical examination and radiographic review. Also discussed is management of Distal Radius fractures including splinting in the setting of an emergency department consultation.
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Carpal tunnel syndrome after Distal Radius fracture.
Orthopedic Clinics of North America, 2012Co-Authors: Genghis E. Niver, Asif M. IlyasAbstract:: Carpal tunnel syndrome is a common condition and is a well-recognized phenomenon following a Distal Radius fracture. The treating surgeon should be vigilant in noticing the signs and symptoms. If acute carpal tunnel syndrome is noted, then surgical release of the carpal tunnel and fracture fixation should be performed urgently. If early carpal tunnel syndrome findings are noted during Distal Radius fracture management, all potential causes should be evaluated. Delayed carpal tunnel syndrome presenting after a Distal Radius fracture has healed is best managed in standard fashion. There is no role for prophylactic carpal tunnel release at the time of Distal Radius fixation in a patient who is asymptomatic.
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Surgical approaches to the Distal Radius
HAND, 2011Co-Authors: Asif M. IlyasAbstract:Introduction Fractures of the Distal Radius are among the most common fractures seen. They encompass a myriad of presentations and fracture patterns that often benefit from various open reduction and internal fixation techniques—including volar plating, dorsal plating, radial plating, intramedullary nailing, and fragment-specific fixation. In order to obtain optimal reduction of these fractures, surgeons require a thorough understanding of the anatomy and various surgical exposures. Anatomy The Distal Radius is surrounded by a soft tissue envelope rich in vascularity and cutaneous innervation. The osseous surface consists of two articular surfaces and three cortical sides covered almost entirely by soft tissue. Surgical approaches Approaches to the Distal Radius can be broadly divided into volar, radial, and dorsal. Visualization of the articular surface can be accomplished best arthroscopically. Arthroscopy can be performed alone or in conjunction with other open approaches to the Distal Radius. Summary This article will review the pertinent anatomy and various surgical approaches in order to facilitate the surgeon’s ability to safely expose a Distal Radius fracture.
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Treatment of Distal Radius malunions with an intramedullary nail.
Techniques in Hand & Upper Extremity Surgery, 2009Co-Authors: Asif M. Ilyas, Matthew W. Reish, Joseph J. ThoderAbstract:: Malunion of the Distal Radius are the most common complications of Distal Radius fractures. Increased angulation of the Distal Radius can result in altered load concentrations on the wrist, decreased range of motion, decreased grip strength, and residual incongruence of the radiocarpal and Distal radioulnar joints. Multiple options exist for fixation of corrective osteotomies of the Distal Radius, including intramedullary nails. The use of an intramedullary nail provides the benefits of a percutaneous insertion technique, low-profile implant, load-sharing design, and fixed-angle locking screws in the Distal fragment. We describe an innovative technique for intramedullary fixation for corrective osteotomies of extraarticular Distal Radius malunions.
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Intramedullary Fixation of Distal Radius Fractures
Journal of Hand Surgery (European Volume), 2009Co-Authors: Asif M. IlyasAbstract:Intramedullary fixation has recently received increased enthusiasm as an option for Distal Radius fracture fixation. Indications for this fracture fixation technique should be limited to predominately displaced extra-articular or simple intra-articular Distal Radius fractures. Intramedullary fixation permits limited soft tissue dissection and insertion of a low-profile implant that acts as an internal splint. Purported benefits include a familiar fracture fixation technique, less soft tissue irritation, and locked fixed-angle technology. Thorough understanding of the radial and dorsal approaches to the Distal Radius is a prerequisite. Important aspects of intramedullary fixation of Distal Radius fractures include proper fracture selection, good fracture reduction, protection of sensory nerves, and avoidance of inadvertent intra-articular screw placement. Relevant surgical anatomy, technique, postoperative care, and a review of complications are presented.
Jesse B. Jupiter - One of the best experts on this subject based on the ideXlab platform.
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Best Approaches in Distal Radius Fracture Malunions.
Current Reviews in Musculoskeletal Medicine, 2019Co-Authors: Brady T. Evans, Jesse B. JupiterAbstract:Malunion remains a common complication in the treatment of Distal Radius fractures. The purpose of this review was to discuss the various approaches in planning and surgical management for extra- and intra-articular Distal Radius malunions. Several recent studies have reported good results with surgical correction of Distal Radius malunions utilizing a number of preoperative planning methods and surgical approaches. Three-dimensional models and custom cutting guides have recently become more popular, but their benefit in comparison to other methods remains unclear. Regardless of preoperative planning method or surgical approach, good results can be achieved with correction of Distal Radius malunion with careful attention to patient selection, indications, and surgical technique.
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Distal Radius fractures classification of treatment and indications for surgery
Orthopedic Clinics of North America, 2007Co-Authors: Asif M. Ilyas, Jesse B. JupiterAbstract:Distal Radius fractures are common injuries. Multiple classification systems have highlighted the evolution of the understanding of Distal Radius fractures. Understanding the classifications of Distal Radius fractures is important in identifying the important aspects that affect their outcome. Surgical indications of Distal Radius fractures can be divided into the following categories: patient factors, fracture reduction, fracture stability, and the presence of associated injuries.
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Distal Radius Fractures—Classification of Treatment and Indications for Surgery
Orthopedic Clinics of North America, 2007Co-Authors: Asif M. Ilyas, Jesse B. JupiterAbstract:Distal Radius fractures are common injuries. Multiple classification systems have highlighted the evolution of the understanding of Distal Radius fractures. Understanding the classifications of Distal Radius fractures is important in identifying the important aspects that affect their outcome. Surgical indications of Distal Radius fractures can be divided into the following categories: patient factors, fracture reduction, fracture stability, and the presence of associated injuries.
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treatment of osteoporotic Distal Radius fractures
Osteoporosis International, 2005Co-Authors: David Ring, Jesse B. JupiterAbstract:Fracture of Distal Radius is most commonly an injury of the fit osteoporotic patient. As the population and health of older individuals continue to expand, osteoporotic Distal Radius fractures will become increasingly common. While many older patients have limited functional demands and can accept some deformity and wrist dysfunction, others remain very active into older age and desire optimal wrist alignment and function. The difficulty obtaining reliable fixation in osteoporotic bone presents a challenge to the surgeon that has been partially addressed by newer implants with screws that directly engage the plate, creating fixed angle bolts that have better fixation in osteoporotic bone. Decision-making is based upon a balance of the goals of the individual patient with the risks of intervention.
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fractures of the Distal Radius
Journal of Bone and Joint Surgery American Volume, 1996Co-Authors: Diego L. Fernandez, Jesse B. JupiterAbstract:Fractures of the Distal Radius , Fractures of the Distal Radius , کتابخانه دیجیتال جندی شاپور اهواز
David M Lichtman - One of the best experts on this subject based on the ideXlab platform.
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treatment of Distal Radius fractures
Journal of The American Academy of Orthopaedic Surgeons, 2010Co-Authors: David M Lichtman, Martin I. Boyer, David Ring, John S. Taras, Randipsingh R Bindra, Matthew D Putnam, David J Slutsky, William C Watters, Michael J Goldberg, Michael W KeithAbstract:AbstractThe clinical practice guideline is based on a systematic review of published studies on the treatment of Distal Radius fractures in adults. None of the 29 recommendations made by the work group was graded as strong; most are graded as inconclusive or consensus; seven are graded as weak. The
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plating of the Distal Radius
Journal of The American Academy of Orthopaedic Surgeons, 2005Co-Authors: Arvind D Nana, Atul B Joshi, David M LichtmanAbstract:: Distal Radius fractures are common injuries that can be treated by a variety of methods. Restoration of the Distal Radius anatomy within established guidelines yields the best short- and long-term results. Guidelines for acceptable reduction are (1) radial shortening 15 degrees , (3) sagittal tilt on lateral projection between 15 degrees dorsal tilt and 20 degrees volar tilt, (4) intra-articular step-off < 2 mm of the radiocarpal joint, and (5) articular incongruity < 2 mm of the sigmoid notch of the Distal Radius. Treatment options range from closed reduction and immobilization to open reduction with plates and screws; options are differentiated based on their ability to reinforce and stabilize the three columns of the Distal Radius and ulna. Plating allows direct restoration of the anatomy, stable internal fixation, a decreased period of immobilization, and early return of wrist function. Buttress plates reduce and stabilize vertical shear intra-articular fractures through an antiglide effect, where-as conventional and locking plates address metaphyseal comminution and/or preserve articular congruity/reduction. With conventional and locking plates, intra-articular fractures are directly reduced; with buttress plates, the plate itself helps reduce the intra-articular fracture. Complications associated with plating include tendon irritation or rupture and the need for plate removal.
David Ring - One of the best experts on this subject based on the ideXlab platform.
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New concepts in the treatment of Distal Radius fractures.
Journal of Bone and Joint Surgery American Volume, 2020Co-Authors: John S. Taras, Amy L. Ladd, David M. Kalainov, David S. Ruch, David RingAbstract:: Fracture of the Distal Radius is the type of fracture most commonly seen in emergency departments. The understanding of nonsurgical and surgical care of Distal Radius fractures is evolving with recently developed methods of fixation. It is worthwhile to review some new methods of treatment, the role of bone grafting and synthetic substitutes, the principles of complex fracture management, and the treatment of common complications of Distal Radius fractures.
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treatment of Distal Radius fractures
Journal of The American Academy of Orthopaedic Surgeons, 2010Co-Authors: David M Lichtman, Martin I. Boyer, David Ring, John S. Taras, Randipsingh R Bindra, Matthew D Putnam, David J Slutsky, William C Watters, Michael J Goldberg, Michael W KeithAbstract:AbstractThe clinical practice guideline is based on a systematic review of published studies on the treatment of Distal Radius fractures in adults. None of the 29 recommendations made by the work group was graded as strong; most are graded as inconclusive or consensus; seven are graded as weak. The
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Nonunion of the Distal Radius
Hand Clinics, 2005Co-Authors: David RingAbstract:: Distal Radius nonunion is either more common or more commonly recognized. The success of operative treatment to gain union seems to have improved along with improvements in operative fixation of fractures of the Distal Radius. Operative treatment to gain union or arthrodese the wrist can improve function and comfort with relatively few complications.
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treatment of osteoporotic Distal Radius fractures
Osteoporosis International, 2005Co-Authors: David Ring, Jesse B. JupiterAbstract:Fracture of Distal Radius is most commonly an injury of the fit osteoporotic patient. As the population and health of older individuals continue to expand, osteoporotic Distal Radius fractures will become increasingly common. While many older patients have limited functional demands and can accept some deformity and wrist dysfunction, others remain very active into older age and desire optimal wrist alignment and function. The difficulty obtaining reliable fixation in osteoporotic bone presents a challenge to the surgeon that has been partially addressed by newer implants with screws that directly engage the plate, creating fixed angle bolts that have better fixation in osteoporotic bone. Decision-making is based upon a balance of the goals of the individual patient with the risks of intervention.
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Treatment of the neglected Distal Radius fracture.
Clinical Orthopaedics and Related Research, 2005Co-Authors: David RingAbstract:Operative treatment of inadequately or imperfectly treated fractures of the Distal Radius can improve wrist and hand function substantially, but rarely restores the limb to normal. Patients with malunion of the Distal Radius present either with poor radiographic alignment before complete healing of
Karl-josef Prommersberger - One of the best experts on this subject based on the ideXlab platform.
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Nonunion of Distal Radius fractures : Nonunions
Clinical Orthopaedics and Related Research, 2020Co-Authors: Karl-josef Prommersberger, Diego L. FernandezAbstract:Nonunion of a Distal Radius fracture is extremely uncommon. Healing problems in the Distal Radius seem to be related to unstable situations, such as concomitant fracture of the Distal Radius and ulna, and to an inadequate period of immobilization. Nonunion should be suspected if there is continuing pain after remobilization of the wrist in combination with a progressing deformity. The diagnosis may be confirmed by showing movement at the fracture site on lateral radiographs ofthe wrist in flexion and extension. Because of the rarity of Distal Radius fracture nonunion, it is not surprising that there is no consensus on the optimum mode of operative treatment. Based on our experience with reconstruction surgery in 23 patients, we think that most nonunions of the Distal Radius are amenable to attempts to realign and heal the fracture even when the Distal fragment is small. Therefore, surgeons should try to preserve even a small amount of wrist motion and reserve wrist fusion as a final resort.
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Rotational deformity in malunited fractures of the Distal Radius.
Journal of Hand Surgery (European Volume), 2020Co-Authors: Karl-josef Prommersberger, Steffen C. Froehner, Rainer Schmitt, Ulrich LanzAbstract:Abstract Purpose To evaluate rotational deformity in malunited fractures of the Distal Radius and its efffect on forearm rotation. Methods Thirty-seven patients with a symptomatic malunion of the Distal Radius (25 with dorsal angulation and 12 with volar angulation) were assessed for rotational deformity of the Distal fragment. Spiral computed tomographic scans were taken of both wrists. Rotational deformity was evaluated by comparing the radial torsion angle of the injured and uninjured sides according to Frahm. Multivariable regression analyses were used to identify the radiologic parameter that had the most important influence on forearm rotation. Results Of the 37 patients, 23 showed a rotational deformity of the Distal Radius. In both dorsally and volarly angulated malunions, pronation and supination deformities were identified. There was a tendency toward more pronation deformities with volar malunion. Volar angulated malunion with a rotational deformity of less than 10° showed the smallest amount of forearm supination. Losses of pronation-supination did not correlate with the amount of rotational deformity. Conclusions This study showed that rotational deformity is common with angulated malunions of the Distal Radius. The effect on forearm rotation should not be overestimated. Pretreatment computed tomographic scanning of both wrists to identify and measure malrotation of the Distal Radius may be helpful to improve the outcome after corrective osteotomy.
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Malunion of the Distal Radius.
Archives of Orthopaedic and Trauma Surgery, 2012Co-Authors: Karl-josef Prommersberger, Thomas Pillukat, M. Mühldorfer, Jörg Van SchoonhovenAbstract:Fractures of the Distal Radius are extremely common injuries, which are steadily becoming a public health issue. One of the most common complications following Distal Radius fractures is still malunion of the Distal Radius. This review of the literature surrounding Distal Radius malunion covers the biomechanics of Distal radial malunion, treatment options, indications for surgery, surgical techniques, and results.
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Nonunion of Distal Radius fractures.
Clinical Orthopaedics and Related Research, 2004Co-Authors: Karl-josef Prommersberger, Diego L. FernandezAbstract:: Nonunion of a Distal Radius fracture is extremely uncommon. Healing problems in the Distal Radius seem to be related to unstable situations, such as concomitant fracture of the Distal Radius and ulna, and to an inadequate period of immobilization. Nonunion should be suspected if there is continuing pain after remobilization of the wrist in combination with a progressing deformity. The diagnosis may be confirmed by showing movement at the fracture site on lateral radiographs of the wrist in flexion and extension. Because of the rarity of Distal Radius fracture nonunion, it is not surprising that there is no consensus on the optimum mode of operative treatment. Based on our experience with reconstruction surgery in 23 patients, we think that most nonunions of the Distal Radius are amenable to attempts to re-align and heal the fracture even when the Distal fragment is small. Therefore, surgeons should try to preserve even a small amount of wrist motion and reserve wrist fusion as a final resort.