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Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator

Yıl 2020, Cilt: 11 Sayı: 4, 214 - 219, 30.09.2020
https://doi.org/10.18663/tjcl.657375

Öz

Aim: Distal radius fracture extending into the joint is very common; in any case, the administration of this fracture is controvertible. Related to the significance of intra-articular fracture of the distal radius and the best treatment strategy for the fracture, we tried to evaluate the achievement rate following the treatment of comminuted intra-articular fracture of the distal radius by means of closed reduction and utilization of external fixator.
Material and Methods: This retrospective study was taken over at our division of orthopedics by means of appraisal of radiographs and patient documents of those overlook from 2016 to 2018. Radiographic criteria incorporated the level of angulation and shortening of the range of radius. Information were evaluated SPSS 18 programming and were exhibited as mean ± standard deviation (SD). The essentialness level was set at P ≤ 0.05.
Results: Generally: 28% of the patients was seen ≤ 2 mm shortening of the radius, 53% of the patients had 2- 5 mm outspread shortening and 19% of the patients had in excess of 5 mm shortening of the range. Most of the members patients had admissible results. The mean average angulation was 6.28 ± 2.85 degrees and the average shortening was 3.92 ± 2.22. %39 percent of the patients had shortening of under 5 mm, 56% had shortening of 5- 10 mm and 5% in excess of 10 mm shortening, individually.
Conclusion: The aftereffects of our examination demonstrated that the smaller than expected external fixator is a decent and viable treatment alternative for acquiring outspread length, angulation and hard association in intra-articular fracture of the distal radius. 

Kaynakça

  • 1. Abramo A, Kopylov P, Geijer M, Tägil M. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures a randomized study of 50 patients. Acta Orthop 2009; 80: 478-85.
  • 2. Colles A. On the fracture of the carpal extremity of the radius. Edinb Med Surg J Clin Orthop Relat Res 2006; 445: 5-7.
  • 3. Fernandez DL. Fractures of the distal radius: operative treatment. Instr Course Lect 1993; 42: 73–88.
  • 4. Adams BD. Effects of radial deformity on distal radioulnar joint mechanics. J Hand Surg Am 1993; 18: 492-8.
  • 5. Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007; 21: 316-22
  • 6. Al-Rashid M, Theivendran K, Craigen MAC. Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. J Bone Joint Surg Br 2006; 88: 1610-2
  • 7. Arora R, Lutz M, Fritz D, Zimmermann R, Oberladstätter J, Gabl M. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg 2005; 125: 399-404
  • 8. Arslan H, Subasi M, Kesemenli C, Kapukaya A, Necmioglu S. Distraction osteotomy for malunion of the distal end of the radius with radial shortening. Acta Orthop Belg 2003; 69: 23-8
  • 9. Atroshi I, Brogren E, Larsson GU, Kloow J, Hofer M, Berggren AM. Wrist-bridging versus non-bridging external fixation for displaced distal radius fractures: A randomized assessor-blind clinical trial of 38 patients followed for 1 year. Acta Orthop 2006; 77: 445-53
  • 10. Revill SI, Robinson JO, Rosen M, Hogg MI. The reliability of a linear analogue for evaluating pain. Anaesthesia 1976; 31: 1191-8
  • 11. Lichtman DM, Bindra RR. Treatment of distal radius fractures. J Am Acad Orthop Surg 2010; 18: 180–9
  • 12. Zhang LH, Ya-nan W, Zhi M et al. Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: A meta-analysis of randomized controlled trials J Surg Res 2015; 193: 324- 33.
  • 13. Cui Z , Pan J, Yu B et al. Internal versus external fixation for unstable distal radius fractures: An up-to-date meta-analysis. Int Orthop 2011; 35: 1333-41
  • 14. Wang J, Yang Y, Ma J et al. Open reduction and internal fixation versus external fixation for unstable distal radial fractures: A meta-analysis. Orthop Traumatol Surg Res 2013; 99: 321-31.
  • 15. Augé WK, Velázquez PA. The application of indirect reduction techniques in the distal radius: The role of adjuvant arthroscopy. Arthroscopy 2000; 16: 830-5
  • 16. Azzopardi T, Ehrendorfer S, Coulton T, Abela M. Unstable Extra-articular Fractures of the Distal Radius: A Prospective, Randomised Study of Immobilisation in a Cast Versus Supplementary Percutaneous Pinning. J Bone Joint Surg Br 2005; 57: 837-40
  • 17. Bednar DA A-HH. Nonbridging external fixation for fractures of the distal radius. Can J Surg 2004; 47: 426–30.
  • 18. Arshad AJ MK. Radial Length and Radial Angle in Closed Reduction Plaster Cast Immobilization Versus External Fixation in Comminuted Intra Articular Fracure of Distal Radius. J Pak Orthop Assoc 2013; 25: 14–7.
  • 19. Jenkins NH, Jones DG, Johnson SR, Mintowt-Czyz WJ. External fixation of Colles’ fractures. An anatomical study. J Bone Jt Surg Br 1987; 69: 207-11.
  • 20. Melone CP. Distal radius fractures: Patterns of articular fragmentation. Orthopedic Clinics of North America 1993; 24: 239-53
  • 21. Jakim I, Pieterse HS SM. External fixation for intra-articular fractures of the distal radius. J Bone Jt Surg Br 1991; 73: 6
  • 22. Krishnan J, Wigg AER, Walker RW, Slavotinek J. Intra-articular fractures of the distal radius: A prospective randomised controlled trial comparing static bridging and dynamic non-bridging external fixation. J Hand Surg Am 2003; 25: 417-21.

Eklem içi distal radius kırıklarında kapalı redüksiyon ve eksternal fiksatör kullanılarak yapılan tedavinin başarı ve komplikasyon oranları

Yıl 2020, Cilt: 11 Sayı: 4, 214 - 219, 30.09.2020
https://doi.org/10.18663/tjcl.657375

Öz

Amaç: Eklem içine uzanan distal radius kırığı çok yaygındır; birçok tedavi yöntemi mevcuttur. İntra-artiküler distal radiusun parçalanmış kırığının önemini ve bu tarz kırıklar için en iyi tedavi stratejisi ile ilgili olarak, kapalı redüksiyon ve eksternal fiksatör kullanımı ile tedavisinin başarısını ve komplikasyon oranlarını değerlendirmeye çalıştık.
Gereç ve Yöntemler: Bu retrospektif çalışma, 2016'dan 2018'e kadar Ortopedi kliniğimizde tedavi edilen hastaların radyografileri ve hasta dosyalarının değerlendirilmesi ile yapıldı. Radyografik kriterler olarak distal radiusun angulasyon dereceleri ve kısalma miktarları değerlendirildi.Sonuçlar SPSS 18 programında değerlendirildi ve ortalama ± standart sapma (SD) olarak gösterildi. Anlamlılık seviyesi p ≤ 0.05 olarak belirlendi
Bulgular: Hastaların %28'inde ≤2 mm yarıçapın kısalması, %53'ünde 2-5 mm arasında kısalması ve %19'unda 5 mm’den fazla kısalma görüldü. Hastaların çoğunluğunun kabul edilebilir sonuçları vardı. Ortalama angulasyon 6.28 ± 2.85 derece ve ortalama kısalma 3.92 ± 2.22 mm idi. Hastaların %39'unda 5 mm'nin altında kısalma, %56'sında 5 - 10 mm kısalma ve %5'inde 10 mm'yi aşan kısalma vardı.
Sonuç: Çalişmamızın sonuçları intra-artiküler distal radius kırığının eksternal fiksatör tedavisinin beklenden daha az olsada angülasyon, radial kısalma gibi sonuçalar açısından alternatif iyi bir tedavi seçeneği olduğunu göstermiştir.

Kaynakça

  • 1. Abramo A, Kopylov P, Geijer M, Tägil M. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures a randomized study of 50 patients. Acta Orthop 2009; 80: 478-85.
  • 2. Colles A. On the fracture of the carpal extremity of the radius. Edinb Med Surg J Clin Orthop Relat Res 2006; 445: 5-7.
  • 3. Fernandez DL. Fractures of the distal radius: operative treatment. Instr Course Lect 1993; 42: 73–88.
  • 4. Adams BD. Effects of radial deformity on distal radioulnar joint mechanics. J Hand Surg Am 1993; 18: 492-8.
  • 5. Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007; 21: 316-22
  • 6. Al-Rashid M, Theivendran K, Craigen MAC. Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. J Bone Joint Surg Br 2006; 88: 1610-2
  • 7. Arora R, Lutz M, Fritz D, Zimmermann R, Oberladstätter J, Gabl M. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg 2005; 125: 399-404
  • 8. Arslan H, Subasi M, Kesemenli C, Kapukaya A, Necmioglu S. Distraction osteotomy for malunion of the distal end of the radius with radial shortening. Acta Orthop Belg 2003; 69: 23-8
  • 9. Atroshi I, Brogren E, Larsson GU, Kloow J, Hofer M, Berggren AM. Wrist-bridging versus non-bridging external fixation for displaced distal radius fractures: A randomized assessor-blind clinical trial of 38 patients followed for 1 year. Acta Orthop 2006; 77: 445-53
  • 10. Revill SI, Robinson JO, Rosen M, Hogg MI. The reliability of a linear analogue for evaluating pain. Anaesthesia 1976; 31: 1191-8
  • 11. Lichtman DM, Bindra RR. Treatment of distal radius fractures. J Am Acad Orthop Surg 2010; 18: 180–9
  • 12. Zhang LH, Ya-nan W, Zhi M et al. Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: A meta-analysis of randomized controlled trials J Surg Res 2015; 193: 324- 33.
  • 13. Cui Z , Pan J, Yu B et al. Internal versus external fixation for unstable distal radius fractures: An up-to-date meta-analysis. Int Orthop 2011; 35: 1333-41
  • 14. Wang J, Yang Y, Ma J et al. Open reduction and internal fixation versus external fixation for unstable distal radial fractures: A meta-analysis. Orthop Traumatol Surg Res 2013; 99: 321-31.
  • 15. Augé WK, Velázquez PA. The application of indirect reduction techniques in the distal radius: The role of adjuvant arthroscopy. Arthroscopy 2000; 16: 830-5
  • 16. Azzopardi T, Ehrendorfer S, Coulton T, Abela M. Unstable Extra-articular Fractures of the Distal Radius: A Prospective, Randomised Study of Immobilisation in a Cast Versus Supplementary Percutaneous Pinning. J Bone Joint Surg Br 2005; 57: 837-40
  • 17. Bednar DA A-HH. Nonbridging external fixation for fractures of the distal radius. Can J Surg 2004; 47: 426–30.
  • 18. Arshad AJ MK. Radial Length and Radial Angle in Closed Reduction Plaster Cast Immobilization Versus External Fixation in Comminuted Intra Articular Fracure of Distal Radius. J Pak Orthop Assoc 2013; 25: 14–7.
  • 19. Jenkins NH, Jones DG, Johnson SR, Mintowt-Czyz WJ. External fixation of Colles’ fractures. An anatomical study. J Bone Jt Surg Br 1987; 69: 207-11.
  • 20. Melone CP. Distal radius fractures: Patterns of articular fragmentation. Orthopedic Clinics of North America 1993; 24: 239-53
  • 21. Jakim I, Pieterse HS SM. External fixation for intra-articular fractures of the distal radius. J Bone Jt Surg Br 1991; 73: 6
  • 22. Krishnan J, Wigg AER, Walker RW, Slavotinek J. Intra-articular fractures of the distal radius: A prospective randomised controlled trial comparing static bridging and dynamic non-bridging external fixation. J Hand Surg Am 2003; 25: 417-21.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Makale
Yazarlar

Serdar Menekşe 0000-0002-4121-8917

Yayımlanma Tarihi 30 Eylül 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 11 Sayı: 4

Kaynak Göster

APA Menekşe, S. (2020). Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator. Turkish Journal of Clinics and Laboratory, 11(4), 214-219. https://doi.org/10.18663/tjcl.657375
AMA Menekşe S. Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator. TJCL. Eylül 2020;11(4):214-219. doi:10.18663/tjcl.657375
Chicago Menekşe, Serdar. “Achievement Rate and Complications of Comminuted ıntra-Articular Distal Radius Fracture Treatment by Means of Closed Reduction and Use of External Fixator”. Turkish Journal of Clinics and Laboratory 11, sy. 4 (Eylül 2020): 214-19. https://doi.org/10.18663/tjcl.657375.
EndNote Menekşe S (01 Eylül 2020) Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator. Turkish Journal of Clinics and Laboratory 11 4 214–219.
IEEE S. Menekşe, “Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator”, TJCL, c. 11, sy. 4, ss. 214–219, 2020, doi: 10.18663/tjcl.657375.
ISNAD Menekşe, Serdar. “Achievement Rate and Complications of Comminuted ıntra-Articular Distal Radius Fracture Treatment by Means of Closed Reduction and Use of External Fixator”. Turkish Journal of Clinics and Laboratory 11/4 (Eylül 2020), 214-219. https://doi.org/10.18663/tjcl.657375.
JAMA Menekşe S. Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator. TJCL. 2020;11:214–219.
MLA Menekşe, Serdar. “Achievement Rate and Complications of Comminuted ıntra-Articular Distal Radius Fracture Treatment by Means of Closed Reduction and Use of External Fixator”. Turkish Journal of Clinics and Laboratory, c. 11, sy. 4, 2020, ss. 214-9, doi:10.18663/tjcl.657375.
Vancouver Menekşe S. Achievement rate and complications of comminuted ıntra-articular distal radius fracture treatment by means of closed reduction and use of external fixator. TJCL. 2020;11(4):214-9.


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