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Briotti J, Wilson S, Goh G, Lawson-Smith M. Wrist Arthrodesis Using the Medartis Carpometacarpal Joint Sparing Plate. Hand (N Y) 2024; 19:607-613. [PMID: 36541766 PMCID: PMC11141422 DOI: 10.1177/15589447221141474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Total wrist arthrodesis is a well-established surgical technique that provides reliable pain relief in patients with advanced wrist disease. Key limitations of existing plating systems include hardware pull-out, hardware failure, and nonunion. There is limited literature on the newer style carpometacarpal joint (CMCJ) sparing plating system, produced by Medartis. The objective of this study was to determine the long-term clinical and radiological outcomes of wrist arthrodesis with a CMCJ sparing wrist plate. METHODS This study retrospectively identified 23 wrist arthrodeses using the Medartis CMCJ sparing plate for review. This study assessed the outcomes of 18 unilateral wrist fusions and 1 bilateral wrist fusion. The study group consisted of 12 men and 5 women with an average age of 56 years (range: 29-82 years) with a mean follow-up period of 17 months. RESULTS At the time of follow-up, all patients' wrists had fused without postsurgical complication. The final grip strength in the operative hand was 28.2 kg/cm2, which was 87% of the contralateral side. The mean Quick Disabilities of the Arm, Shoulder, and Hand score at follow-up was 23.9, with all patients returning to daily living activities and work. Patients reported minimal pain (1.3/10), with almost all (17/18) satisfied with the outcome of the surgery and describing that they would recommend this procedure. CONCLUSION Our case series highlights that the Medartis wrist arthrodesis plate is a newer design that is a well-tolerated option for wrist arthrodesis based on clinical assessment, functional hand assessment, and patient satisfaction, when compared with the existing literature on traditional plating systems.
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Affiliation(s)
- Joshua Briotti
- Royal Perth Hospital, WA, Australia
- University of Notre Dame Australia, Fremantle, WA, Australia
| | | | | | - Matthew Lawson-Smith
- University of Notre Dame Australia, Fremantle, WA, Australia
- Fremantle Hospital, WA, Australia
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2
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Owen DH, Booth JW, Agius PA, Perriman DM, Smith PN, Roberts CJ. Union and Complication Rates After Total Wrist Arthrodesis: A Systematic Review and Meta-Analysis. J Hand Surg Am 2023:S0363-5023(23)00556-7. [PMID: 38043034 DOI: 10.1016/j.jhsa.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/23/2023] [Accepted: 10/05/2023] [Indexed: 12/04/2023]
Abstract
PURPOSE Total wrist arthrodesis (TWA) has been performed using various techniques. We aimed to provide pooled prevalence estimates of union and complications of TWA by technique. A secondary aim was to provide estimates of union and complication rates by treatment of the carpometacarpal joint (CMCJ) in TWA using plates. Given the widespread adoption of wrist arthrodesis plates (WAP), we hypothesized that these implants would result in higher union and lower complication rates. We also hypothesized that TWA with CMCJ arthrodesis would improve these outcomes. METHODS Online databases including PubMed, Medline, Embase, and Cochrane were searched. Studies reporting union and/or complication rates of 10 or more TWA performed with a similar technique (analyzed as bone graft only, bone graft with minimal fixation, intramedullary, augmented intramedullary, plate, WAP, and other) were included. Studies with fewer than 10 TWA, studies reporting TWA where union or complications could not be analyzed separately, and studies without union and complication rates were excluded. Data extraction was performed independently by two English-speaking reviewers with a translator where required. Pooled prevalence estimates were made using a random-effects meta-analysis model and presented as a percent prevalence with 95% confidence and prediction intervals. RESULTS One hundred and thirty-six studies with a total of 3,517 patients and 3,969 TWA were analyzed. No differences in union and complication prevalence were observed between TWA techniques and in TWA with different treatments of the CMCJ using plates and WAP. CONCLUSION Using meta-analysis, we found no difference in union and complication prevalence between TWA techniques and TWA with different treatments of the CMCJ with plates and WAP. It must be acknowledged that this research included low-quality studies with high heterogeneity, and confidence in the precision of the estimates is low. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic IV.
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Affiliation(s)
- David H Owen
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia; Australian National University Medical School, Canberra, Australia; Gippsland Orthopaedics, Traralgon, Australia.
| | - Joshua W Booth
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia; Australian National University Medical School, Canberra, Australia
| | - Paul A Agius
- Faculty of Health, Deakin University, Burwood, Australia; Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Diana M Perriman
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia; Australian National University Medical School, Canberra, Australia
| | - Paul N Smith
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia; Australian National University Medical School, Canberra, Australia
| | - Chris J Roberts
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia; Australian National University Medical School, Canberra, Australia
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Owen DH, Wang D, Cong X, Mowbray C, Perriman DM, Roberts CJ, Smith PN, Drobetz H, Ackland D. Biomechanical Performance of Total Wrist Arthrodesis Plates With and Without Arthrodesis of the Carpometacarpal Joint. Hand (N Y) 2023:15589447231198263. [PMID: 37804161 DOI: 10.1177/15589447231198263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
BACKGROUND It is unknown whether total wrist arthrodesis (TWA) should be performed with or without arthrodesis of the carpometacarpal joint (CMCJ). The aim of this study is to compare CMCJ-spanning TWA plates using 3D printed wrist arthrodesis model with and without arthrodesis of the CMCJ. METHODS Total wrist arthrodesis plates mounted to 3D printed models were tested under a 4-N bending load at 4 Hz for 50 000 cycles, increased by 15% every 10 000 cycles until failure. RESULTS Plates with arthrodesis CMCJ were stiffer and failed at a significantly greater load and number of cycles than plates mounted to models without CMCJ arthrodesis. The Synthes stainless steel locking TWA plate performed better than the Trimed plate applied to the model without CMCJ arthrodesis and the Acumed plate applied to the model with CMCJ arthrodesis. Based on these findings, we recommend arthrodesis of the CMCJ in TWA. CONCLUSIONS Incorporation of the CMCJ in TWA may protect against plate failure. If arthrodesis of the CMCJ is not performed, plate removal should be considered before breakage occurs. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- David H Owen
- Canberra Hospital, ACT, Australia
- Australian National University Medical School, Canberra, ACT, Australia
| | | | - Xu Cong
- The University of Melbourne, VIC, Australia
| | | | - Diana M Perriman
- Canberra Hospital, ACT, Australia
- Australian National University Medical School, Canberra, ACT, Australia
| | - Chris J Roberts
- Canberra Hospital, ACT, Australia
- Australian National University Medical School, Canberra, ACT, Australia
| | - Paul N Smith
- Canberra Hospital, ACT, Australia
- Australian National University Medical School, Canberra, ACT, Australia
| | - Herwig Drobetz
- Lismore Base Hospital, NSW, Australia
- Bond University, Robina, QLD, Australia
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Rioux-Forker D, Patel RS, Hinchcliff KM, Shin AY. The Effect of 3rd Carpometacarpal Arthrodesis in the Outcomes of Total Wrist Fusion Using Modern Plate Technology. J Wrist Surg 2023; 12:400-406. [PMID: 37841357 PMCID: PMC10569833 DOI: 10.1055/s-0043-1768945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/28/2022] [Indexed: 10/17/2023]
Abstract
Background The inclusion of the third carpometacarpal (CMC) joint in the fusion mass in total wrist fusion (TWF) remains controversial. Our goal was to evaluate the clinical outcomes and effects of third CMC joint arthrodesis compared with bridging the CMC joint during TWF. A retrospective chart review was performed. Outcomes assessed included hardware loosening, hardware failure, symptomatic hardware necessitating removal, and need for revision arthrodesis. Case Description/Literature Review We found that concomitant third CMC joint arthrodesis was associated with a significantly reduced rate of radiocarpal and midcarpal joint nonunion, hardware loosening, and symptomatic hardware removal when compared to bridging of the CMC joint. There was no significant difference in hardware failure rates or the need for revision arthrodesis. Clinical Relevance When using a contoured dorsal spanning plate, concomitant CMC joint arthrodesis should be considered during TWF to mitigate against hardware loosening and symptomatic hardware. Level of Evidence Level IV.
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Affiliation(s)
- Dana Rioux-Forker
- Division of Plastic Surgery, Department of Surgery, Saint Luke's Hospital, Kansas City, Missouri
| | - Raahil S. Patel
- Department of Orthopedic Surgery, University of South Florida, Tampa, Florida
| | - Katharine M. Hinchcliff
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, California
| | - Alexander Y. Shin
- Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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Bhat AK, Pai GM, Acharya AM, Manohar A. Wrist Arthrodesis Using a Trapezoidal Wedge Graft from the Distal Radius and a Low-Profile Reconstruction Plate. Indian J Orthop 2023; 57:1092-1099. [PMID: 37384010 PMCID: PMC10293482 DOI: 10.1007/s43465-023-00884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/24/2023] [Indexed: 06/30/2023]
Abstract
Background Various intramedullary or dorsally based fusions have been utilised to perform wrist arthrodesis. Although the dorsal plate is rigid and well constructed, the standard of care was replenishing the arthrodesis site with an iliac crest bone graft. Due to the high morbidity of the donor site, alternatives such as distal radius bone grafts have gained popularity. In this study, wrist arthrodesis was performed with a locally accessible trapezoidal wedge graft from the distal radius and a low-profile reconstruction plate to evaluate the radiological and functional outcome. Methods We retrospectively reviewed 22 wrists, 14 brachial plexus injuries, 4 post-traumatic injuries, and 4 rheumatoid arthritis patients, with a mean follow-up of 31 months. Union was evaluated on radiography. The functional outcomes were evaluated using a visual analog scale incorporated into a questionnaire. Results All 22 fusions united successfully, with a mean duration of 12 weeks and a wrist position of an average 17.5 degrees of extension and 6 degrees of ulnar deviation. The aesthetics of the wrist showed the most significant change, and overall satisfaction levels increased. Conclusions A locally accessible cortico-cancellous graft from the dorsum of the radius is a reliable alternative to an iliac crest or carpal bone graft with high potential for the union. It also serves as a stable strut in our construct, allowing us to use a low-profile reconstruction plate. The Reconstruction (3.5 System) plate can be used safely with excellent results and a low implant prominence or breakage risk.
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Affiliation(s)
- Anil K. Bhat
- Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104 India
| | - G. Mithun Pai
- Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104 India
| | - Ashwath M. Acharya
- Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104 India
| | - Amruth Manohar
- Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104 India
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Aßmann AD, Fürst AE, Bischofberger AS. Standing osteosynthesis of an accessory carpal bone fracture in a Warmblood mare with a 6‐hole 3.5 talonavicular fusion plate and 3.5‐mm screws. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Anton D. Aßmann
- The Equine Hospital, Vetsuisse‐Faculty University of Zurich Zurich Switzerland
| | - Anton E. Fürst
- The Equine Hospital, Vetsuisse‐Faculty University of Zurich Zurich Switzerland
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Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture. HAND SURGERY & REHABILITATION 2021; 41:42-47. [PMID: 34688950 DOI: 10.1016/j.hansur.2021.10.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
Total wrist arthrodesis in severe wrist flexion deformities (greater than 60°) due to spasticity represents a valid therapeutic option. It aims to improve the hand's appearance, hygiene, function and to prevent the deformity from getting worse. The objective of this study is to evaluate the clinical and anatomical results of wrist shortening arthrodesis using a classic volar plate in the dorsal position in functional surgery for central spastic hands. We conducted a single-center analysis of a series of patients who underwent this shortening arthrodesis. The review at a minimum 1-year follow-up included a clinical evaluation (House score, INOM score, patient satisfaction and complications), and anatomical evaluation (arthrodesis position, bone healing and carpometacarpal arthropathy). Twenty-eight patients with a mean age of 40.6 years (18-74) were included at a mean follow-up of 30.6 months (12-75). The fusion rate was 100%. No carpometacarpal arthropathy was noted. The mean position of the fused wrist was 11° extension and 15° ulnar tilt. There were two complications (7%): one postoperative hematoma and one case of discomfort due to impingement that required plate removal. The House score was significantly improved postoperatively (2.4 (0-5) versus 1.8 (0-4), p < 0.001), as was the INOM score (45 (12-64) versus 63 (36-84), p < 0.001). The patient satisfaction rate was 93%. The use of a simple and common material (volar plate in dorsal position) during this challenging surgery (spastic wrist contracture), provides good anatomical results and high patient satisfaction. LEVEL OF EVIDENCE: Level 4, case series, therapeutic study.
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Owen DH, Perriman DM, Policinski I, Damiani M, Smith PN, Roberts CJ. Total wrist arthrodesis with and without arthrodesis of the carpoMetacarpal joint (WAWWAM): study protocol. BMC Musculoskelet Disord 2021; 22:766. [PMID: 34496832 PMCID: PMC8425134 DOI: 10.1186/s12891-021-04644-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background It is controversial whether or not the carpometacarpal joint (CMCJ) should be included in total wrist arthrodesis (TWA). Complications commonly occur at this site and studies examining its inclusion and exclusion are conflicting. A randomised clinical trial comparing wrist arthrodesis with CMCJ arthrodesis and spanning plate to wrist arthrodesis with CMCJ preservation and non-CMCJ spanning plate has not been performed. Method A single centre randomised clinical trial including 120 adults with end-stage isolated wrist arthritis will be performed to compare TWA with and without the CMCJ included in the arthrodesis. The primary outcome is complications in the first post-operative year. Secondary outcomes are Disabilities of the Arm, Shoulder and Hand (DASH) score, Patient Rated Wrist Evaluation (PRWE) and grip strength measured at 1, 2 and 5 years. Late complications, return to work and satisfaction will also be recorded. Discussion It is unknown whether the CMCJ should be included in TWA. This trial will contribute to an improved understanding of optimal management of the CMCJ in total wrist arthrodesis. Trial registration This trial was prospectively registered with the Australia New Zealand Clinical Trials Registry with identifying number ACTRN12621000169842 on the 16th February 2021. WHO: U1111–12626523. ANZCTR: ACTRN12621000169842 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04644-4.
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Affiliation(s)
- David H Owen
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6 Level 1, PO Box Woden ACT, Canberra, 2606, Australia. .,Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra, 0200, Australia.
| | - Diana M Perriman
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6 Level 1, PO Box Woden ACT, Canberra, 2606, Australia.,Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra, 0200, Australia
| | - Igor Policinski
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6 Level 1, PO Box Woden ACT, Canberra, 2606, Australia.,Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra, 0200, Australia
| | - Maurizio Damiani
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6 Level 1, PO Box Woden ACT, Canberra, 2606, Australia.,Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra, 0200, Australia
| | - Paul N Smith
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6 Level 1, PO Box Woden ACT, Canberra, 2606, Australia.,Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra, 0200, Australia
| | - Chris J Roberts
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Building 6 Level 1, PO Box Woden ACT, Canberra, 2606, Australia.,Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra, 0200, Australia
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Spies CK, Ayache A, Löw S, Langer MF, Hohendorff B, Müller LP, Oppermann J, Unglaub F. [Revision surgery after failed (partial-) arthrodesis of the wrist]. DER ORTHOPADE 2020; 49:784-796. [PMID: 32809041 DOI: 10.1007/s00132-020-03967-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
(Partial) arthrodeses of the wrist have been proven cornerstones to treat many lesions for decades, especially in the case of revision surgery. Four-corner, scapho-trapezo-trapezoidal (STT), radio-scapho-lunate (RSL) and total wrist fusions are very common techniques in hand surgery. However, even these proven surgical procedures have significant non-fusion rates. Prior to revising a failed arthrodesis, it is essential to analyse the latter failure precisely. A technically adequate revision is only feasible when based on a correct and meticulous analysis. The understanding of the biological processes and technical aspects of the implants are the basis for solving this issue.
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Affiliation(s)
- C K Spies
- Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland.
| | - A Ayache
- Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland
| | - S Löw
- Praxis für Handchirurgie und Unfallchirurgie, Bad Mergentheim, Deutschland
| | - M F Langer
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland
| | - B Hohendorff
- Abteilung für Hand‑, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Stade, Deutschland
| | - L P Müller
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - J Oppermann
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - F Unglaub
- Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland.,Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
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Quadlbauer S, Pezzei C, Jurkowitsch J, Rosenauer R, Kolmayr B, Keuchel T, Simon D, Beer T, Hausner T, Leixnering M. Rehabilitation after distal radius fractures: is there a need for immobilization and physiotherapy? Arch Orthop Trauma Surg 2020; 140:651-663. [PMID: 32193679 DOI: 10.1007/s00402-020-03367-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 02/07/2023]
Abstract
Although the literature generally agrees that displaced distal radius fractures require surgery, no single consensus exists concerning the length of immobilization and type of post-operative physiotherapeutic rehabilitation program. Palmar locking plate fixation represents a very stable fixation of the distal radius, and was assessed biomechanically in various studies. Surprisingly, most authors report additional immobilization after plate fixation. One reason might be due to the pain caused during active wrist mobilization in the early post-operative stages or secondly to protect the osteosynthesis in the early healing stages preventing secondary loss of reduction. This article addresses the biomechanical principles, current available evidence for early mobilization/immobilization and impact of physiotherapy after operatively treated distal radius fractures.
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Affiliation(s)
- S Quadlbauer
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria.
- Ludwig Boltzmann Institute for Experimental und Clinical Traumatology, AUVA Research Center, 1200, Vienna, Austria.
- Austrian Cluster for Tissue Regeneration, 1200, Vienna, Austria.
| | - Ch Pezzei
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
| | - J Jurkowitsch
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
| | - R Rosenauer
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental und Clinical Traumatology, AUVA Research Center, 1200, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200, Vienna, Austria
| | - B Kolmayr
- Department of Physiotherapy, AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, 1200, Vienna, Austria
| | - T Keuchel
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
| | - D Simon
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
| | - T Beer
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
| | - T Hausner
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental und Clinical Traumatology, AUVA Research Center, 1200, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200, Vienna, Austria
- Department for Orthopedic Surgery and Traumatology, Paracelsus Medical University, 5020, Salzburg, Austria
| | - M Leixnering
- AUVA Trauma Hospital Lorenz Böhler - European Hand Trauma Center, Donaueschingenstrasse 13, 1200, Vienna, Austria
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