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Begum R, Hourston GJM, Bochmann T, Chojnowski AJ. A Systematic 10-Year Review of the Use of Arthroscopy in the Assessment and Treatment of Intercarpal Ligament Injuries Associated with Acute Distal Radius Fracture. J Hand Surg Asian Pac Vol 2022; 27:935-944. [PMID: 36476085 DOI: 10.1142/s2424835522500862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: To review the impact that arthroscopy has made on the assessment and treatment of intercarpal (scapholunate [SL] or lunotriquetral [LT]) ligament injuries associated with acute distal radius fractures (DRF). Methods: A systematic review of EMBASE, MEDLINE and COCHRANE databases for articles published between 2011 and 2021 was performed (PROSPERO ID: CRD42021273293) which included studies reported assessment and outcomes of intercarpal ligament injuries associated with acute DRF. Methodological quality was evaluated. The rate of concomitant injury detection, role of arthroscopy and different clinical outcome assessment measurements used were compared between studies. Results: A total of 20 articles were included with data from 1,346 patients (1,358 wrists). A total of 1,024 intra-articular fractures were included and 294 extra-articular fractures (40 not specified). There was a heterogeneous mix of studies; 10 comparative and 10 non-comparative. Some studies investigated initial assessment findings only, while others assessed radiological outcomes, functional outcomes or both domains over 0.3-99 months. The overall rate of SL ligament injury associated with DRF was 35.3%, while LT ligament injury overall was 18.2%. More frequent were concomitant triangular fibrocartilage complex (TFCC) injuries (44.8%), although this review did not aim to review these. The role of arthroscopy was reviewed, which included assistance in anatomic reduction of the articular surface and systematic inspection of the surrounding soft tissues. Included studies investigated either assessment or assessment and management of intercarpal ligament injury. Meaningful meta-analysis in this heterogeneous group of studies was not possible. Outcomes of comparative studies were described in detail. Conclusions: This review suggests that arthroscopy may have a role in improving reduction of intra-articular DRF and diagnosing and managing soft tissue injuries associated with such fractures. Randomised studies are needed to evaluate whether the detection of intercarpal ligament injury in acute distal radial fractures through arthroscopic assessment alters current management and improves clinical outcome. Level of Evidence: Level III (Therapeutic).
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Affiliation(s)
- Rumina Begum
- Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospital, Norwich, UK
| | - George J M Hourston
- Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospital, Norwich, UK
| | - Thomas Bochmann
- Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospital, Norwich, UK
| | - Adrian J Chojnowski
- Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospital, Norwich, UK
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ÇETİN MÜ, POLAT A, FİDAN F. Orta kolonu ilgilendiren distal radius kırıklarında artroskopik destekli fragman spesifik fiksasyon standart volar plak ile fiksasyona göre üstün müdür? CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1087119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: In this study, the clinical and radiological results of volar plating and arthroscopic intervention-assisted fragment-specific fixation techniques used in patients operated for AO Type B-C distal radius fracture in which the medial colon is affected were compared.
Materials and Methods: X-ray and clinical records of 98 patients who underwent surgical treatment for radius distal end (DER) fracture between April 2011 and January 2017. The patient groups treated with arthroscopy-assisted fragment-oriented fixation (Group A) and plate screw fixation with a volar approach without arthroscopic intervention (Group B) were compared in terms of joint range of motion, grip strength, and clinical scores. Flexion and extension, ulnar deviation, radial deviation, pronation, and supination angles measured with a standard goniometer were recorded in the joint range of motion measurement. Grip strength was measured with a Jamar dynamometer for power measurement. DASH score was used in clinical evaluation.
Results: When the operated wrists of both patient groups were compared, there was no significant difference between the DASH score, grip strength, palmar flexion, and pronation angles of motion. A statistically significant difference was observed between the mean dorsiflexion angles of 55 degrees in group A and 44 degrees in group B, mean radial deviation angles of 25 and 19 degrees, and the mean supination angles of 87 and 80 degrees, respectively.
Conclusion: Although arthroscopic-assisted fragment-specific fixation is technically a laborious procedure that requires a learning curve in patients with intra-articular distal radius fractures, it may be beneficial to provide better postoperative results, especially in young patients with high range of motion expectations.
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Affiliation(s)
| | - Abdulkadir POLAT
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL GAZİOSMANPAŞA TAKSİM HEALTH RESEARCH CENTER
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Scollan JP, Ohliger E, Emara AK, Grits D, McConaghy K, Ng M, Styron J. Prolonged Operative Time Associated with Increased Healthcare Utilization after Open Reduction and Internal Fixation of Intra-Articular and Extra-Articular Distal Radial Fractures: An Analysis of 17,482 Cases. J Wrist Surg 2022; 11:307-315. [PMID: 35971471 PMCID: PMC9375674 DOI: 10.1055/s-0041-1736606] [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: 07/19/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
Background The current literature does not contain a quantitative description of the associations between operative time and adverse outcomes after open reduction and internal fixation (ORIF) of distal radial fractures (DRF). Questions/Purpose We aimed to quantify associations between DRF ORIF operative time and 1) 30-day postoperative health care utilization and 2) the incidence of local wound complications. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for DRF ORIF cases (January 2012-December 2018). A total of 17,482 cases were identified. Primary outcomes included health care utilization (length of stay [LOS], discharge dispositions, 30-day readmissions, and reoperations) per operative-time category. Secondary outcome was incidence of wound complications per operative-time category. Multivariate regression was conducted to determine operative-time categories associated with increased risk while adjusting for demographics, comorbidities, and fracture type. Spline regression models were constructed to visualize associations. Results The 121 to 140-minute category was associated with significantly higher risk of a LOS > 2 days (odds ration [OR]: 1.64; 95% confidence interval [CI]:1.1-2.45; p = 0.014) and nonhome discharge (OR: 1.72; 95% CI:1.09-2.72; p = 0.02) versus 41 to 60-minute category. The ≥ 180-minute category exhibited highest odds of LOS > 2 days (OR: 2.08; 95%CI: 1.33-3.26; p = 0.001), nonhome discharge disposition (OR: 1.87; 95% CI: 1.05-3.33; p = 0.035), and 30-day reoperation occurrence (OR: 3.52; 95% CI: 1.59-7.79; p = 0.002). There was no association between operative time and 30-day readmission ( p > 0.05 each). Higher odds of any-wound complication was first detected at 81 to 100-minute category (OR: 3.02; 95% CI: 1.08-8.4; p = 0.035) and peaked ≥ 181 minutes (OR: 9.62; 95% CI: 2.57-36.0; p = 0.001). Spline regression demonstrated no increase in risk of adverse outcomes if operative times were 50 minutes or less. Conclusion Our findings demonstrate that prolonged operative time is correlated with increased odds of health care utilization and wound complications after DRF ORIF. Operative times greater than 60 minutes seem to carry higher odds of postoperative complications.
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Affiliation(s)
- Joseph P. Scollan
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Erin Ohliger
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Ahmed K. Emara
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Daniel Grits
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Kara McConaghy
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Mitchell Ng
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Joseph Styron
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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Shihab Z, Sivakumar B, Graham D, Del Piñal F. Outcomes of Arthroscopic-Assisted Distal Radius Fracture Volar Plating: A Meta-Analysis. J Hand Surg Am 2022; 47:330-340.e1. [PMID: 35168831 DOI: 10.1016/j.jhsa.2021.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 09/06/2021] [Accepted: 11/10/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The use of wrist arthroscopy to assist fixation of distal radius fractures with volar locking plates (VLPs) has been gaining popularity in recent years; however, there is no consensus on its benefits. This meta-analysis compares outcomes of arthroscopic-assisted VLP to fluoroscopic-assisted VLP in distal radius fractures through a systematic review of the published literature. METHODS A systematic search of publications from databases (Medline, EMBASE, Scopus, and Cochrane) was obtained from inception to May 2020. A random-effects meta-analysis was used to calculate effect sizes. Outcomes included postoperative radiographic reduction (gap, stepoff, radial inclination, volar tilt, and ulnar variance), procedural outcomes (operative time, additional soft tissue injuries and complications), and functional outcomes (range of motion; visual analog scale score; Disabilities of the Arm, Shoulder, and Hand score; Patient-Rated Wrist Evaluation score; Mayo clinic score; and grip strength). RESULTS Six studies, involving 280 patients, met the final inclusion criteria. The meta-analysis for postoperative stepoff was statistically significant, favoring arthroscopic-assisted VLP. In addition, there was greater identification of associated soft tissue injuries, increased wrist extension, and a longer operative duration when performing arthroscopic-assisted VLP fixation. There were no differences in other postoperative radiographic outcomes, complications, or functional outcomes. CONCLUSIONS The current literature suggests that arthroscopic-assisted VLP is a useful adjunct to intra-articular reduction and treatment of associated soft tissue injuries in distal radius fractures. Considerations should include operative time, costs, and the additional training required. Further studies are needed to assess functional outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
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Affiliation(s)
- Zaid Shihab
- Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, Queensland, Australia.
| | - Brahman Sivakumar
- Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Queensland, Australia; Department of Hand & Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - David Graham
- Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, Queensland, Australia; Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Queensland, Australia; Griffith University School of Medicine and Dentistry, Southport, Queensland, Australia; Departmemt of Orthopaedic Surgery, Queensland Children's Hospital, South Brisbane, Queensland, Australia
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Mirarchi AJ, Nazir OF. Minimally Invasive Surgery: Is There a Role in Distal Radius Fracture Management? Curr Rev Musculoskelet Med 2021; 14:95-100. [PMID: 33443658 PMCID: PMC7930151 DOI: 10.1007/s12178-020-09689-x] [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] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW This review explores minimally invasive surgical techniques for distal radius fractures and guides their use in conjunction with, or as an alternative to, volar locked plating. RECENT FINDINGS Fractures of the lunate facet, die-punch fractures, and marginal articular shear injuries present challenges that cannot be easily addressed with volar plating. The use of external fixation, Kirschner wires, and dorsal bridge plating should all be considered. These techniques, in combination and in addition to volar locked plating, continue to play an important role in fracture management. Arthroscopically assisted surgery with minimally invasive fixation allows for detailed inspection of the radiocarpal joint. Closed treatment and casting continue to play an important role in distal radius fracture care. The role of minimally invasive surgery for distal radius fractures is still being defined. While fixation using a volar locking plate is by far the most common treatment method, other techniques should be considered to improve outcomes and decrease complications.
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Affiliation(s)
- Adam J. Mirarchi
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, USA
| | - Omar F. Nazir
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, USA
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Ding H, Lu Y. [Research progress in the treatment of distal radius fractures assisted by wrist arthroscopy]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:1341-1345. [PMID: 33063502 DOI: 10.7507/1002-1892.201912041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To review the research progress of wrist arthroscopy assisted treatment of distal radius fractures. Methods To summarize and describe the anatomical characteristics and fracture classification of the distal radius, indications and contraindications of wrist arthroscopy-assisted treatment, surgical methods, and associated soft tissue injuries, and summarize the advantages and disadvantages of the operation through a large number of literature at home and abroad on the treatment of distal radius fractures assisted by wrist arthroscopy. Results Wrist arthroscopy as a minimally invasive technique for the treatment of distal radius fractures, compared with traditional surgery, can accurately observe intra-articular damage and perform operations under the microscope to avoid secondary damage to blood vessels, nerve, and tendon, etc., and can achieve one-stage repair and reconstruction by repairing the ligament, trigonal fibrocartilage complex, and carpal dislocation. It has the advantages of less trauma, fast postoperative recovery, extensive indications, fewer complications, and satisfactory effectiveness. Conclusion Wrist arthroscopy has advantages that traditional X-ray film, CT, MRI, and arthrography examinations do not have. Moreover, wrist arthroscopy has achieved satisfactory effectiveness in the adjuvant treatment of intra-articular distal radius fractures.
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Affiliation(s)
- Haibo Ding
- Tianjin Medical University, Tianjin, 300070, P.R.China
| | - Yun Lu
- Department of Hand and Foot Surgery and Reparative and Reconstructive Surgery, Tianjin Union Medical Center, Tianjin, 300121, P.R.China
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Meaike JJ, Kakar S. Management of Comminuted Distal Radius Fractures: A Critical Analysis Review. JBJS Rev 2020; 8:e2000010. [PMID: 32960024 DOI: 10.2106/jbjs.rvw.20.00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Distal radius fractures occur in a bimodal age and sex distribution. Their incidence continues to rise with an increasingly active aging population. The current American Academy of Orthopaedic Surgeons guidelines for operative intervention are radial shortening of >3 mm, dorsal tilt of >10[degrees], or intra-articular displacement or step-off of >2 mm. The method of reduction and fixation should be selected on a case-by-case basis with a focus on patient factors, fracture behavior, surgical proficiency, and functional outcomes.
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Affiliation(s)
- Joshua J Meaike
- 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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Kastenberger T, Kaiser P, Schmidle G, Schwendinger P, Gabl M, Arora R. Arthroscopic assisted treatment of distal radius fractures and concomitant injuries. Arch Orthop Trauma Surg 2020; 140:623-638. [PMID: 32193675 PMCID: PMC7181439 DOI: 10.1007/s00402-020-03373-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 12/16/2022]
Abstract
Wrist arthroscopy is mainly used to assist fracture reduction and fixation and to diagnose and treat concomitant injuries mainly to the scapholunate (SL), lunotriquetral (LT) ligament and the triangular fibrocartilage complex (TFCC). Arthroscopy is beneficial in improving anatomical reduction of fracture steps and gaps in intra-articular distal radius fractures (DRFs). Yet, the literature that the functional outcome correlates with the use of arthroscopy, is limited. Non-surgical treatment and immobilization is recommended for Geissler grade I-III Sl-ligament injuries, while open reduction, ligament suture and/or K-wire pinning is mandatory for complete ligament tears according to Geissler grade IV. This manuscript describes the current literature and gives insight into the authors' opinions and practice.
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Affiliation(s)
- Tobias Kastenberger
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Peter Kaiser
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Gernot Schmidle
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Peter Schwendinger
- Department for Trauma Surgery and Sports Traumatology, Academic Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria
| | - Markus Gabl
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Rohit Arora
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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Scapholunate, lunotriquetral and TFCC ligament injuries associated with intraarticular distal radius fractures: Arthroscopic assessment and correlation with fracture types. HAND SURGERY & REHABILITATION 2019; 39:102-106. [PMID: 31874275 DOI: 10.1016/j.hansur.2019.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 10/13/2019] [Accepted: 11/22/2019] [Indexed: 11/21/2022]
Abstract
The aim of this study was to evaluate the prevalence of arthroscopic scapholunate (SL) and/or lunotriquetral (LQ) laxity and triangular fibrocartilaginous complex (TFCC) injuries in patients who have an intraarticular fracture of the distal radius and to correlate these lesions with fracture type. Fifty-seven intraarticular radius fractures, whether or not they were associated with an ulnar styloid fracture, were evaluated and treated by arthroscopy. Scapholunate and lunotriquetral ligament injuries were classified according to the EWAS classification. TFCC lesions were assessed according to Palmer's classification. Each injury was documented through preoperative X-rays and a CT scan. Fracture type and soft tissue injury were not significantly associated one to another. Arthroscopic examination revealed at least one soft tissue injury in 39 intraarticular fractures of the distal radius (68.4%). Twenty-five percent of arthroscopic SL laxities (including severe EWAS 3 injuries) were not detected on standard radiographs. Arthroscopic SL laxity was present in 8 of 11 cases (72.7%) of radial styloid fracture and in 15 of 25 cases (60%) of fractures with at least one radial styloid component. There was no association between LQ integrity and fracture type. Ulnar styloid fractures (base or tip) and TFCC lesions were significantly correlated (P<0.0001). The prevalence of soft tissue lesions secondary to intraarticular fractures of the distal radius was 68.4%. However, there was no statistically significant relationship between the different types of radius fractures and soft tissue injuries. On the other hand, ulnar styloid fracture was predictive of TFCC injury.
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Saab M, Guerre E, Chantelot C, Clavert P, Ehlinger M, Bauer T. Contribution of arthroscopy to the management of intra-articular distal radius fractures: Knowledge update based on a systematic 10-year literature review. Orthop Traumatol Surg Res 2019; 105:1617-1625. [PMID: 31526708 DOI: 10.1016/j.otsr.2019.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 02/02/2023]
Abstract
The objective of this study was to review current data on the contribution of wrist arthroscopy to the management of intra-articular distal radius fractures (IADRFs). The literature published over the last 10 years was reviewed by searching databases with the key indexing terms 'distal radius fracture', 'articular', and 'wrist arthroscopy'. The information in the 21 articles thus retrieved was used to answer the following questions: (i) Can arthroscopy improve the reduction of IADRFs? (ii) How does arthroscopy contribute to the diagnosis and treatment of concomitant ligament injuries? and (iii) Does arthroscopy help to improve the functional scores? The contribution of arthroscopy to IADRF reduction remains controversial. Follow-ups were limited (15 months on average) and some of the studies provided only level IV evidence. The data do not consistently suggest that arthroscopically assisted surgery may improve the quality of reduction. In contrast, they highlight the usefulness of arthroscopy in allowing the same-stage management of carpal ligament injuries. In the 12 studies providing data on this point, scapholunate inter-osseous ligament injuries were present in 41% of cases; one-fourth of these injuries were full-thickness tears that were successfully repaired by arthroscopy. The triangular fibrocartilage complex was injured in 48% of cases, and 30% of these injuries were peripheral ulnar detachments that were successfully repaired by arthroscopy. At present, arthroscopy does not allow the repair of all diagnosed ligament injuries. Comparative studies with longer follow-ups will shed light on the ability of arthroscopy to improve functional scores. LEVEL OF EVIDENCE: IV.
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Affiliation(s)
- Marc Saab
- Service orthopédie B, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France.
| | - Elvire Guerre
- Service orthopédie B, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France
| | - Christophe Chantelot
- Service orthopédie B, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur-Emile-Laine, 59037 Lille cedex, France
| | - Philippe Clavert
- Service de chirurgie du membre supérieur, CCOM, Hôpitaux Universitaires de Strasbourg, avenue Baumann, Illkirch cedex, France
| | - Matthieu Ehlinger
- Service de chirurgie orthopédique et de traumatologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - Thomas Bauer
- Service de chirurgie orthopédique et traumatologie, Hôpital Ambroise Paré AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
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Wollstein R, Allon R, Zvi Y, Katz A, Werech S, Palmon O. Association between Functional Outcomes and Radiographic Reduction Following Surgery for Distal Radius Fractures. J Hand Surg Asian Pac Vol 2019; 24:258-263. [DOI: 10.1142/s2424835519500310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Quality of reduction in distal radius fractures (DRF) is assessed using radiographic parameters, however few studies examine the association between radiographic measurements and functional outcomes. Our purpose was to evaluate the relationship between radiographic measurements and clinical outcome measures following surgery for DRF using detailed testing to demonstrate further associations between post-surgical radiographic measurements and function. Methods: Measurements were performed on postoperative radiographs of 38 patients following ORIF of DRF. Measurements included: radial inclination, radial height, ulnar variance, volar tilt, radiocarpal interval (d2/w2), and the intra-articular step-off. Clinical outcome measures included motion, grip strength, functional dexterity testing, Moberg pick-up test, specific activities of daily living, DASH score, pain scale, manual-assessment questionnaire. Results: Different radiographic parameters correlated with different specific tasks. The parameter correlated with most functional tasks was ulnar-variance. Radial inclination, radial-styloid scaphoid distance, and fracture classification correlated with some functions. Intraarticular step-off, and radial height were not associated with functional testing. Conclusions: Surgical radiographic results may affect post-operative function. Detailed task specific testing may enable a better evaluation of surgical outcomes. Further study and refinement of functional assessment may change our surgical goals in DRF.
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Affiliation(s)
- Ronit Wollstein
- Department of Orthopaedic Surgery, New York University, School of Medicine, New York, NY, USA
- Technion Israel Institute of Technology, School of Medicine, Haifa, Israel
| | - Raviv Allon
- Technion Israel Institute of Technology, School of Medicine, Haifa, Israel
| | - Yoav Zvi
- Technion Israel Institute of Technology, School of Medicine, Haifa, Israel
| | - Alan Katz
- Technion Israel Institute of Technology, School of Medicine, Haifa, Israel
| | - Sharon Werech
- Lin Medical Center, Kupat Holim Clalit, Haifa, Israel
| | - Orit Palmon
- Lin Medical Center, Kupat Holim Clalit, Haifa, Israel
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Does arthroscopic assistance improve reduction in distal articular radius fracture? A retrospective comparative study using a blind CT assessment. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2018; 29:405-411. [DOI: 10.1007/s00590-018-2348-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/25/2018] [Indexed: 10/27/2022]
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Why do we use arthroscopy for distal radius fractures? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2018; 28:1505-1514. [DOI: 10.1007/s00590-018-2263-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 05/30/2018] [Indexed: 01/12/2023]
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