In patients with complex distal radius fractures, reconstruction of the distal radius, ulna, and triangular fibrocartilage complex can be challenging. Welcome to eradius, the website of the international distal radius fracture study group. The dorsal and radial cortices are thin and the volar and ulnar cortices are thick. Request pdf on nov 1, 2012, frederic lebailly and others published osteosynthese des fractures du radius distal par technique hk2 find, read and cite all the research you need on. Incidence fractures of the distal end radius represent approximately 16% of all fractures treated by orthopaedic. Osteosynthese des fractures du radius distal par technique. Effective restoration of the bony architecture requires intimate knowledge of the anatomy of the distal radius, a thorough understanding of the goals of treatment, versatility in surgical approaches, and familiarity with. Maitrise orthopedique articles fractures du radius distal. Distal radius fractures sunshine coast hand therapy. Distal radius anatomy applied to the treatment of wrist. Factors predicting late collapse of distal radius fractures. There is little guidance in the current literature as how to manage these fractures and their associated injuries. Many papers have been written about them, with more than 200 having been published in the first 6 months of 2018 alone.
Hearon, md january 27, 2016 2 epidemiology medicare pts, new hampshire, 19982004 drfx 125 per 10,000 beneficiaries rate for whites 2. Pdf osteosynthese des fractures du radius distal chez l. Redisplacement during nonoperative treatment of distal radius fractures may result in symptomatic malunions in any patient. Although fractures of the distal radius are a common clinical presentation, many factors affect instability of these injuries. Presence or absence of intraarticular involvement 2. Out of the total number of cases n412 for fracture distal end radius, 5012% cases were managed with cast, 9122%with percutaneous fixation with kwire, 98 with external fixature, 78. Osteosynthese des fractures du radius distal chez ladulte. A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Fraktur radius, fraktur ulna, fraktur colles elbow. A transverse, extraarticular fracture of the distal radius distal 2cm of the radius that is angulated dorsally and impacted by the proximal carpal row the scaphoid and lunate, caused by a fall on an outstretched hand. Distal radius fractures have been a common affliction for millennia, but their treatment is a more recent development as a result of human erudition.
Distal radius fractures in adults northwestern university. Morrison, md, george koulouris, mmbs, mmed, franzcr distal radius fractures are the most common upper limb fractures and account for approximately one sixth of all fractures treated in emergency departments. Background the radius is the most common bone in the arm to sustain a fracture. Distal radius radiographic indices and perilunate fracture. Variable angle lcp twocolumn volar distal radius plate 2. Distal radius anatomy applied to the treatment of wrist fractures by plate. Treatment of distal radius fractures orthoguidelines. Six months after a conservatively treated distal radius fracture the mean arc of flexion and extension and the forearm rotation were know to be 75% to 97% and 87 to 97%, respectively, compared with the uninjured side 610.
The aim of this study was to assess the influence of age, sex, distal radial ulnar joint injury druj, ulnar styloid fracture, and dorsal displacement in late collapse of distal radius fractures. The second long bone in the forearm,the ulna,also can be fractured. After soft tissue swelling subsides, open reduction and internal fixation of the distal radius is performed. The management of distal ulnar fractures in adults. Distal radius fractures disclosures i have stock ownership in johnson and johnson and pfizer. Both techniques achieved an 87% successful reduction rate initially. The radial inclination of a distal radius fracture is shown in red in image at right. Distal radius fractures most common ue fx 1 out of 6 fractures seen in er 3rd most common fracture high morbidity rate. Bartons fracture an intraarticular fracture of the distal radius with dislocation of the radiocarpal joint. Long term reduction was decreased in both groups with only.
Redisplacement of distal radius fracture after initial. The radius is the bone in your forearm that is on the same side as your thumb. Distal radius fractures a free powerpoint ppt presentation displayed as a flash slide show on id. Arthroscopic reduction and internal fixation of distal radius. Read online osteosynthese des fractures du radius distal plaques ou. Redisplacement of distal radius fracture after initial closed. Although it appears complicated, it is actually only a four. Features and benefits oblong combihole allows accurate plate positioning on the bone dedicated screws. Severity of these fractures is directly related to bone mineral density of the patient, and clinical results are dependent on this parameter as well. All books are in clear copy here, and all files are secure so dont worry about it. The distal end of the radius is the end that is closest to the wrist. The evolution of distal radius fracture management a. Other closed fractures of distal end of radius alone. O fixateur externe cas clinique resultat traitement des.
In a prospective pilot study of a nonbridging external fixator in early 2001, 6 consecutive cases. These common fractures usually occur when significant force is applied to the distal radial metaphysis. Fractures of the distal radius are common injuries and account for up to 15% of all extremity fractures. Klein, md kennedy white orthopaedic center what is a distal radius fracture. Distal radius fractures are the most common long bone fracture. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. For fragmentspecific fracture fixation with variable angle locking technology.
A line drawn between the distal ends of the articular surface of the radius on a ap view of the wrist. For complete metaphyseal displaced fractures and fractures involving both the radius and ulna, the need for close followup should be emphasised due to the risk of loss of. Oct 25, 2015 in 2002, randomized controlled trial comparing finger trap vs manual manipulation. Classification of distal radius fractures wikipedia. Distal radius radiographic indices may play a role as risk factors in pathogenesis of kienbocks disease, scaphoid fracture and nonunion. Radiographs of the affected wrist are shown in figure a.
W1 role of advanced imaging in distal radius fractures dean federman, mmbs, eoin c. Distal radius fractures what causes this condition. Distal metaphyseal fractures of the radius have very good remodelling potential because of the proximity to the growth plate. Distal radial fracture radiology reference article. The form and severity of fracture of distal radius as well as the concomitant injury of discoligamentary structures of the wrist also depend on the position of the wrist at the moment of hitting the ground. Distal radius fractures are an increasingly prevalent upper extremity injury, especially among elderly patients. The distal apex of the template should be positioned 24 mm proximal to the subchondral surface of the distal radius, between listers tubercle and the center of the lunate facet so that the implant will support the loads in the wrist. Osteosynthese des fractures du radius distal plaques ou. A line that is perpendicular to the diaphysis of the radius. They represent approximately 3% of all upper extremity injures. This site is an academic site devoted to studying distal radius fractures and is open to all surgeons. Distal radius fractures in adults jegan krishnan, mbbs, fracs, phd although distal radius fractures are a common injury in the elderly and young adult population, the classification, treatment options, and assessment of outcomes of these fractures remain controversial.
Fractures du radius et cubitus distal springerlink. The ulna bone may also be broken in younger people, these fractures typically occur during sports or a motor vehicle collision. Slutsky, md, frcsc, mojca herman, ma, otrl, cht 3475 torrance blvd. While immobilization has served as the only available treatment for most of our history, many advances. Closed reduction and kwiring with the kapandji technique.
Fractures of distal end radius are classified on the basis of. Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Fracture, pouteaucolles, extremite inferieure distale du radius. Radius distal, poignet, techniques chirurgicales du poignet, osteosynthese, plaque, broches.
Two hundred twenty three patients were randomized with distal radius fractures to undergo finger trap reduction or manual manipulation. Colles fractures occur proximal to the distal radioulnar joint. For claims with a date of service on or after october 1, 2015, use an equivalent icd10cm code or codes. In younger people, these fractures typically occur during sports or a motor vehicle collision. A distal radius fracture occurs when a sudden force causes the radius bone, located on the thumb side of the wrist, to break. Fraktur radius, fraktur ulna, fraktur colles free download as powerpoint presentation. The distal ulna represents the fixed point around which the radius and the hand acts in daily living.
Evidencebased information on distal radius fracture from hundreds of trustworthy sources for health and social care. Surgical anatomy the distal radius has metaphyseal flare and three articular surfaces. Comment reduire lincidence des cal vicieux des fractures. Distal radial fractures are a heterogeneous group of fractures that occur at the distal radius and are the dominant fracture type at the wrist. In the context of the radius bone, a ray can be thought of rotating around an axis line extending diagonally clarification needed from center of capitulum to the center of distal ulna. Most of these patients can be treated nonoperatively in a plaster of paris, with excellent functional results 2, 3. Nonbridging external fixation for fractures of the distal. In 2002, randomized controlled trial comparing finger trap vs manual manipulation. One study found that only 2 9% of collesfound that only 2. Distal radius fractures are commonly encountered in the ed. In particular, the presence of a dorsally comminuted subset of distal radius fractures presents a challenge, even for internal fixation. Treatment options include conservative management, internal. The work group deemed that it is warranted to issue a recommendation on this topic despite a lack of evidence determining maintenance of adequate fracture reduction during nonoperative treatment. Howev er, unsatisfactory surgical outcomes have been reported in.
Distal radius fracture is the medical term for a broken wrist. Mar 03, 2017 fractures of distal end radius are classified on the basis of. Jan 10, 2015 introduction distal radius fracture represent approximately one sixth of all fractures there are three main peaks of fracture distribution,children aged 514 years,male aged under 50 years and females over the age of 40 years distal radius fractures occur through the distal metaphysis of the radius may involve articular surface frequently. Comment reduire lincidence des cal vicieux des fractures du radius distal par une fixation specifique des fragments radioguidee how well can stepoff and gap distances be reduced when treating intraarticular distal radius fractures with fragmentspecific fixation when using fluoroscopy. Download osteosynthese des fractures du radius distal plaques ou. F, torrance, ca 90503, usa watsonjones pointed out that a fracture is a soft tissue injury that happens to involve the bone 1. Introduction distal radius fracture represent approximately one sixth of all fractures there are three main peaks of fracture distribution,children aged 514 years,male aged under 50 years and females over the age of 40 years distal radius fractures occur through the distal metaphysis of the radius may involve articular surface frequently.
The frykman classification of distal radial fractures is based on the ap appearance and encompasses the eponymous entities of colles fracture, smith fracture, barton fracture, chauffeur fracture it assesses the pattern of fractures, involvement of the radioulnar joint and presence of a distal ulnar fracture classification. En 1964, le rapport castaing a debanalise cette fracture en analysant ses differents aspects et en soulignant les limites du traitement orthopedique. Symptoms include pain, bruising, and rapidonset swelling. The distal radius fracture is the most common type of wrist fracture. Optimized plate design allows for ideal support of the radial and intermediate distal radius columns. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. In a prospective, randomized study of 100 distal radius fractures in adults treated by kwiring, strohm et al 23 found both the functional and radiographic outcomes of. Open reduction and internal fixation of displaced, comminuted. Most of the fractures are caused by a fall on the outstretched hand with the wrist in dorsiflexion.
The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart. Different modalities of distal end radius fracture treatment. Intermediate column fractures icf of the distal radius are fractures only or mainly limited to the middle column of the distal radius that is a result of an axial load passed to the lunate fossa. W1 role of advanced imaging in distal radius fractures. Distal radius fractures are common, comprising 17% of fractures in the upper extremity.
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