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. The dorsal and radial cortices are thin and the volar and ulnar cortices are thick. Fraktur radius, fraktur ulna, fraktur colles free download as powerpoint presentation. O fixateur externe cas clinique resultat traitement des. Distal radius anatomy applied to the treatment of wrist. Distal radius fractures what causes this condition. Pdf osteosynthese des fractures du radius distal chez l. 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. Welcome to eradius, the website of the international distal radius fracture study group. Radiographs of the affected wrist are shown in figure a. This site is an academic site devoted to studying distal radius fractures and is open to all surgeons. The evolution of distal radius fracture management a.
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. 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. Read online osteosynthese des fractures du radius distal plaques ou. 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. 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. The ulna bone may also be broken in younger people, these fractures typically occur during sports or a motor vehicle collision.
The radial inclination of a distal radius fracture is shown in red in image at right. Redisplacement during nonoperative treatment of distal radius fractures may result in symptomatic malunions in any patient. Distal radius fractures disclosures i have stock ownership in johnson and johnson and pfizer. Distal radius radiographic indices may play a role as risk factors in pathogenesis of kienbocks disease, scaphoid fracture and nonunion. There is little guidance in the current literature as how to manage these fractures and their associated injuries. 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. These common fractures usually occur when significant force is applied to the distal radial metaphysis. Various factors affect secondary displacement of fracture fragments after anatomic or near anatomic initial closed reduction. A line drawn between the distal ends of the articular surface of the radius on a ap view of the wrist.
Besides pain and swelling,a distal radius fracture may result in the inability to move the wrist. The radius is the bone in your forearm that is on the same side as your thumb. Osteosynthese des fractures du radius distal par technique. Factors predicting late collapse of distal radius fractures.
Slutsky, md, frcsc, mojca herman, ma, otrl, cht 3475 torrance blvd. The second long bone in the forearm,the ulna,also can be fractured. Distal radius fractures are commonly encountered in the ed. All books are in clear copy here, and all files are secure so dont worry about it. In patients with complex distal radius fractures, reconstruction of the distal radius, ulna, and triangular fibrocartilage complex can be challenging. Mar 03, 2017 fractures of distal end radius are classified on the basis of. Comment reduire lincidence des cal vicieux des fractures.
Oct 25, 2015 in 2002, randomized controlled trial comparing finger trap vs manual manipulation. Fractures of distal end radius are classified on the basis of. Features and benefits oblong combihole allows accurate plate positioning on the bone dedicated screws. Distal radius fractures have been a common affliction for millennia, but their treatment is a more recent development as a result of human erudition. Hearon, md january 27, 2016 2 epidemiology medicare pts, new hampshire, 19982004 drfx 125 per 10,000 beneficiaries rate for whites 2. Different modalities of distal end radius fracture treatment. For claims with a date of service on or after october 1, 2015, use an equivalent icd10cm code or codes.
Fractures of the distal radius are common injuries and account for up to 15% of all extremity fractures. Fractures of distal radius account for up to 20% of all fractures treated in emergency department. 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. They represent approximately 3% of all upper extremity injures. Distal radius fractures in adults northwestern university. 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. Fracture, pouteaucolles, extremite inferieure distale du radius. Distal metaphyseal fractures of the radius have very good remodelling potential because of the proximity to the growth plate. Evidencebased information on distal radius fracture from hundreds of trustworthy sources for health and social care. Distal radius fractures are the most common long bone fracture. Incidence fractures of the distal end radius represent approximately 16% of all fractures treated by orthopaedic. After soft tissue swelling subsides, open reduction and internal fixation of the distal radius is performed. Colles fractures occur proximal to the distal radioulnar joint. Many papers have been written about them, with more than 200 having been published in the first 6 months of 2018 alone.
Howev er, unsatisfactory surgical outcomes have been reported in. Surgical anatomy the distal radius has metaphyseal flare and three articular surfaces. Distal radius fractures most common ue fx 1 out of 6 fractures seen in er 3rd most common fracture high morbidity rate. Classification of distal radius fractures wikipedia. 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. 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. Distal radius fractures are common, comprising 17% of fractures in the upper extremity. Distal radius fractures a free powerpoint ppt presentation displayed as a flash slide show on id. En 1964, le rapport castaing a debanalise cette fracture en analysant ses differents aspects et en soulignant les limites du traitement orthopedique.
Background the radius is the most common bone in the arm to sustain a fracture. 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. Other closed fractures of distal end of radius alone. Distal radius fractures sunshine coast hand therapy. Redisplacement of distal radius fracture after initial. Osteosynthese des fractures du radius distal chez ladulte. Optimized plate design allows for ideal support of the radial and intermediate distal radius columns. Download osteosynthese des fractures du radius distal plaques ou. On the other hand, the arthroscope allows us to see inside the joint with.
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. For fragmentspecific fracture fixation with variable angle locking technology. Distal radial fractures are a heterogeneous group of fractures that occur at the distal radius and are the dominant fracture type at the wrist. Fraktur radius, fraktur ulna, fraktur colles elbow.
A distal radius fracture occurs when a sudden force causes the radius bone, located on the thumb side of the wrist, to break. Although it appears complicated, it is actually only a four. Distal radius anatomy applied to the treatment of wrist fractures by plate. The distal end of the radius is the end that is closest to the wrist. W1 role of advanced imaging in distal radius fractures dean federman, mmbs, eoin c. Klein, md kennedy white orthopaedic center what is a distal radius fracture.
W1 role of advanced imaging in distal radius fractures. Treatment of distal radius fractures orthoguidelines. 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. While immobilization has served as the only available treatment for most of our history, many advances. In a prospective pilot study of a nonbridging external fixator in early 2001, 6 consecutive cases. Long term reduction was decreased in both groups with only. Symptoms include pain, bruising, and rapidonset swelling. Closed reduction and kwiring with the kapandji technique. The distal ulna represents the fixed point around which the radius and the hand acts in daily living. Variable angle lcp twocolumn volar distal radius plate 2. Distal radius fractures are an increasingly prevalent upper extremity injury, especially among elderly patients. Open reduction and internal fixation of displaced, comminuted.
F, torrance, ca 90503, usa watsonjones pointed out that a fracture is a soft tissue injury that happens to involve the bone 1. Fractures du radius et cubitus distal springerlink. 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. Bartons fracture an intraarticular fracture of the distal radius with dislocation of the radiocarpal joint. Two hundred twenty three patients were randomized with distal radius fractures to undergo finger trap reduction or manual manipulation. 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. 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. 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. Nonbridging external fixation for fractures of the distal. Presence or absence of intraarticular involvement 2. In particular, the presence of a dorsally comminuted subset of distal radius fractures presents a challenge, even for internal fixation. Most of the fractures are caused by a fall on the outstretched hand with the wrist in dorsiflexion. Although fractures of the distal radius are a common clinical presentation, many factors affect instability of these injuries. Treatment options include conservative management, internal.
Most of these patients can be treated nonoperatively in a plaster of paris, with excellent functional results 2, 3. Distal radius radiographic indices and perilunate fracture. In younger people, these fractures typically occur during sports or a motor vehicle collision. Severity of these fractures is directly related to bone mineral density of the patient, and clinical results are dependent on this parameter as well. Distal radius fracture is the medical term for a broken wrist. Arthroscopic reduction and internal fixation of distal radius. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature. In 2002, randomized controlled trial comparing finger trap vs manual manipulation. The management of distal ulnar fractures in adults. One study found that only 2 9% of collesfound that only 2. Osteosynthese des fractures du radius distal plaques ou. Ppt distal radius fractures powerpoint presentation free.
The distal radius fracture is the most common type of wrist fracture. 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. 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. Maitrise orthopedique articles fractures du radius distal. The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart. 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. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Redisplacement of distal radius fracture after initial closed. Distal radial fracture radiology reference article. Both techniques achieved an 87% successful reduction rate initially.
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