Limits...
Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors.

Jung HW, Hong H, Jung HJ, Kim JS, Park HY, Bae KH, Jeon IH - Clin Orthop Surg (2015)

Bottom Line: A total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study.Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union.Furthermore, dorsal comminutions did not affect secondary displacement directly.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: To evaluate risk factors of redisplacement and remind surgeons of key factors regarding conservative treatment of distal radius fracture.

Methods: A total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study. Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union. Secondary displacement was defined as a loss of reduction during the follow-up period, and was divided into 'early' and 'late' categories. We analyzed the influence of initial displacement radiologic variables, dorsal cortex comminution, and patient age on the development of secondary displacement.

Results: Development of secondary displacement was significantly associated only with initial displacement radiologic variables (p < 0.001), development of the late secondary displacement was significantly associated with age (p = 0.005), and initial displacement radiologic variables were associated significantly with a serial increase in ulnar variance (p = 0.003).

Conclusions: Greater displacement on the initial radiographs indicates a higher possibility of development for secondary displacement, and older patients had a higher probability of late secondary displacement development. Furthermore, dorsal comminutions did not affect secondary displacement directly.

No MeSH data available.


Related in: MedlinePlus

The lateral radiograph shows a free-floating fragment at dorsal metaphyseal cortex, indicating dorsal comminution.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553288&req=5

Figure 1: The lateral radiograph shows a free-floating fragment at dorsal metaphyseal cortex, indicating dorsal comminution.

Mentions: In our study population, closed reduction and stabilization were performed with the use of a U-shape splint initially, and short arm casts were applied subsequently. Initial X-rays were evaluated for fracture type based on the AO classification. Anteroposterior and lateral X-rays of the wrist were taken at every visit in the outpatient clinic. We analyzed the immediate postreduction X-rays, those taken at the first follow-up visit (1 week after injury), and those taken after union (more than 8 weeks after injury). The radial inclination, radial length, volar tilting angle, ulnar variance, and presence of dorsal metaphyseal comminution were measured. In cases that received surgical treatment due to redisplacement during the follow-up period, the X-rays before surgery were analyzed. Dorsal metaphyseal comminution was determined by the presence of free-floating bone fragments at the dorsal cortex on the lateral radiographs according to Makhni's definition (Fig. 1).13) Radiographic parameters constituting 'acceptable alignment' were dorsal tilt less than 10°, volar tilt ranging from 5° to 25°, radial inclination not less than 17°, and fragment translation less than 2 mm (Table 1).31114)


Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors.

Jung HW, Hong H, Jung HJ, Kim JS, Park HY, Bae KH, Jeon IH - Clin Orthop Surg (2015)

The lateral radiograph shows a free-floating fragment at dorsal metaphyseal cortex, indicating dorsal comminution.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553288&req=5

Figure 1: The lateral radiograph shows a free-floating fragment at dorsal metaphyseal cortex, indicating dorsal comminution.
Mentions: In our study population, closed reduction and stabilization were performed with the use of a U-shape splint initially, and short arm casts were applied subsequently. Initial X-rays were evaluated for fracture type based on the AO classification. Anteroposterior and lateral X-rays of the wrist were taken at every visit in the outpatient clinic. We analyzed the immediate postreduction X-rays, those taken at the first follow-up visit (1 week after injury), and those taken after union (more than 8 weeks after injury). The radial inclination, radial length, volar tilting angle, ulnar variance, and presence of dorsal metaphyseal comminution were measured. In cases that received surgical treatment due to redisplacement during the follow-up period, the X-rays before surgery were analyzed. Dorsal metaphyseal comminution was determined by the presence of free-floating bone fragments at the dorsal cortex on the lateral radiographs according to Makhni's definition (Fig. 1).13) Radiographic parameters constituting 'acceptable alignment' were dorsal tilt less than 10°, volar tilt ranging from 5° to 25°, radial inclination not less than 17°, and fragment translation less than 2 mm (Table 1).31114)

Bottom Line: A total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study.Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union.Furthermore, dorsal comminutions did not affect secondary displacement directly.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: To evaluate risk factors of redisplacement and remind surgeons of key factors regarding conservative treatment of distal radius fracture.

Methods: A total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study. Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union. Secondary displacement was defined as a loss of reduction during the follow-up period, and was divided into 'early' and 'late' categories. We analyzed the influence of initial displacement radiologic variables, dorsal cortex comminution, and patient age on the development of secondary displacement.

Results: Development of secondary displacement was significantly associated only with initial displacement radiologic variables (p < 0.001), development of the late secondary displacement was significantly associated with age (p = 0.005), and initial displacement radiologic variables were associated significantly with a serial increase in ulnar variance (p = 0.003).

Conclusions: Greater displacement on the initial radiographs indicates a higher possibility of development for secondary displacement, and older patients had a higher probability of late secondary displacement development. Furthermore, dorsal comminutions did not affect secondary displacement directly.

No MeSH data available.


Related in: MedlinePlus