Background: The most effective method for the fixation of an intra-articular distal radial fracture has not been established. Two commonly used treatment methods are external fixation combined with percutaneous pin fixation and plate fixation. We performed a prospective multicenter randomized trial to compare these two treatment strategies.
Methods: A total of 137 patients with 144 intra-articular distal radial fractures were recruited into the study. The average age of the patients was forty-two years, and all patients were sixty years old or less. The patients were randomized to fracture fixation with one of the two methods. At six, twelve, and twenty-four months postoperatively, the patients were assessed with use of the Gartland and Werley point system and the modified Green and O'Brien scoring system. Arthritis was graded on radiographs according to a modification of the Knirk and Jupiter criteria.
Results: Seventy-four (51%) of the fractures were treated with external fixation and percutaneous pin fixation, and seventy were treated with dorsal, volar, or combined plate fixation. At the time of the twenty-four-month follow-up, the results for the plate fixation group were significantly better than those for the external fixation and percutaneous pin fixation group according to the Gartland and Werley point system (p = 0.04) and the radiographic arthritis grading system (p = 0.01). The difference was especially notable among patients with AO group-C2 fractures.
Conclusions: Plate fixation is better than external fixation combined with percutaneous pin fixation for the treatment of intra-articular fractures of the distal part of the radius.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2106/JBJS.F.01581 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Robotic-Assisted Decompression, Decortication, and Instrumentation for Minimally Invasive Transforaminal Lumbar Interbody Fusion.
JBJS Essent Surg Tech
December 2024
Department of Spine Surgery, Hospital for Special Surgery, New York, NY.
Article Synopsis
- Robotic-assisted spine surgery enhances the precision and safety of procedures like pedicle screw placement, minimizing blood loss and reducing hospital stays while alleviating postoperative pain.
- Recent advancements allow robotic systems to perform not only screw insertion but also critical tasks like surgical decompression and bone preparation, transitioning from experimental models to actual human applications.
- The Mazor X Stealth Edition Spine Robotic System facilitates these procedures by combining advanced software for planning and real-time imaging, leading to more efficient and accurate minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).
Proximal Humerus Fractures: A Review of Anatomy, Classification, Management Strategies, and Complications.
Cureus
November 2024
Pulmonology and Critical Care, Government Medical College, Srinagar, Srinagar, IND.
Proximal humerus fractures are prevalent in older adults, particularly women, primarily due to osteoporosis and increased fall risk. These fractures often result from low-energy falls in elderly patients, while in younger individuals, they are more likely to occur with high-energy trauma, which may involve additional injuries to soft tissue and neurovascular structures. Proper anatomical understanding, including key structures and blood supply, is crucial for effective management and to prevent complications.
View Article and Find Full Text PDFThe Impact of a Resident, Fellow, or Physician Assistant on Operative Time and Complication Rate in Closed Reduction and Percutaneous Pin Fixation of Pediatric Distal Humerus Supracondylar Fractures.
J Surg Educ
January 2025
University of Minnesota Department of Orthopedic Surgery, Minneapolis, Minnesota; Gillette Children's Specialty Healthcare, Saint Paul, Minnesota; Children's Hospitals and Clinics of Minnesota, Saint Paul, Minnesota.
Objective: We sought to compare operative times and complications for attending surgeons operating alone or with an assistant including an orthopedic resident, fellow, or physician assistant (PA) for closed reduction and percutaneous pinning (CRPP) of pediatric supracondylar humerus fractures (SCH), an archetypal procedure integral to the education of orthopedic trainees.
Design: Using a retrospective database collected following institutional review board approval, a 1-way ANOVA (non-parametric) was used to assess the effect of assistant absence or presence by type of assistant on mean operative time. We analyzed the association between the attending surgeon assistant categories and the complication rate using Fisher's Exact Test.
Case report: Complications after using the "blind-stitch" method in a dairy cow with a left displaced abomasum: treatment, outcome, and economic evaluation.
Front Vet Sci
November 2024
Clinic for Ruminants and Swine, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany.
Article Synopsis
- - A 4th lactation dairy cow had complications after an unsuccessful treatment for a left displaced abomasum (LDA) using the "blind-stitch" method, leading to abnormal health signs and inflammation at the incision site.
- - After administering antibiotics and fluids, the cow underwent a laparotomy and omentopexy surgery to resolve adhesion issues, and was monitored before being discharged two weeks later.
- - The cow produced 18,000 kg of milk post-treatment, with total costs for both interventions at 1,207 €, alongside an estimated revenue loss of 4,168 € due to complications, highlighting the need for careful method selection for LDA corrections.
Safety and Effectiveness of Ultrasound-Guided Percutaneous Versus Open Brachial Artery Access: Results of the Multicenter Prospective ARCHIBAL Study Percutaneous or Open Brachial Artery Access.
Ann Vasc Surg
November 2024
Département de Chirurgie Vasculaire, Clinique Générale, Groupe Vivalto, Annecy, France.
Background: Although brachial access (BA) has become increasingly used in percutaneous endovascular procedures, results from head-to-head comparisons between open brachial access (OBA) and ultrasound-guided percutaneous brachial access (PBA) are limited in the literature. The objective of our multicenter, prospective, noninterventional ARCHIv BrachiAL study was to compare the safety and efficacy of OBA and PBA to perform peripheral arterial interventions.
Methods: From July 2019 to January 2021, all patients needing peripheral endovascular procedures with brachial artery access were consecutively included in the study by 15 surgeons in 14 centers.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!