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Pre-Operative Assessment in Distal Radius Fractures

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Arthroscopic Management of Distal Radius Fractures

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Abstract

The determinants of clinical outcome following distal radial fracture are multi-factorial and may provide several challenges to the treating surgeon. These can be considered under the following headings: patient history including medical co-morbidities, functional demands and injury history; examination findings including the condition of the soft tissue envelope and neurological status; radiographic parameters including fracture characteristics, articular involvement, stability features and associated injuries to the ulna or carpus. Finally, classification of the injury may aid treatment selection and prognostic prediction. With vigilant pre-operative planning, the surgeon can ensure the best outcome for an individual patient.

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References

  1. Abbaszadegan H, Jonsson U, von Sivers K. Prediction of instability of Colles’ fractures. Acta Orthop Scand. 1989;60: 646–50

    Article  CAS  PubMed  Google Scholar 

  2. Andersen DJ, Blair WF, Steyers CM Jr, et al. Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility. J Hand Surg [Am]. 1996;21:574–82

    Article  CAS  Google Scholar 

  3. Apergis E, Darmanis S, Theodoratos G, et al. Beware of the ulno-palmar distal radial fragment. J Hand Surg [Br]. 2002; 27:139–45

    CAS  Google Scholar 

  4. Auge WK II, Velazquez PA. The application of indirect reduction techniques in the distal radius: the role of adjuvant arthroscopy. Arthroscopy. 2000;16:830–5

    Article  PubMed  Google Scholar 

  5. Bacorn RW, Kurtzke JF. Colles’ fracture; a study of two thousand cases from the New York State Workmen’s Compensation Board. J Bone Joint Surg Am. 1953;35-A: 643–58

    CAS  PubMed  Google Scholar 

  6. Bauman TD, Gelberman RH, Mubarak SJ, et al. The acute carpal tunnel syndrome. Clin Orthop Relat Res. 1981;(156): 151–6

    Google Scholar 

  7. Berger RA. The anatomy of the ligaments of the wrist and distal radioulnar joints. Clin Orthop Relat Res. 2001;(383): 32–40

    Google Scholar 

  8. Capo JT, Accousti K, Jacob G, et al. The effect of rotational malalignment on X-rays of the wrist. J Hand Surg Eur. 2009; 34:166–72

    CAS  Google Scholar 

  9. Cassebaum WH. Colles’ fracture; a study of end results. J Am Med Assoc. 1950;143:963–5

    CAS  PubMed  Google Scholar 

  10. Cole RJ, Bindra RR, Evanoff BA, et al. Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography. J Hand Surg [Am]. 1997;22: 792–800

    Article  CAS  Google Scholar 

  11. Cooney WP III, Linscheid RL, Dobyns JH. External pin fixation for unstable Colles’ fractures. J Bone Joint Surg Am. 1979;61:840–5

    PubMed  Google Scholar 

  12. del Piñal F. Dry arthroscopy of the wrist: its role in the management of articular distal radius fractures. Scand J Surg. 2008;97:298–304

    PubMed  Google Scholar 

  13. del Piñal F, Garcia-Bernal FJ, Pisani D, et al. Dry arthroscopy of the wrist: surgical technique. J Hand Surg Am. 2007; 32:119–23

    Article  PubMed  Google Scholar 

  14. Epner RA, Bowers WH, Guilford WB. Ulnar variance–the effect of wrist positioning and roentgen filming technique. J Hand Surg [Am]. 1982;7:298–305

    CAS  Google Scholar 

  15. Fernandez DL. Fractures of the distal radius: operative treatment. Instr Course Lect. 1993;42:73–88

    CAS  PubMed  Google Scholar 

  16. Flinkkila T, Nikkola-Sihto A, Kaarela O, et al. Poor interobserver reliability of AO classification of fractures of the ­distal radius. Additional computed tomography is of minor value. J Bone Joint Surg Br. 1998;80:670–2

    Article  Google Scholar 

  17. Flinkkila T, Nikkola-Sihto A, Raatikainen T, et al. Role of metaphyseal cancellous bone defect size in secondary displacement in Colles’ fracture. Arch Orthop Trauma Surg. 1999;119:319–23

    Article  CAS  PubMed  Google Scholar 

  18. Forward DP, Davis TR, Sithole JS. Do young patients with malunited fractures of the distal radius inevitably develop symptomatic post-traumatic osteoarthritis? J Bone Joint Surg Br. 2008;90:629–37

    CAS  PubMed  Google Scholar 

  19. Friberg S, Lundstrom B. Radiographic measurements of the radio-carpal joint in normal adults. Acta Radiol Diagn (Stockh). 1976;17:249–56

    CAS  Google Scholar 

  20. Frykman G. Fracture of the distal radius including sequelae–shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand Suppl. 1967; 108:103+

    Google Scholar 

  21. Gelberman RH, Salamon PB, Jurist JM, et al. Ulnar variance in Kienbock’s disease. J Bone Joint Surg Am. 1975;57:674–6

    CAS  PubMed  Google Scholar 

  22. Graham TJ. Surgical correction of malunited fractures of the distal radius. J Am Acad Orthop Surg. 1997;5:270–81

    PubMed  Google Scholar 

  23. Harness NG, Ring D, Zurakowski D, et al. The influence of three-dimensional computed tomography reconstructions on the characterization and treatment of distal radial fractures. J Bone Joint Surg Am. 2006;88:1315–23

    Article  PubMed  Google Scholar 

  24. Howard PW, Stewart HD, Hind RE, et al. External fixation or plaster for severely displaced comminuted Colles’ fractures? A prospective study of anatomical and functional results. J Bone Joint Surg Br. 1989;71:68–73

    CAS  PubMed  Google Scholar 

  25. Johnston GH, Friedman L, Kriegler JC. Computerized tomographic evaluation of acute distal radial fractures. J Hand Surg [Am]. 1992;17:738–44

    Article  CAS  Google Scholar 

  26. Jupiter JB, Fernandez DL. Comparative classification for fractures of the distal end of the radius. J Hand Surg [Am]. 1997;22:563–71

    Article  CAS  Google Scholar 

  27. Katz MA, Beredjiklian PK, Bozentka DJ, et al. Computed tomography scanning of intra-articular distal radius fractures: does it influence treatment? J Hand Surg [Am]. 2001; 26:415–21

    Article  CAS  Google Scholar 

  28. Kazuki K, Kusunoki M, Shimazu A. Pressure distribution in the radiocarpal joint measured with a densitometer designed for pressure-sensitive film. J Hand Surg [Am]. 1991; 16:401–8

    Article  CAS  Google Scholar 

  29. Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68:647–59

    CAS  PubMed  Google Scholar 

  30. Koh S, Andersen CR, Buford WL Jr, et al. Anatomy of the distal brachioradialis and its potential relationship to distal radius fracture. J Hand Surg [Am]. 2006;31:2–8

    Article  Google Scholar 

  31. Kopylov P, Johnell O, Redlund-Johnell I, et al. Fractures of the distal end of the radius in young adults: a 30-year follow-up. J Hand Surg [Br]. 1993;18:45–9

    CAS  Google Scholar 

  32. Kreder HJ, Hanel DP, McKee M, et al. Consistency of AO fracture classification for the distal radius. J Bone Joint Surg Br. 1996;78:726–31

    CAS  PubMed  Google Scholar 

  33. Kreder HJ, Hanel DP, McKee M, et al. X-ray film measurements for healed distal radius fractures. J Hand Surg [Am]. 1996;21:31–9

    Article  CAS  Google Scholar 

  34. Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury. 1989;20:208–10

    Article  CAS  PubMed  Google Scholar 

  35. Lewis MH. Median nerve decompression after Colles’s fracture. J Bone Joint Surg Br. 1978;60-B:195–6

    CAS  PubMed  Google Scholar 

  36. Lidstrom A. Fractures of the distal end of the radius. A clinical and statistical study of end results. Acta Orthop Scand Suppl. 1959;41:1–118

    CAS  PubMed  Google Scholar 

  37. Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg [Am]. 2000;25:464–8

    Article  CAS  Google Scholar 

  38. Lozano-Calderon SA, Doornberg J, Ring D. Fractures of the dorsal articular margin of the distal part of the radius with dorsal radiocarpal subluxation. J Bone Joint Surg Am. 2006;88:1486–93

    Article  PubMed  Google Scholar 

  39. Lundy DW, Quisling SG, Lourie GM, et al. Tilted lateral radiographs in the evaluation of intra-articular distal radius fractures. J Hand Surg [Am]. 1999;24:249–56

    Article  CAS  Google Scholar 

  40. Mackenney PJ, McQueen MM, Elton R. Prediction of instability in distal radial fractures. J Bone Joint Surg Am. 2006; 88:1944–51

    Article  CAS  PubMed  Google Scholar 

  41. McQueen M, Caspers J. Colles fracture: does the anatomical result affect the final function? J Bone Joint Surg Br. 1988;70:649–51

    CAS  PubMed  Google Scholar 

  42. Medoff RJ. Essential radiographic evaluation for distal radius fractures. Hand Clin. 2005;21:279–88.

    Article  PubMed  Google Scholar 

  43. Melone CP Jr. Articular fractures of the distal radius. Orthop Clin North Am. 1984;15:217–36

    PubMed  Google Scholar 

  44. Melone CP Jr. Open treatment for displaced articular fractures of the distal radius. Clin Orthop Relat Res. 1986;(202): 103–11

    Google Scholar 

  45. Melone CP Jr. Distal radius fractures: patterns of articular fragmentation. Orthop Clin North Am. 1993;24:239–53

    PubMed  Google Scholar 

  46. Miyake T, Hashizume H, Inoue H, et al. Malunited Colles’ fracture. Analysis of stress distribution. J Hand Surg [Br]. 1994;19:737–42

    CAS  Google Scholar 

  47. Nesbitt KS, Failla JM, Les C. Assessment of instability factors in adult distal radius fractures. J Hand Surg [Am]. 2004;29:1128–38

    Article  Google Scholar 

  48. Orbay JL, Fernandez DL. Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg [Am]. 2004;29:96–102

    Article  Google Scholar 

  49. Orbay JL, Touhami A. Current concepts in volar fixed-angle fixation of unstable distal radius fractures. Clin Orthop Relat Res. 2006;445:58–67

    PubMed  Google Scholar 

  50. Palmer AK. The distal radioulnar joint. Anatomy, biomechanics, and triangular fibrocartilage complex abnormalities. Hand Clin. 1987;3:31–40

    CAS  PubMed  Google Scholar 

  51. Palmer AK, Glisson RR, Werner FW. Ulnar variance determination. J Hand Surg [Am]. 1982;7:376–9

    CAS  Google Scholar 

  52. Pogue DJ, Viegas SF, Patterson RM, et al. Effects of distal radius fracture malunion on wrist joint mechanics. J Hand Surg [Am]. 1990;15:721–7

    Article  CAS  Google Scholar 

  53. Porter M, Stockley I. Fractures of the distal radius. Intermediate and end results in relation to radiologic parameters. Clin Orthop Relat Res. 1987;220:241–52

    PubMed  Google Scholar 

  54. Pruitt DL, Gilula LA, Manske PR, et al. Computed tomography scanning with image reconstruction in evaluation of distal radius fractures. J Hand Surg [Am]. 1994;19:720–7

    Article  CAS  Google Scholar 

  55. Richards RS, Bennett JD, Roth JH, et al. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg [Am]. 1997;22:772–6

    Article  CAS  Google Scholar 

  56. Sarmiento A. The brachioradialis as a deforming force in Colles’ fractures. Clin Orthop Relat Res. 1965;38:86–92

    CAS  PubMed  Google Scholar 

  57. Shih JT, Lee HM, Hou YT, et al. Arthroscopically-assisted reduction of intra-articular fractures and soft tissue management of distal radius. Hand Surg. 2001;6:127–35

    Article  CAS  PubMed  Google Scholar 

  58. Simpson NS, Jupiter JB. Delayed onset of forearm compartment syndrome: a complication of distal radius fracture in young adults. J Orthop Trauma. 1995;9:411–8

    Article  CAS  PubMed  Google Scholar 

  59. Smaill GB. Long-term follow-up of Colles’s fracture. J Bone Joint Surg Br. 1965;47:80–5

    CAS  PubMed  Google Scholar 

  60. Souer JS, Ring D, Matschke S, et al. Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Joint Surg Am. 2009;91:830–8

    Article  PubMed  Google Scholar 

  61. Spence LD, Savenor A, Nwachuku I, et al. MRI of fractures of the distal radius: comparison with conventional radiographs. Skeletal Radiol. 1998;27:244–9

    Article  CAS  PubMed  Google Scholar 

  62. Sponsel KH, Palm ET. Carpal tunnel syndrome following Colles’ fracture. Surg Gynecol Obstet. 1965;121:1252–6

    CAS  PubMed  Google Scholar 

  63. Stockley I, Harvey IA, Getty CJ. Acute volar compartment syndrome of the forearm secondary to fractures of the distal radius. Injury. 1988;19:101–4

    Article  CAS  PubMed  Google Scholar 

  64. Trumble TE, Schmitt SR, Vedder NB. Factors affecting functional outcome of displaced intra-articular distal radius fractures. J Hand Surg [Am]. 1994;19:325–40

    Article  CAS  Google Scholar 

  65. Varitimidis SE, Basdekis GK, Dailiana ZH, et al. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction? J Bone Joint Surg Br. 2008;90:778–85

    Article  CAS  PubMed  Google Scholar 

  66. Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. J Hand Surg [Am]. 2000;25:19–28

    Article  CAS  Google Scholar 

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Acknowledgement

To co-authors Daniel G Mandziak, M.B.B.S., Royal Adelaide Hospital and Adam C Watts M.B.B.S., F.R.C.S.(Tr and Ortho), Modbury Public Hospital, Adelaide, Australia for their contribution to this chapter.

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma, University of Adelaide, Royal Adelaide and Modbury Public Hospital, 196, Melbourne Street, North Adelaide, SA, 5006, Australia

    Gregory I. Bain

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  1. Gregory I. Bain
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  1. Calderón de la Barca 16-entlo., Santander, 39002, Spain

    Francisco Piñal

  2. Via Pietro da Rimini 4, Rimini, 47900, Italy

    Riccardo Luchetti

  3. Institut de la Main, Clinique Jouvenet, square Jouvenet 6, Paris CX, 75007, France

    Christophe Mathoulin

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Bain, G.I. (2010). Pre-Operative Assessment in Distal Radius Fractures. In: Piñal, F., Luchetti, R., Mathoulin, C. (eds) Arthroscopic Management of Distal Radius Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-05354-2_1

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  • DOI: https://doi.org/10.1007/978-3-642-05354-2_1

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