BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with lon...BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial findings.AIM To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.METHODS A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and Scopus.The search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related terminology.The search was restricted to articles published in English from 1980 until June 2023.Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed journals.RESULTS A total of 2508 articles from PubMed and 883 from Scopus were identified initially.Following screening and removal of duplicates,13 articles met the inclusion criteria.These articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and complications.Hemiarthroplasty was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe osteoporosis.Functional outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across studies.Complications included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant choice.Long-term outcomes were inadequately documented,warranting further research.CONCLUSION Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly.Long-term outcomes and complications require further study.展开更多
BACKGROUND Distal radius fractures accompanied by the volar margin of the lunate fossa(VMLF)lesions are often overlooked or inadequately reduced in clinical practice.AIM To investigate the impact of VMLF fragment in d...BACKGROUND Distal radius fractures accompanied by the volar margin of the lunate fossa(VMLF)lesions are often overlooked or inadequately reduced in clinical practice.AIM To investigate the impact of VMLF fragment in distal radius fractures on the stability and function of the wrist joint.METHODS This was a retrospective study of patients with distal radius fractures who underwent surgical treatment between January 2013 and December 2017.The patients were divided into two groups according to whether the VMLF fragments were fixed or not.X-rays and computed tomography were performed before surgery,immediately postoperatively,and at 1,3,and 6 mo to measure the scapholunate angle,radiolunate angle,capitolunate angle,and effective radiolunate flexion(ERLF).The Mayo wrist score and disabilities of the arm,shoulder,and hand(DASH)score were determined at 1 year.RESULTS Thirty-five patients were included.There were 15 males and 20 females.Their mean age was 52.5±14.3(range:19-70)years.There were 38 wrists(17 on the left side,15 on the right,and three bilateral;16 in the fixed group,and 22 in the unfixed group).The interval between trauma and surgery was from 1 h to 1 mo.The incidence of postoperative wrist instability in the unfixed group(86.4%)was higher than in the fixed group(25.0%)(P≤0.001).Ten patients had ERLF>25°in the unfixed group and none in the fixed group(P=0.019).The Mayo wrist score was 94±5.7 in the fixed group and 68±15.1 in the unfixed group(P<0.001).The DASH score was 4.6±2.5 in the fixed group and 28.5±19.5 in the unfixed group(P<0.001).CONCLUSION Injuries of VMLF,even small fractures,might damage the radial-lunar ligament,leading to postoperative wrist instability,sagittal force line imbalance,and poor recovery of wrist joint function.展开更多
Objective: To investigate the application of artificial tiger bone powder on fracture healing time, wrist functional recovery and quality of life (QOL) in elderly patients with distal radius fracture. Methods: The stu...Objective: To investigate the application of artificial tiger bone powder on fracture healing time, wrist functional recovery and quality of life (QOL) in elderly patients with distal radius fracture. Methods: The study was a randomised controlled trials performed from January 2015 to December 2016 in a hospital. Elderly patients with distal radius fracture were divided into the treatment and the control groups by the random sealed envelope method. All patients were given splint or plaster fixation after manipulative reduction, and functional exercise, the treatment group was also given artificial tiger bone powder orally (trade name: Jintiange capsule), the control group was given an oral placebo in their appearance and usage identical with the treatment group. Prior to treatment and 6, 12 months after treatment, the wrist function was assessed by range of motion, including flexion-extension, radial-ulnar and pronation-supination, and the QOL was assessed by the Mos 36-item Short Form Health Survey. Each patient's fracture healing time was recorded. Results: Before treatment, there were no significant differences in wrist function and QOL between the two groups. At 6 and 12 months after treatment, the wrist function and QOL in the treatment group were better than those in the control group, the differences were statistically significant (P < 0.05). The fracture healing time in the treatment group was shorter than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: The early usage of artificial tiger bone powder for elderly patients with distal radius fracture can promote the healing of fracture, recovery of wrist joint function, and ultimately improve the QOL for elderly patients.展开更多
Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,whi...Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.展开更多
Distal radius fractures are common and while historically most have been treated nonoperatively the frequency with which distal radius fractures are treated surgically is increasing. Criteria for considering surgical ...Distal radius fractures are common and while historically most have been treated nonoperatively the frequency with which distal radius fractures are treated surgically is increasing. Criteria for considering surgical treatment are often based on radiographic appearance of the fracture. Less often discussed is patient preference: what do patients want. We investigated responses of a general population when presented with various treatment options following a hypothetical distal radius fracture. Many respondents chose nonoperative treatment even when told that surgery might result in a better outcome. This information can help during the shared decision-making process when discussing treatment options with a patient who presents with a distal radius fracture.展开更多
目的研究桡骨远端伸直型骨折患者应用中医正骨手法联合筋伤膏对腕关节活动度的影响。方法选取2018年3月—2020年3月酒泉市中医院收治的100例桡骨远端伸直型骨折患者为研究对象,按挂号的先后顺序分为对照组和观察组,各50例。对照组采用...目的研究桡骨远端伸直型骨折患者应用中医正骨手法联合筋伤膏对腕关节活动度的影响。方法选取2018年3月—2020年3月酒泉市中医院收治的100例桡骨远端伸直型骨折患者为研究对象,按挂号的先后顺序分为对照组和观察组,各50例。对照组采用西医复位治疗,观察组采用中医正骨手法联合筋伤膏治疗。比较两组临床疗效、临床指标变化、治疗前后视觉模拟评分量表(Visual Analog Scale,VAS)评分、腕关节功能改良加特兰德-韦利评分(Gartland-Werley,GW)及治疗前后腕关节活动度。结果观察组总有效率为100.00%高于对照组,差异有统计学意义(χ^(2)=5.982,P=0.014)。治疗后,观察组各项临床指标优于对照组,差异有统计学意义(P均<0.05)。治疗后,两组背伸度、掌屈度、旋后度明显升高,差异有统计学意义(P均<0.05),且观察组治疗后背伸度、掌屈度、旋后度更高,差异有统计学意义(P均<0.05)。治疗后,两组VAS、GW评分显著降低,差异有统计学意义(P均<0.05),且观察组治疗后VAS、GW评分更低,差异有统计学意义(P均<0.05)。结论桡骨远端伸直型骨折患者采用中医正骨手法联合筋伤膏治疗效果显著,可改善患者临床症状,促进骨折愈合,提高腕关节活动度。展开更多
文摘BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial findings.AIM To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.METHODS A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and Scopus.The search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related terminology.The search was restricted to articles published in English from 1980 until June 2023.Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed journals.RESULTS A total of 2508 articles from PubMed and 883 from Scopus were identified initially.Following screening and removal of duplicates,13 articles met the inclusion criteria.These articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and complications.Hemiarthroplasty was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe osteoporosis.Functional outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across studies.Complications included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant choice.Long-term outcomes were inadequately documented,warranting further research.CONCLUSION Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly.Long-term outcomes and complications require further study.
基金High Levels of Health Technical Personnel in Beijing City Health System,No.2013-3-050.
文摘BACKGROUND Distal radius fractures accompanied by the volar margin of the lunate fossa(VMLF)lesions are often overlooked or inadequately reduced in clinical practice.AIM To investigate the impact of VMLF fragment in distal radius fractures on the stability and function of the wrist joint.METHODS This was a retrospective study of patients with distal radius fractures who underwent surgical treatment between January 2013 and December 2017.The patients were divided into two groups according to whether the VMLF fragments were fixed or not.X-rays and computed tomography were performed before surgery,immediately postoperatively,and at 1,3,and 6 mo to measure the scapholunate angle,radiolunate angle,capitolunate angle,and effective radiolunate flexion(ERLF).The Mayo wrist score and disabilities of the arm,shoulder,and hand(DASH)score were determined at 1 year.RESULTS Thirty-five patients were included.There were 15 males and 20 females.Their mean age was 52.5±14.3(range:19-70)years.There were 38 wrists(17 on the left side,15 on the right,and three bilateral;16 in the fixed group,and 22 in the unfixed group).The interval between trauma and surgery was from 1 h to 1 mo.The incidence of postoperative wrist instability in the unfixed group(86.4%)was higher than in the fixed group(25.0%)(P≤0.001).Ten patients had ERLF>25°in the unfixed group and none in the fixed group(P=0.019).The Mayo wrist score was 94±5.7 in the fixed group and 68±15.1 in the unfixed group(P<0.001).The DASH score was 4.6±2.5 in the fixed group and 28.5±19.5 in the unfixed group(P<0.001).CONCLUSION Injuries of VMLF,even small fractures,might damage the radial-lunar ligament,leading to postoperative wrist instability,sagittal force line imbalance,and poor recovery of wrist joint function.
文摘Objective: To investigate the application of artificial tiger bone powder on fracture healing time, wrist functional recovery and quality of life (QOL) in elderly patients with distal radius fracture. Methods: The study was a randomised controlled trials performed from January 2015 to December 2016 in a hospital. Elderly patients with distal radius fracture were divided into the treatment and the control groups by the random sealed envelope method. All patients were given splint or plaster fixation after manipulative reduction, and functional exercise, the treatment group was also given artificial tiger bone powder orally (trade name: Jintiange capsule), the control group was given an oral placebo in their appearance and usage identical with the treatment group. Prior to treatment and 6, 12 months after treatment, the wrist function was assessed by range of motion, including flexion-extension, radial-ulnar and pronation-supination, and the QOL was assessed by the Mos 36-item Short Form Health Survey. Each patient's fracture healing time was recorded. Results: Before treatment, there were no significant differences in wrist function and QOL between the two groups. At 6 and 12 months after treatment, the wrist function and QOL in the treatment group were better than those in the control group, the differences were statistically significant (P < 0.05). The fracture healing time in the treatment group was shorter than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: The early usage of artificial tiger bone powder for elderly patients with distal radius fracture can promote the healing of fracture, recovery of wrist joint function, and ultimately improve the QOL for elderly patients.
文摘Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.
文摘Distal radius fractures are common and while historically most have been treated nonoperatively the frequency with which distal radius fractures are treated surgically is increasing. Criteria for considering surgical treatment are often based on radiographic appearance of the fracture. Less often discussed is patient preference: what do patients want. We investigated responses of a general population when presented with various treatment options following a hypothetical distal radius fracture. Many respondents chose nonoperative treatment even when told that surgery might result in a better outcome. This information can help during the shared decision-making process when discussing treatment options with a patient who presents with a distal radius fracture.
文摘目的研究桡骨远端伸直型骨折患者应用中医正骨手法联合筋伤膏对腕关节活动度的影响。方法选取2018年3月—2020年3月酒泉市中医院收治的100例桡骨远端伸直型骨折患者为研究对象,按挂号的先后顺序分为对照组和观察组,各50例。对照组采用西医复位治疗,观察组采用中医正骨手法联合筋伤膏治疗。比较两组临床疗效、临床指标变化、治疗前后视觉模拟评分量表(Visual Analog Scale,VAS)评分、腕关节功能改良加特兰德-韦利评分(Gartland-Werley,GW)及治疗前后腕关节活动度。结果观察组总有效率为100.00%高于对照组,差异有统计学意义(χ^(2)=5.982,P=0.014)。治疗后,观察组各项临床指标优于对照组,差异有统计学意义(P均<0.05)。治疗后,两组背伸度、掌屈度、旋后度明显升高,差异有统计学意义(P均<0.05),且观察组治疗后背伸度、掌屈度、旋后度更高,差异有统计学意义(P均<0.05)。治疗后,两组VAS、GW评分显著降低,差异有统计学意义(P均<0.05),且观察组治疗后VAS、GW评分更低,差异有统计学意义(P均<0.05)。结论桡骨远端伸直型骨折患者采用中医正骨手法联合筋伤膏治疗效果显著,可改善患者临床症状,促进骨折愈合,提高腕关节活动度。
