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Nonsurgical Treatment of a Distal Radius Fracture: When & How?
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Young Ho Shin, Jun O Yoon, Jae Kwang Kim
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J Korean Fract Soc 2018;31(2):71-78. Published online April 30, 2018
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DOI: https://doi.org/10.12671/jkfs.2018.31.2.71
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 Abstract
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- Distal radius fractures are a common upper extremity fracture and a considerable number of patients have a stable fracture. In the treatment of distal radius fractures, there is considerable disagreement regarding the need for a strict anatomical restoration with operation in elderly patients. Therefore, nonsurgical treatment is a still important treatment option in distal radius fractures. The radiological parameters of before or after manual reduction are important for deciding whether to perform operation or not. The radiological parameters include dorsal angulation of the articular surface, radial shortening, extent of dorsal comminution, intra-articular displacement, concomitant ulnar metaphyseal fracture, shear fracture, and fracture-dislocation of the distal radio-ulnar joint. In addition, clinical situations of patients, including age, activity level, underline disease, and recovery level, which the patients wish should be considered, comprehensively. For the duration of a splint or cast, three to four weeks are recommended in impacted or minimally displaced fractures and five to six weeks in displaced fractures. After reduction of the displaced fractures, patients should undergo a radiologicical examination every week to check the redisplacement or deformity of the fracture site until two or three weeks post trauma. Arm elevation is important for controlling fracture site swelling and finger exercises, including metacarpophalangeal joint motion, are needed to prevent hand stiffness. Active range of motion exercise of the wrist should be initiated immediately after removing the splint or cast.
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Citations
Citations to this article as recorded by  - The Clinical Effect of Complex Korean Medical Admission Treatment in Patients with Fractures of Distal Radius by Traffic Accident: 2 Cases Series Report
Gyu-cheol Choi, Ji-won Lee, Ji-Eun Bae, Dong-jin Kim, Jeong-su Hong, Da-hyun Kyung
Journal of Korean Medicine Rehabilitation.2021; 31(1): 187. CrossRef - The Clinical Effect of Rehabilitation Protocol for Distal Radius Fracture in Korean Medicine: A Report of 3 Cases
Won-Bae Ha, Ji-Hye Geum, Nak-Yong Koh, Jung-Han Lee
Journal of Korean Medicine Rehabilitation.2018; 28(3): 97. CrossRef
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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture
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Jae Kwang Kim, Jong Oh Kim, Seung Yup Lee, Nam Hoon Do
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J Korean Fract Soc 2009;22(2):104-109. Published online April 30, 2009
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DOI: https://doi.org/10.12671/jkfs.2009.22.2.104
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Abstract
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- PURPOSE
To report the surgical results of volar percutaneous cannulated compression screw fixation in subacute scaphoid fracture.
MATERIALS AND METHODS
Between January 2004 and January 2007, eight consecutive patients with subacute scaphoid waist fracture, who sought medical attention between 4 weeks to 6 months after injury, were included in this study. All patients were male of an average age 29.2 years (range, 19 to 44). Mean duration of injury was 10.3+/-4.1 weeks. An acutrak cannulated screw (Acumed, Hillsboro, OR) was introduced volarly under image intensifier guidance in all patients. We performed radiological evaluation preoperatively and postoperatively. And we performed 12 months postoperatively using grip strength, range of motion (ROM) of the wrist, Mayo Modified Wrist Score (MMWS) and Disabilities of the Arm, Shoulder and the Hand (DASH) score for functional evaluation.
RESULTS
Preoperative radiography showed minimal sclerosis line in three patients and a bone resorption around fracture sites in two patients. However, no patient had dorsal intercalated segment instability or more than 35 degrees of lateral intrascaphoid angle. Fractures united successfully at 11.6+/-2.1 weeks postoperatively without any requirement for a further procedure. At 12 months follow-up evaluations, ROM of the injured wrist was 93% of the uninjured wrist and grip strength of the injured wrist was 95% of the injured wrist. The mean MMWS was 93+/-6.6 and the mean DASH score was 4.8+/-1.2.
CONCLUSION
We believe that volar percutaneous cannulated screw fixation is a reliable method in case of subacute scaphoid waist fracture without scaphoid deformity or carpal instability.
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Citations
Citations to this article as recorded by - Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft
Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi
Journal of the Korean Fracture Society.2010; 23(1): 69. CrossRef
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