Online ISSN: 2515-8260

Keywords : Distal radius fracture


Volar locking plate fixation for unstable distal radius fractures- A prospective study of functional and anatomical outcome

Dr. Nagulapati Vishnu Vardhan, Dr. Biju Ravindran, Dr.Pagadala Girija Devi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 43-50

Distal end radius fractures constitute one-sixth of all fractures treated in the emergency department. These fractures often are unstable, are difficult to reduce anatomically. Various modes of treatment include plaster application, External fixator, Plate fixation with locking compression plate. Recently, there has been an increasing interest in plate fixation, especially volar locking compression plate fixation of distal radius fractures. The purpose of this study is to evaluate the functional and anatomical outcome of unstable distal radius fractures treated by volar locking compression plate.
METHODS AND MATERIALS:
Forty-eight patients with unstable fractures of the distal radius treated with open reduction and internal fixation with volar LCP were taken under the study. Lafontaine 's criteria for instability were used to assess the fracture stability. Volar Henry approach was employed in all patients. Post-operative follow up at 6 weeks, 3 months, 6 months, 1 year and every 6 months later on as necessary. The assessment of functional results was made using the Demerit system of Gartland & Werly and Sarmiento's modification of Lidstrom's criteria was used for assessing anatomical outcome.
RESULTS:
Out of 48 patients, 34 were males and 14 females.  26 met with road traffic accidents and 22 have fallen on their outstretched hand. The assessment of functional results was made using Gartland & Werley demerit system based on residual deformity, subjective evaluation, objective evaluation & complications. 22 cases had excellent results and 22 cases had good results and 4 cases had fair results at the end of 12 months.
CONCLUSIONS:
Volar LCP is an effective treatment option for unstable distal radius fractures which promotes anatomic realignment, prevents delayed collapse, allows early joint motion and results in successful functional and anatomical outcomes

A PROSPECTIVE COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF DISTAL RADIUS DISPLACED EXTRA ARTICULAR FRACTURES TREATED BY CONSERVATIVE VERSUS OPERATIVE METHODS IN TERTIARY HEALTH CARE HOSPITAL.

Dr.Kuruva Suresh, Dr.Kondareddy Hari Krishna Reddy, Dr.Aithagani Sandeep kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 117-126

Background: Fractures of the distal radius are one of the most common injuries seen in our day-to-day practice. It accounts for almost 4% of the injuries seen in the emergency department. Despite its high incidence and the substantial possible implications of suboptimal management, no high-level evidence regarding the best treatment method yet exists.
Aim: Aim of the study is to compare the functional outcomes of extra articular distal radius displaced fractures managed surgically with those managed conservatively.
Materials and Methods: In this prospective cohort study conducted between November 2020 to December 2021, 18 to 65 years old patients with displaced extraarticular distal radial fracture were treated surgically or conservatively. Modified Mayo Wrist Score were calculated after a follow up of 12 months.
Results: At the end of 12 months the patients were evaluated, and it was noticed that patients who were treated surgically had significantly better functional and clinical outcomes, as indicated by significantly higher Mayo scores than patients treated conservatively by casting (all p values < 0.05).
Conclusions: Patients treated with volar plate fixation were able to resume activities of daily living few weeks earlier compared to those managed with K-wire fixation and conservative group. Therefore, we can conclude that volar plate fixation gives significantly better clinical and functional results than other methods of treatment.

Evaluation of role of Vitamin D in grip strength in postmenopausal women withdistal radius fracture

Dr. Naveena Jyothi H

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 846-852

Background: In the skin, under influence of ultraviolet radiation, 7-dehydrocholesterol is
photoconverted to provitamin D3, which is converted to Vitamin D3 (cholecalciferol). In the
serum, bound to a Vitamin D binding protein (VDBP), Vitamin D3 is transported to the liver,
where it is hydroxylated to 25(OH)D3. In the kidneys, 25(OH)D3 is further metabolized to
1α,25-dihydroxy vitamin D3 [1,25(OH)D3], the biologically active form of Vitamin
D.Vitamin D (Cholecalciferol) is known to contribute to muscular function.
Material and Methods: In this comparative study, Two groups were formed, First group as a
case in which vitamin D was supplemented and second group as control in which Vitamin D
was not supplemented, both the group had 25 number of post- menopausal women who had
Vitamin D level between sufficient range (30-100ng/ml) and were treated with same mode of
treatment (closed reduction and Percutaneous K-wire fixation) for Distal end radius fracture.
Grip strength recovery (in %) was compared in both the group after a period of 6 months.
Results: Final grip strength recovery of all patients came out to be 67%, out of which, in
supplemented group it came out to be 73% while in non-supplemented group came out to be
60% with p value of statistically significance proving major difference in grip strength
recovery in % at 6 months in both the groups.
Conclusion:We concluded with our series that vitamin D supplementation significantly helps
in improving the grip strength recovery in Post-menopausal women after a Distal End Radius
fracture.