Contents
Paul S. Cederna and Theodore A. Kung (Source: Hand Clinics)
Source: Hand Clinics - July 10, 2021 Category: Orthopaedics Source Type: research
Forthcoming Issues
Ulnar-sided Wrist Pain (Source: Hand Clinics)
Source: Hand Clinics - July 10, 2021 Category: Orthopaedics Source Type: research
A Critical Assessment of the Most Cited Papers on Distal Radius Fractures
This article reviews the impact of the most cited works on distal radius fractures. Judged by the most cited works in this field, distal radius fracture research has followed other paradigm shifts in the history of science. Landmark papers showed that restoring premorbid anatomy led to better outcomes, and a plurality of fixation strategies emerged. A breakthrough in technology came with volar plating, and the new paradigm emerged: precise anatomic reduction is achieved typically with volar plates, unless fragment-specific approaches are needed. This paradigm is being challenged as the association among malunion, arthritis...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: David W. Grant, Kevin C. Chung Source Type: research
Nuances of Radiographic Assessment of Distal Radius Fractures to Avoid Missed Fragments
This article should help the reader work through imaging interpretation starting from the initial, often displaced radiographs to postreduction imaging and determination if further 3-dimensional imaging is necessary. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Jeremy E. Raducha, Christopher J. Got Source Type: research
How to Treat Distal Radius Fractures
Operative intervention for distal radius fractures is typically reserved for patients with displaced fractures that may result in bothersome compromises in function, although patient-specific factors (age, activity level, and preference) are considered. Operative intervention is associated with earlier improvement in function but exposes the patient to the risk of anesthesia and surgery. Although surgery is associated with an initial increase in cost of care, the benefits of earlier return to activity may offset these increases. Efforts to contain cost through implant selection, use of ambulatory surgical centers, and judi...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Paul M. Inclan, Christopher J. Dy Source Type: research
Outcome Measurement for Distal Radius Fractures
This article reviews the current evidence and provides recommendations for a DRF standardized outcome set. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Matthew J. Hall, Peter J. Ostergaard, Tamara D. Rozental Source Type: research
What Is the Evidence in Treating Distal Radius Fractures in the Geriatric Population?
This article provides current evidence to facilitate informed, individualized decision-making when treating distal radius fractures in geriatric patients. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Lauren Fader, Ethan Blackburn Source Type: research
Closed Reduction Techniques for Distal Radius Fractures and Appropriate Casting Methods
This article presents a brief review of indications and a technical guide to successful closed reduction and casting for the orthopedic surgeon. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Ashley B. Anderson, Scott M. Tintle Source Type: research
Kirschner Wire Fixation of Distal Radius Fractures, Indication, Technique and Outcomes
Distal radius fractures are the most common upper extremity fracture that present to US emergency departments. Given the variable presentation, including age and fracture pattern, there are many techniques that have been utilized to treat them. Closed reduction and percutaneous pin (CRPP) fixation remains a viable option in extra-articular and simple intra-articular fracture patterns. CRPP techniques flourished in the mid-twentieth century until the treatment patterns shifted to primarily volar-locked plating in the twenty-first century. Although several meta-analyses have been performed comparing outcomes and complication...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Michael B. Gottschalk, Eric R. Wagner Source Type: research
Plate Fixation of Distal Radius Fractures
There are several options for plate fixation of distal radius fractures. Volar plating has broad applicability and consistent outcomes, and thus is the most commonly used plate type. Dorsal plates are advantageous for specific fracture patterns, and can provide direct fracture reduction and buttressing, but may be prominent and can cause tendon irritation. Bridge plates offer an alternative to external fixation while avoiding the complications with prominent hardware, because they span highly comminuted fractures and can be used for immediate weight bearing; however, they require plate removal. Choice of plate fixation sho...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Lili E. Schindelar, Asif M. Ilyas Source Type: research
Strategies for Specific Reduction in High-Energy Distal Radius Fractures
High-energy distal radius fractures frequently result in comminution with intra-articular fragmentation. Knowledge of predictable patterns of injury allows the surgeon to develop a preoperative plan for anatomic reduction and stable fixation of individual fragments that are too small or too distal to be fixed with standard volar locked plating. We review the column model, which organizes the distal radius into an intermediate column, radial column, and pedestal as the basis of a reconstructive algorithm and emphasize the importance of the volar ulnar fragment. Specific reduction and fixation techniques are described to ass...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Nicholas Pulos, Alexander Y. Shin Source Type: research
Arthroscopy in Distal Radius Fractures
Wrist arthroscopy in the setting of distal radius fractures allows for direct visualization of the articular surface and treatment of associated soft tissue injuries. Arthroscopic techniques may be used to fine tune reductions with residual articular step-off or gap after an initial reduction attempt and are critical for addressing free articular fragments and die-punch lesions. Surgeon training, experience, and comfort with wrist arthroscopy remains a barrier to widespread adoption of this technique. Level I studies are needed to investigate whether improved articular reduction leads to meaningful clinical differences. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Jeffrey Yao, Nathaniel Fogel Source Type: research
Distal Radius Fracture and the Distal Radioulnar Joint
In this article, we discuss the incidence and types of injuries to the distal radioulnar joint (DRUJ) that occur in the setting of a distal radius fracture. We review the anatomy of the distal radioulnar joint, which is critical to understanding its biomechanics, and how injury could cause symptomatic incongruency and instability. We highlight how patients with an injury to the distal radioulnar joint might present both at the time of injury and after treatment of a distal radius fracture, the appropriate workup, the available treatment options, and the evidence-based literature. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Christina Nypaver, David J. Bozentka Source Type: research
Is Therapy Needed After Distal Radius Fracture Treatment, What Is the Evidence?
The role of hand therapy in management of distal radius fractures remains unclear. Some evidence demonstrates that initiating early range of motion and urging patients to return to routine activities of daily living as soon as possible may produce favorable outcomes that are as effective as formal supervised therapy. Extended supervised therapy does not appear to impact outcomes and a single instruction session with a home-based program produces similar results. Although we feel that formal structured therapy may have a role in select high-risk patients, the literature remains unclear on which patients would benefit most f...
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Paul Kooner, Ruby Grewal Source Type: research
Complex Regional Pain Syndrome and Distal Radius Fracture
This article reviews the available literature on the diagnosis and treatment of CRPS in di stal radius fractures. (Source: Hand Clinics)
Source: Hand Clinics - April 21, 2021 Category: Orthopaedics Authors: Lauren Kate Dutton, Peter Charles Rhee Source Type: research
