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Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures

July 10, 2021/in Volume 7 | Issue 2 | July-December 2021

Vol 7 | Issue 2 | July-December 2021 | page: 04-08 | Yogesh Pethapara, Vishwajeet Singh, Ronak Patel DOI-10.13107/ti.2021.v07i02.016 Author: Yogesh Pethapara [1], Vishwajeet Singh [1], Ronak Patel [1] [1] Department of Orthopedics, Maruti Superspeciality Orthopaedic Hospital, Morbi, Gujarat, India. Address of Correspondence Dr. Yogesh Pethapara, Maruti Superspeciality Orthopaedic Hospital, Morbi, Gujarat, India. 363641. E-mail: […]

Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

July 10, 2021/in Volume 7 | Issue 2 | July-December 2021

Vol 7 | Issue 2 | July-December 2021 | page: 01-03 | Vishal V. Navale, Manasee Gulati DOI-10.13107/ti.2021.v07i02.015 Author: Vishal V. Navale [1], Manasee Gulati [2] [1] Department of Orthopaedics, Mysore Medical College and Research Institute, Mysore, Karnataka, India. [2]Department of Physical Therapy, Manipal Academy of Higher Education, Manipal Hospitals, Bengaluru, Karnataka, India. Address of […]

Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures

July 10, 2021/in Volume 7 | Issue 2 | July-December 2021

Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

July 10, 2021/in Volume 7 | Issue 2 | July-December 2021

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Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures

July 10, 2021/in Volume 7 | Issue 2 | July-December 2021

Vol 7 | Issue 2 | July-December 2021 | page: 04-08 | Yogesh Pethapara, Vishwajeet Singh, Ronak Patel

DOI-10.13107/ti.2021.v07i02.016

Author: Yogesh Pethapara [1], Vishwajeet Singh [1], Ronak Patel [1]

[1] Department of Orthopedics, Maruti Superspeciality Orthopaedic Hospital, Morbi, Gujarat, India.

Address of Correspondence
Dr. Yogesh Pethapara, Maruti Superspeciality Orthopaedic Hospital, Morbi, Gujarat, India. 363641.
E-mail: matrixyp1@gmail.com

Abstract

Background: Fractures of distal end of radius are the most common fractures among the patients treated at emergency rooms. Despite a considerable progress in medical field over the last several years, distal end of radial fracture outcomes seem to be unsatisfactory in fairly large number of cases. The aim of this study was to determine the functional outcome of hand and wrist after distal end of radius fractures managed by different treatment modalities, to determine the complications of each methods used for treatment of distal end of radius fractures, to compare anatomical outcome with functional outcome after management of fracture distal end of radius.
Methods: A clinical, observational, prospective type of study was carried out on 40 cases with fractures of distal end of radius. The fractures were classified according to AO classification. After initial evaluation patients were taken up for either conservative or operative treatment. All the cases were followed up and assessed for minimum of 6 months. Patients with complications were followed up more frequently. Results: Anatomical results were evaluated according to Sarmiento’s modification of Lindstrom Criteria. Clinical and functional results were evaluated according to demerit point system of Gartland and Werley with Sarmiento modification
Conclusions: There is direct relationship between anatomical result and functional outcome. Therefore, every effort should be made to restore normal length and alignment, as well as articular surface congruency of distal radius.
Keywords: Distal end of radius, Demerit point system of Gartland and Werley with Sarmiento modification, Sarmiento’s modification of Lindstrom Criteria, Functional evaluation

References

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3. Jupiter JB. Fractures of the distal end of the radius. J Bone Joint Surg [Am] 1991 mar;73-A:461-9.

4. Van Der Linden W, Ericson R. Colles‟ fracture: how should its displacement be measured and how should it be immobilized? J Bone Joint Surg [Am] 1981;63-A:1285-8.

5. Porter M, Stockley I. Fractures of the distal radius: intermediate and end results in relation to radiologic parameters. ClinOrthop 1987;220:241-52.

6. Cooney WP 3rd, Lindscheid R, Dobyns J. External pin fixation for unstable Colles‟ fracture. J Bone Joint Surg [Br] 1979; 61-B:840-5.

7. Solgaard S. Function after distal radius fracture. ActaOrthopaedicaScandinavica. 1988;59(1):39-42.

8. altissimi m, antenucci r, fiacca c, mancini g. Long-term Results of Conservative Treatment of Fractures of the Distal Radius. Clinical Orthopaedics and Related Research. 1986;&NA;(206):202-210.

9. Baruah R, Islam M, Haque R. Immobilisation of extra-articular distal radius fractures (Colles type) in dorsiflexion. The functional and anatomical outcome. Journal of Clinical Orthopaedics and Trauma. 2015;6(3):167-172.

10. Arora R, Gabl M, Erhart S, Schmidle G, Dallapozza C, Lutz M. Aspects of Current Management of Distal Radius Fractures in the Elderly Individuals. Geriatric Orthopaedic Surgery & Rehabilitation. 2011;2(5-6):187-194.

11. Ayhan KILIC, Yavuz KABUKCUOGLU, Ufuk OZKAYA, Murat GUL, Sami SOKUCU, Umit OZDOGAN. Volar locking plate fixation of unstable distal radius fracturesActaOrthopTraumatolTurc 2009;43(4):303-308

12. Chung, Kevin C, Watt, Andrws, Kotsis, Sandra VMPH, Margaliot, ZVI, Hase, Steven, Kim H. Myra. Treatment of unstable distal radius fractures with volar loking compression plate. The J Bone & Joint Surg 2006 Dec; 88-A(12): 2687-2694.

13. RE Anakwe, LAK Khan,RE Cook, and JE McEachan Locked volar plating for complex distal radius fractures: Patient reported outcomes and satisfaction J OrthopSurg Res. 2010; 5: 51.

14. Sanjay Meena, Pankaj Sharma, Abhishek Kumar Sambharia,1 and Ashok Dawar2 Fractures of Distal Radius: An Overview J Family Med Prim Care. 2014 Oct-Dec; 3(4): 325–332. doi: 10.4103/2249-4863.148101

How to Cite this article: Pethapara Y, Singh V, Patel R | Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures | July-December 2021; 7(2): 04-08.

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Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

July 10, 2021/in Volume 7 | Issue 2 | July-December 2021

Vol 7 | Issue 2 | July-December 2021 | page: 01-03 | Vishal V. Navale, Manasee Gulati

DOI-10.13107/ti.2021.v07i02.015

Author: Vishal V. Navale [1], Manasee Gulati [2]

[1] Department of Orthopaedics, Mysore Medical College and Research Institute, Mysore, Karnataka, India.
[2]Department of Physical Therapy, Manipal Academy of Higher Education, Manipal Hospitals, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. Vishal V. Navale, Department of Orthopaedics, Mysore Medical College and Research Institute, Mysore, Karnataka, India.
E-mail: nvvishal2010@gmail.com

Abstract

Introduction: An articular fracture of the base of the thumb metacarpal consisting of a single, variable-sized, volar-ulnar fracture fragment is termed Bennett fracture. In the studies conducted so far there has been paucity in the knowledge about the methods of k wire fixation for the Bennett fracture and hence the purpose of this study is to compare functional outcome between the trans – 2nd metacarpal fixation and trans – trapezius fixation with K wire for Bennett fracture.
Methods: Patients were 18 years and above with no previous injury on the 1st metacarpal . Final assessment was performed from six months to nine months after the treatment with the DASH Score, VAS scale for pain, Hand Grip strength by Dynamometer. Radiographic images were taken at 6 months post-op in two separate views to evaluate post-traumatic arthritis of the first CMC joint.
Results: Statistical analysis showed a correlation between Pain and DASH score to be 0.946 in TTZ group and 0.966 in T2MC group and hence signifies that patients in T2MC group had a better functional outcome with lower DASH score and lower pain score. Significant correlation was seen between Pain and Grip strength, with -0.587 in TTZ group and -0.482 in T2MC group. Higher pain score correlated with higher DASH score and lower Grip strength and hence we can conclude that T2MC had a better functional outcome post-surgery than TTZ technique of fixation. Post op radiographs showed that T2MC group of patients had a better outcome with less arthritic complications and less pain and better grip strength.
Conclusion: This study gives us the overview about the two fixation methods of Bennett fracture , and that when trans 2nd metacarpal fixation is done , there are less chances of arthritis of the CMC joint as well as better functional outcomes post operatively as compared to trans trapezial fixation and hence guides a surgeon to make a decision about the technique of fixation to be employed during fixing such fracture.
Keywords: Bennett fracture, Trans-trapezial, Trans- 2nd metacarpal, Functional outcome

References

1. Drelich M, Godlewski P. Metacarpal fractures. Orthop Traumatol Rehabil 2004;6:331–335. 2. Kahler DM. Fractures and dislocations of the base of the thumb.J South Orthop Assoc 1995;4:69 –76. 3. Gedda KO, Moberg E. Open reduction and osteosynthesis of the so-called Bennett fracture in the carpo-metacarpal joint of the thumb. Acta Orthop Scand 1952;22:249–57. 4. Yin Y, Wang Y, Wang Z, Qu W, Tian W, Chen S. Accuracy of fluoroscopic examination in the treatment of Bennett fracture. BMC Musculoskelet Disord. 2021 Jan 4;22(1):3. doi: 10.1186/s12891-020-03867-1. PMID: 33397336; PMCID: PMC7783999. 5. Fractures of the Metacarpals and Phalanges: Charles S. Day. Greens Operative Hand surgery –Elsevier, 7th edition 2016, pg 272. 6. Fischborn T, Beckenbauer D, Held M, Daigeler A, Medved F. Analysis of operative techniques of fractures of the first metacarpal base. Ann Plast Surg 2018;80:507–14. 7. Hand – surgical treatment: Thomas P Ruedi. AO principles of fracture management – AO Publishing , second edition 2007, pg 683. 8. Kamphuis SJM, Greeven APA, Kleinveld S, Gosens T, Van Lieshout EMM, Verhofstad MHJ. Bennett fracture: Comparative study between open and closed surgical techniques. Hand Surg Rehabil. 2019 Apr;38(2):97-101. 9. Crosby CA, Wehbe MA, Mawr B. Hand strength: normative values. J Hand Surg Am 1994;19:665–70. 10. van Niekerk JL, Ouwens R. Fractures of the base of the first metacarpal bone: results of surgical treatment. Injury 1989;20:359–62. 11. Kamphuis SJM, Greeven APA, Kleinveld S, Gosens T, Van Lieshout EMM, Verhofstad MHJ. Bennett fracture: Comparative study between open and closed surgical techniques. Hand Surg Rehabil. 2019 Apr;38(2):97-101. doi: 10.1016/j.hansur.2018.11.003. Epub 2019 Jan 9. PMID: 30639054. 12. Greeven APA, Van Groningen J, Schep NWL, Van Lieshout EMM, Verhofstad MHJ. Open reduction and internal fixation versus closed reduction and percutaneous fixation in the treatment of Bennett fractures: A systematic review. Injury. 2019 Aug;50(8):1470-1477. doi: 10.1016/j.injury.2019.06.027. Epub 2019 Jun 28. PMID: 31288938.

How to Cite this article: Navale VV, Gulati M | Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture | July-December 2021; 7(2): 01-03.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures

Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures

Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

Full Sized Blog Element (Big Preview Pic)

Radiological Assessment and Functional Outcomes of Hand and Wrist in Patients with Distal End Radius Fractures

Author: Yogesh Pethapara [1], Vishwajeet Singh [1], Ronak Patel [1]

Abstract

References

(Article Text HTML) (Download PDF)

Comparison of Functional Outcome Between Trans– 2nd Metacarpal Fixation and Trans-Trapezius Fixation with K-Wire for Bennett Fracture

Author: Vishal V. Navale [1], Manasee Gulati [2]

Abstract

References

(Article Text HTML) (Download PDF)

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