- 1.S.I.R.:
-
- 1: Swiss Surg. 2000;6(6):304-14.
-
[Plate osteosynthesis of distal radius fractures--incidence, indications and results]
Heim D.
Chirurgische Abteilung, Spital Frutigen.
From 1.1.95 to 31.12.98 133 distal radius fractures were treated surgically. Internal fixation with a plate was carried out in 34 fractures (25%). 17 plates were placed dorsally, 16 plates on the volar aspect and one fracture was treated with a combined dorsal and volar plate. 29/34 fractures (87%) were reviewed 1 year after surgery. All fractures healed without further surgery. No infection occurred. 15 implants were removed. 23/29 (79%) internal fixations showed a good or excellent result, 6/29 (21%) a fair result. These 6 patients had in common: an intraarticular fracture (5), a volar tilt (5), a postoperative algodystrophy (5) or a secondary dorsal displacement (2). In conclusion: One fourth of all surgically treated distal radius fractures underwent plate osteosynthesis with about 80% of good or excellent results. Dorsal plate osteosynthesis showed better results than volar plate fixation. An additional, temporary external fixator in fractures with radial shortening proved a reliable help intraoperatively. Secondary displacement in these fractures did not occur.
PMID: 11142154 [PubMed - indexed for MEDLINE]
Related articles
- Volar fixed-angle plate osteosynthesis of unstable distal radius fractures: 12 months results.
Arch Orthop Trauma Surg. 2009 May; 129(5):661-9. Epub 2009 Feb 19.
[Arch Orthop Trauma Surg. 2009]
- [Results after palmar plate-osteosynthesis with angularly stable T-plate in 100 distal radius fractures: a prospective study]
Unfallchirurg. 2003 Apr; 106(4):272-80.
[Unfallchirurg. 2003]
- [Open reduction and internal fixation of distal radius extension fractures in women over 60 years of age with the dorsal radius plate (pi-plate)]
Handchir Mikrochir Plast Chir. 2006 Apr; 38(2):82-9.
[Handchir Mikrochir Plast Chir. 2006]
- Review[Treatment of distal radius fracture. Surgical technique: bore wire osteosynthesis]
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990; :647-56.
[Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990]
- ReviewUse of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. Surgical technique.
J Bone Joint Surg Am. 2006 Mar; 88 Suppl 1 Pt 1:29-36.
[J Bone Joint Surg Am. 2006]
- » See reviews... | » See all...
Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius.
Division of Hand Surgery, Department of Orhopedic Surgery, Beth Israel Deaconess Medical Center and Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. trozenta@bidmc.harvard.edu
PURPOSE: Despite the recent popularity of volar plating for dorsally displaced distal radius fractures there is a paucity of data documenting the results of this treatment method. The purpose of this study was to determine the functional outcome of patients treated with volar fixed-angle plating for dorsally displaced, unstable distal radius fractures. METHODS: We reviewed the records of all patients treated at our institution with internal fixation using volar plates for dorsally displaced, comminuted distal radius fractures. Patients with follow-up periods shorter than 12 months were excluded from the study. Outcomes were evaluated at the latest follow-up examination with the Disabilities of the Arm, Shoulder, and Hand and the Gartland and Werley scoring systems. RESULTS: We studied 41 patients with a mean age of 53 years. The average follow-up period was 17 months. All fractures were stabilized with volar locking plates. Radiographs in the immediate postoperative period showed a mean radial height of 11 mm, mean radial inclination of 21 degrees , and mean volar tilt of 4 degrees. At fracture healing the mean radial height was 11 mm, mean radial inclination was 21 degrees, and mean volar tilt was 5 degrees. The average score on the Disabilities of the Arm, Shoulder, and Hand questionnaire was 14 and all patients achieved excellent and good results on the Gartland and Werley scoring system, indicating minimal impairment in activities of daily living. Nine patients experienced postoperative complications. There were 4 instances of loss of reduction with fracture collapse, 3 patients required hardware removal for tendon irritation, 1 patient developed a wound dehiscence, and 1 patient had metacarpophalangeal joint stiffness. CONCLUSIONS: Patients with unstable, dorsally displaced fractures of the distal radius treated with volar fixed-angle devices have good or excellent functional outcomes despite a high complication rate. When compared with previous reports on dorsal plating volar plates appear to have a higher incidence of fracture collapse but a lower rate of hardware-related complications. Complex fracture patterns thus mandate a careful and individualized approach.4.http://en.wikipedia.org/wiki/Distal_radius_fracture
"The most common cause of this type of fracture is a fall on an outstretched hand"
DS: CONCLUSION:
This makes a lot of sense; let's reduce this situation to its REAL dimensions:
AN OLD MAN WITH OSTEOPOROSIS AND AN ENLARGED PROSTATE - that's right! that's the 'divine' pope! - WAKES UP IN THE MIDDLE OF THE NIGHT TO GO TO THE BATHROOM. FINDS HIMSELF IN AN UNFAMILIAR ENVIRONMENT, IS SLIGHTLY DROWSY, DOESN'T NOTICE SOME OBSTACLE ON THE FLOOR, AND BOOM, FALLS FACE DOWN, USING HIS RIGHT HAND TO REFLEXIVELY PROTECT HIS FACE AND HEAD; IN THE PROCESS TWISTS HIS ANKLE AND BREAKS HIS WRIST.
VAYIKRA - LEVITICUS 19:14
" YOU SHALL NOT PLACE AN OBSTACLE IN FRONT OF A BLIND MAN"
What the pope has been doing lately is exactly that:
placing secret obstacles in front of UNSUSPECTING ISRAELIS, DOING THINGS IN THE DARK, IN SECRET, TRYING TO GET WHAT HE WANTS IN ROUNDABOUT WAYS - I.E. THE KNESSET LAND REFORM.
AGAIN, EXACT DIVINE RETRIBUTION FROM ABOVE: AN EYE FOR AN EYE, A TOOTH FOR A TOOTH.
NB: Addendum:
This reminds me of the story of Pharaoh, who was going to the Nile secretly every morning to relieve himself; he had presented himself as a god with no need for bodily functions: So....
Hashem repeatedly chose a special meeting place for Moshe and Pharaoh and instructed Moshe, "Go to Pharaoh in the morning; behold he is going out to the water." (Shmos 7: 15) Moshe Rabbeinu was sent to meet Pharaoh far from his palace- at the foot of the Nile River. Rashi (ad loc.) explains that Hashem chose this auspicious site in response to Pharaoh's arrogant claim to the masses. He proclaimed himself as a deity without common bodily needs. In order to preserve this myth, he secretly traveled early each morning to the Nile River to relieve himself there. Hashem therefore chose this perfect moment to send Moshe to remind Pharaoh of his mortality and disclose his secret identity.
In the same vein, the Vatican is very careful to COVER-UP the fact that the pope FELL WHILE ATTENDING TO HIS BODILY FUNCTIONS: HE HAD TO PEE in the middle of the night, just like every other old man, for G-d's sake!.
And Hashem BROKE HIS ARROGANCE by making him fall right there, in the toilet.
But Rome is trying very hard to HIDE THIS FACT.
So my job is to REMIND EVERYBODY of the NATURE OF THIS POPE: just an old man, very fallible - literally: fallible means ; WHO CAN FALL - - and plain.
No comments:
Post a Comment