Vertical Undisplaced Fracture Distal End Radius

Following xray shows an undisplaced vertical fracture of distal radius in 34 years old male who struck his forearm in a moving object.

Vertical Fracture Distal Radius

Vertical Fracture Distal Radius

The fracture was treated by below elbow cast.

Xray of Volar Barton Fracture of Distal Radius

Volar Barton fracture is intra-articular fracture of distal radius and this xray show a volar Barton fracture in a 31 years old male.

Volar Barton Fracture

Volar Barton Fracture

The patient was advised open reduction and internal fixation using a volar plate for radius but the patient refuced for any surgery.

Option of ligamentotaxis was also discussed using external fixation device but refused.

The limb was splinted with plaster slab. The patient never followed up.

Complications of External Fixation In Treatment of Distal Radius Fractures

Rate of complications of external fixation in distaldistal radius fractures has been reported to be 6-60%.  Though many of the  complications are seen regardless of the treatment, some are directly related to treatment with an external fixator.

Overdistraction of Wrist

Distraction of 5-8 mm across the radiocarpal and midcarpal joints has been reported to be without any unfavorable outcome.

However, overdistraction of the wrist, particularly combined with palmar flexion, results in relative shortening of the extensor tendons and may prevent full  motion of digits. [Read more...]

Xray of Fracture of Radius In Distal Fourth of Bone In 14 Years Old Child

Xray of fracture of radius in 14 years old male. Patient fell while playing Kabaddi in the school.

Fracture of Radius Bone In 14 Years Old Child

Fracture of Radius Bone In 14 Years Old Child

Closed reduction and internal fixation was done using kwires and an above elbow plaster splint was applied.

Midcarpal Instability

Midcarpal instability is characterized by a loss of normal alignment between proximal and distal carpal row bones following ligament injuries of the wrist, when placed under load. Midcarpal instability is a type of non dissociative carpal instability.

Types

There are four types of MCI

Midcarpal Instability Type I

It is also palmar midcarpal instability and occurs secondary to an injury to the palmar midcarpal ligaments

  • Scaphotrapeziotrapezoid ligaments
  • Triquetrohamate and triquetrocapitate ligaments

The injury may be to either or both the ligaments.

The direction of subluxation is palmar. [Read more...]

Xray of Undisplaced Fracture of Distal Radius

53 years old man, shopkeeper by profession, fell from stool and injured his wrist. The xray of the wrist revealed a fracture of distal radius which was not displaced.

Xray of Undisplaced Fracture of Distal End Radius

Xray of Undisplaced Fracture of Distal End Radius

The fracture is marked with an arrow. The fracture was treated by below elbow cast.

Wrist Arthroplasty

Wrist artrhoplasty as a procedure is still in infancy but is promising.

A painless stable wrist is the key to hand function. Without arthroplasy, other procedures make wrist stable only by compromising its motion.

Indications

Arthroplasty is indicated in severe arthritis of the wrist not amenable to nonoperative measures in patients who do not have heavy demands from the wrist in daily use.

The goal is to provide painless mobile wrist to maintain function in the wrist and hand. [Read more...]

Wrist Arthrodesis

Wrist arthrodesis is a salvage procedure to provide the patient with pain free immobile wrist in maximum functional position.

After arthrodesis or fusion, motion between worn joints is eliminated and so is pain.

Indications

As noted before, wrist joint is a salvage procedure. Because it needs to sacrifice motion, other options of treatment must be considered and discussed with patient wherever feasible. [Read more...]

Radial Styloidectomy

Radial styloidectomy is a procedure that involves removal of radial styloid. It is a kind of salvage procedure which aims to reduce pain arsing from radial styoid impingement that that may occur in scaphoid nonunion or scapholunate instability.

It may not be a definitive treatment though.

Radial styloidectomy is an acceptable alternative to more aggressive procedures in patients with low functional demands or those who wish to defer more definitive treatment. [Read more...]

Radioscapholunate Arthrodesis

Radioscpholunate arthrodesis is done in selected patients who would not accept loss of motion that accompanies wrist arthrodesis. It is based on the observation that most activities of daily living can be accomplished with wrist motion in the range of 10° flexion, 35° extension, 10° radial deviation, and 15° ulnar deviation.

Wrist arthroplasty can provide pain free mobiity but is not a good option in persons with high physical demands.

As the name indicates,it is an arthrodesis of radius, lunate and scaphoid. [Read more...]