Elizondo HE, Cárdenas EE, Mendoza JM, Vilchez FC, Mendoza OL, Acosta CO

Language: Spanish
References: 24
Page: 312-316
PDF size: 365.32 Kb.

ABSTRACT

The trend in distal radius fracture is towards open reduction and internal fixation; however, treatment with closed reduction and percutaneous nailing continues to provide good results, but physical therapy and appropriate early rehabilitation are needed. Material and methods: We assessed patients with distal radius fractures treated with reduction with percutaneous maneuvers and nailing; we used clinical functional scales, like the DASH, the Mayo Clinic wrist scale, and the Visual Analog Scale (VAS) to assess pain. Patient results were compared at 12 and 24 weeks. We also compared patients with and without rehabilitation. Results: A total of 60 patients were assessed using the DASH scale; patients with rehabilitation had a score of 4.3, while those without rehabilitation had a score of 10.5 (p = 0.00001). In the Mayo Clinic scale, patients with rehabilitation had a score of 86.7, while those without rehabilitation had a score of 77.8 (p = 0.00001). The VAS was not significant. Conclusion: All patients showed improvement in their clinical assessment scales. However, when patients with and without rehabilitation are compared, the difference was greater in the Mayo Clinic scale and in the DASH scale.

REFERENCES

1. Ruch DS: Fractures of the distal radius and ulna. In: Bucholz RW, Heckman JD, Court-Brown C, editors. Rockwood and Green’s fractures in adults. 6th ed. Vol. 1, Philadelphia: Lippincott Williams and Wilkins, 2006: 909-88

2. Simic PM, Weiland AJ: Fractures of the distal aspect of the radius: changes in treatment over the past two decades. Instr Course Lect 2003; 52: 185-95.

3. Koval KJ, Harrast JJ, Anglen JO, Weinstein JN: Fractures of the distal part of the radius. The evolution of practice over time. Where’s the evidence? J Bone Joint Surg Am 2008; 90(9): 1855-61.

4. Gupta A: The treatment of Colles’ fracture. Immobilization with the wrist dorsiflexed. J Bone Joint Surg Br 1991; 73(2): 312-5.

5. Jones LA: The assessment of hand function: a critical review of techniques. J Hand Surg Am 1989; 14(2 Pt 1): 221-8.

6. Bell HM, Slater EM, Harris WH: Regional anesthesia with intravenous lidocaine. JAMA 1963; 186: 544-9.

7. Frykman G: Fracture of the distal radius including sequelae--shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand 1967: Suppl 108-3.

8. Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP 3rd, Linscheid RL: Scaphoid malunion. J Hand Surg Am 1989; 14(4): 679-87.

9. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996; 29(6): 602-8.

10. McAuliffe TB, Hilliar KM, Coates CJ, Grange WJ: Early mobilization of Colles’ fractures. A prospective trial. J Bone Joint Surg Br 1987; 69(5): 727-9.

11. Fuji K, Henmi T, Kanematsu Y, Mishiro T, Sakai T, Terai T: Fractures of the distal end of radius in elderly patients: a comparative study of anatomical and functional results. J Orthop Surg (Hong Kong) 2002; 10(1): 9-15.

12. Kreder HJ, Hanel DP, Agel J, McKee M, Schemitsch EH, Trumble TE, Stephen D: Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomized, controlled trial. J Bone Joint Surg Br 2005; 87(6): 829-36.

13. Young CF, Nanu AM, Checketts RG: Seven-year outcome following Colles’ type distal radial fracture. A comparison of two treatment methods. J Hand Surg Br 2003; 28(5): 422-6.

14. Christensen OM, Kunov A, Hansen FF, Christiansen TC, Krasheninnikoff M: Occupational therapy and Colles’ fractures. Int Orthop 2001; 25(1): 43-5.

15. Dionyssiotis Y, Dontas IA, Economopoulos D, Lyritis GP: Rehabilitation after falls and fractures. J Musculoskelet Neuronal Interact 2008; 8(3): 244-50.

16. Kopylov P, Johnell O, Redlund-Johnell I, Bengner U: Fractures of the distal end of the radius in young adults: a 30-year follow-up. J Hand Surg Br 1993; 18(1): 45-9.

17. Wolf SL, Sattin RW, Kutner M, O’Grady M, Greenspan AI, Gregor RJ: Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003; 51(12): 1693-701.

18. Duncan SF, Weiland AJ: Minimally invasive reduction and osteosynthesis of articular fractures of the distal radius. Injury 2001; 32 Suppl 1: SA14-24.

19. Habernek H, Weinstabl R, Fialka C, Schmid L. Unstable distal radius fractures treated by modified Kirschner wire pinning: anatomic considerations, technique and results. J Trauma 1994; 36(1): 83-8.

20. Munson GO, Gainor BJ: Percutaneous pinning of distal radius fractures. J Trauma 1981; 21(12): 1032-5.

21. Naidu SH, Capo JT, Moulton M, Ciccone W 2nd, Radin A: Percutaneous pinning of distal radius fractures: a biomechanical study. J Hand Surg Am 1997; 22(2): 252-7.

22. Rayhack JM: The history and evolution of percutaneous pinning of displaced distal radius fractures. Orthop Clin North Am 1993; 24(2): 287-300.

23. Ring D, Jupiter JB: Percutaneous and limited open fixation of fractures of the distal radius. Clin Orthop Relat Res 2000; (375): 105-15.

24. Rodríguez-Merchán EC. Plaster cast versus percutaneous pin fixation for comminuted fractures of the distal radius in patients between 46 and 65 years of age. J Orthop Trauma 1997; 11(3): 212-7.