The aim of this study was to test the null hypothesis that there
is no difference, from the payer perspective, in the cost of treatment
of a distal radial fracture in an elderly patient, aged >
65 years,
between open reduction and internal fixation (ORIF) and closed reduction (CR). Data relating to the treatment of these injuries in the elderly
between January 2007 and December 2015 were extracted using the
Humana and Medicare Advantage Databases. The primary outcome of
interest was the cost associated with treatment. Secondary analysis included
the cost of common complications. Statistical analysis was performed
using a non-parametric Aims
Materials and Methods
We conducted a study to determine whether radiological parameters
correlate with patient reported functional outcome, health-related
quality of life and physical measures of function in patients with
a fracture of the distal radius. The post-operative palmar tilt and ulnar variance at six weeks
and 12 months were correlated with the Patient Rated Wrist Evaluation,
Disabilities of the Arm, Shoulder and Hand, and EuroQol scores,
grip strength, pinch strength and range of movement at three, six
and 12 months for 50 patients (mean age 57 years; 26 to 85) having surgical
fixation, with either percutaneous pinning or reconstruction with
a volar plate, for a fracture of the distal radius.Aims
Patients and Methods
Between 2002 and 2011, 81 patients with a traumatic total brachial
plexus injury underwent reconstruction by double free muscle transfer
(DFMT, 47 cases), single muscle transfer (SMT, 16 cases) or nerve
transfers (NT, 18 cases). They were evaluated for functional outcome and quality of life
(QoL) using the Disability of Arm, Shoulder and Hand questionnaire,
both pre- and post-operatively. The three groups were compared and
followed-up for at least 24 months.Aims
Methods
The aim of this retrospective multicentre study was to evaluate
mid-term results of the operative treatment of Monteggia-like lesions
and to determine the prognostic factors that influence the clinical
and radiological outcome. A total of 46 patients (27 women and 19 men), with a mean age
of 57.7 years (18 to 84) who had sustained a Monteggia-like lesion
were followed up clinically and radiologically after surgical treatment.
The Mayo Modified Wrist Score (MMWS), Mayo Elbow Performance Score
(MEPS), Broberg and Morrey Score, and Disabilities of the Arm, Shoulder
and Hand (DASH) score were used for evaluation at a mean of 65 months
(27 to 111) postoperatively. All ulnar fractures were stabilized
using a proximally contoured or precontoured locking compression
plate. Mason type I fractures of the radial head were treated conservatively, type
II fractures were treated with reconstruction, and type III fractures
with arthroplasty. All Morrey type II and III fractures of the coronoid
process was stabilized using lag screws.Aims
Patients and Methods
This article is a systematic review of the published
literature about the biomechanics, functional outcome and complications
of intramedullary nailing of fractures of the distal radius. We searched the Medline and EMBASE databases and included all
studies which reported the outcome of intramedullary (IM) nailing
of fractures of the distal radius. Data about functional outcome,
range of movement (ROM), strength and complications, were extracted.
The studies included were appraised independently by both authors
using a validated quality assessment scale for non-controlled studies
and the CONSORT statement for randomised controlled trials (RCTs). The search strategy revealed 785 studies, of which 16 were included
for full paper review. These included three biomechanical studies,
eight case series and five randomised controlled trials (RCTs). The biomechanical studies concluded that IM nails were at least
as strong as locking plates. The clinical studies reported that
IM nailing gave a comparable ROM, functional outcome and grip strength
to other fixation techniques. However, the mean complication rate of intramedullary nailing
was 17.6% (0% to 50%). This is higher than the rates reported in
contemporary studies for volar plating. It raises concerns about
the role of intramedullary nailing, particularly when comparative
studies have failed to show that it has any major advantage over
other techniques. Further adequately powered RCTs comparing the
technique to both volar plating and percutaneous wire fixation are needed. Cite this article:
To determine whether an early return to sport in professional
Australian Rules Football players after fixation of a non-thumb
metacarpal fracture was safe and effective. A total of 16 patients with a mean age of 25 years (19 to 30)
identified as having a non-thumb metacarpal fracture underwent open
reduction and internal plate and screw fixation. We compared the
players’ professional performance statistics before and after the
injury to determine whether there was any deterioration in their
post-operative performance.Aims
Patients and Methods
A retrospective study was performed in 18 patients
with achondroplasia, who underwent bilateral humeral lengthening
between 2001 and 2013, using monorail external fixators. The mean
age was ten years (six to 15) and the mean follow-up was 40 months
(12 to 104). The mean disabilities of the arm, shoulder and hand (DASH) score
fell from 32.3 (20 to 40)
pre-operatively to 9.4 (6 to 14) post-operatively (p = 0.037). A
mean lengthening of 60% (40% to 95%) was required to reach the goal
of independent perineal hygiene. One patient developed early consolidation,
and fractures occurred in the regenerate bone of four humeri in
three patients. There were three transient radial nerve palsies. Humeral lengthening increases the independence of people with
achondroplasia and is not just a cosmetic procedure. Cite this article:
There is no consensus on the benefit of arthroscopically
assisted reduction of the articular surface combined with fixation
using a volar locking plate for the treatment of intra-articular
distal radial fractures. In this study we compared the functional
and radiographic outcomes of fluoroscopically and arthroscopically
guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral
unstable intra-articular distal radial fractures were randomised
equally into the two groups for treatment. The mean age of these
74 patients was 64 years (24 to 92). We compared functional outcomes
including active range of movement of the wrist, grip strength and Disabilities
of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic
outcomes that included gap, step, radial inclination, volar angulation
and ulnar variance. There were no significant differences between the techniques
with regard to functional outcomes or radiographic parameters. The
mean gap and step in the fluoroscopic and arthroscopic groups were
comparable at 0.9 mm (standard deviation Arthroscopic reduction conferred no advantage over conventional
fluoroscopic guidance in achieving anatomical reduction of intra-articular
distal radial fractures when using a volar locking plate. Cite this article:
To date, there is insufficient evidence available to compare
the outcome of cemented and uncemented fixation of the humeral stem
in reverse shoulder arthroplasty (RSA). A systemic review comprising 41 clinical studies was performed
to compare the functional outcome and rate of complications of cemented
and uncemented stems in RSA. These included 1455 cemented and 329
uncemented shoulders. The clinical characteristics of the two groups
were similar. Variables were compared using pooled frequency-weighted means
and relative risk ratios (RR).Aims
Methods
