BACKGROUND: Fractures of the distal extremity of the radius are the most common bone lesions of the superior extremity of the body, representing 17% of the fractures treated in First Aid facilities. The restoration of anatomical relationships in the radiocarpal joint is considered to be a prerequisite for good functional recovery. There are numerous methods of treatment of these fractures. The Epibloc system is a percutaneous endomedullary synthesis alternative to the plaster cast in wrist fracture treatment. MATERIALS AND METHODS: The authors describe their experience with 81 fractures (63 type A2-3 fractures and 18 type C1) of the wrist treated with the Epibloc System (ES). The results were evaluated clinically, functionally and radiographically on the 7th, 14th, 35th, 90th day. The Gartland and Werley score modified by Sarmiento was used for the functional assessment of the wrist injuries RESULTS: Twenty-nine patients (35.8%) had excellent results, 43 (53.1%) had good results. Forty-seven of the patients (58%) had a ROM of 100% of normal, with a dorsiflexion-palmar flexion (DF-PF) arc of 120 degrees or more. Seven (8.6 %) of the patients developed Sudeck's osteodystrophy. A "very moderate" or "moderate" malunion was observed in 19 cases (23.4% CONCLUSION: 1. The ES is a surgical technique for the treatment of numerous wrist fractures. These fractures can result in excellent mobility as well as a low rate of complications and secondary loss of reduction. 2. This method enables early functional recovery with low incidence of rigidity and algodystrophy. 3. This technique is best indicated for AO type A2-3 and type C1. 4. The ES is inadequate for patients with severe osteopaenia and markedly comminuted intra-articular fractures.
BACKGROUND:Fractures of the distal extremity of the radius are the most common bone lesions of the superior extremity of the body, representing 17% of the fractures treated in First Aid facilities. The restoration of anatomical relationships in the radiocarpal joint is considered to be a prerequisite for good functional recovery. There are numerous methods of treatment of these fractures. The Epibloc system is a percutaneous endomedullary synthesis alternative to the plaster cast in wrist fracture treatment. MATERIALS AND METHODS: The authors describe their experience with 81 fractures (63 type A2-3 fractures and 18 type C1) of the wrist treated with the Epibloc System (ES). The results were evaluated clinically, functionally and radiographically on the 7th, 14th, 35th, 90th day. The Gartland and Werley score modified by Sarmiento was used for the functional assessment of the wrist injuries RESULTS: Twenty-nine patients (35.8%) had excellent results, 43 (53.1%) had good results. Forty-seven of the patients (58%) had a ROM of 100% of normal, with a dorsiflexion-palmar flexion (DF-PF) arc of 120 degrees or more. Seven (8.6 %) of the patients developed Sudeck's osteodystrophy. A "very moderate" or "moderate" malunion was observed in 19 cases (23.4% CONCLUSION: 1. The ES is a surgical technique for the treatment of numerous wrist fractures. These fractures can result in excellent mobility as well as a low rate of complications and secondary loss of reduction. 2. This method enables early functional recovery with low incidence of rigidity and algodystrophy. 3. This technique is best indicated for AO type A2-3 and type C1. 4. The ES is inadequate for patients with severe osteopaenia and markedly comminuted intra-articular fractures.
Authors: Marco Passiatore; Rocco De Vitis; Andrea Perna; Marco D'Orio; Vitale Cilli; Giuseppe Taccardo Journal: Eur J Orthop Surg Traumatol Date: 2020-05-13