Hamed Yazdanshenas1,2,3,4, Eleby Rudolph Washington1,2, Firoozeh Madadi5, Firooz Madadi6, Arya Nick Shamie2, Francis John Hornicek2, Kodi Azari2. 1. Department of Orthopedic Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA. 2. Department of Orthopedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. 3. Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. 4. Department of Family Medicine Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA. 5. Department of Anesthesiology, Shahid Beheshti University of Medicine and Science, Tehran, Iran. 6. Department of Orthopedic Surgery, Shahid Beheshti University of Medicine and Science, Tehran, Iran.
Abstract
BACKGROUND: There are different treatments as well as controversies surrounding the adequate treatment for Distal Radius Fractures (DRF). In the absence of enough evidence[HYPHEN]base data regarding clinical effectiveness of available treatments, cost should be considered as an essential factor in selecting the surgical technique for DRF treatment. The goal of this study is introducing an improved and modified pin[HYPHEN]and[HYPHEN]plaster (MP&P) technique as an affordable alternative for treatment of DRF. This study also assesses and compares the outcomes of DRF treatment by using the introduced method versus external fixation (EF) technique. METHODS: In this clinical cohort study, 98 patients presenting with closed DRF Types III or IV, randomly were classified into two modified P&P (50 patients) and EF (48 patients) groups and assessed for functional, clinical, radiographic and overall outcome at the time, 2, 10 and 22 months after surgery. They were also followed[HYPHEN]up for up to 3 years to determine the rate of complications. RESULTS: Eighty one percent of EF and 86% of MP&P group were female. The average ages in the EF and MP&P groups were 44.9 ± 12.4 and 46.1 ± 5.4, respectively. Around 70% of the patients in each group had a Type III fracture, and 30% had Type IV. The rate of complications was higher among EF group patients (seven major and seven minor complications) compared to the MP&P (only 4 minor complications), however the difference between two groups regarding the complications and treatment outcome were insignificant, except in extension ROM and the quick[HYPHEN]dash score (only in two and four months follow up visits) and also returning to work (only in two month follow up visit). CONCLUSION: This study introduces a modified P&P technique that protects the transverse palmar curvature, prevents the collapse of the distal radius, and simplifies casting, thereby obviating a full arm cast and mitigating elbow stiffness in patient outcomes. This modified technique could be considered as a more cost[HYPHEN]conscious alternative to external fixation for patients with distal radius fractures.
BACKGROUND: There are different treatments as well as controversies surrounding the adequate treatment for Distal Radius Fractures (DRF). In the absence of enough evidence[HYPHEN]base data regarding clinical effectiveness of available treatments, cost should be considered as an essential factor in selecting the surgical technique for DRF treatment. The goal of this study is introducing an improved and modified pin[HYPHEN]and[HYPHEN]plaster (MP&P) technique as an affordable alternative for treatment of DRF. This study also assesses and compares the outcomes of DRF treatment by using the introduced method versus external fixation (EF) technique. METHODS: In this clinical cohort study, 98 patients presenting with closed DRF Types III or IV, randomly were classified into two modified P&P (50 patients) and EF (48 patients) groups and assessed for functional, clinical, radiographic and overall outcome at the time, 2, 10 and 22 months after surgery. They were also followed[HYPHEN]up for up to 3 years to determine the rate of complications. RESULTS: Eighty one percent of EF and 86% of MP&P group were female. The average ages in the EF and MP&P groups were 44.9 ± 12.4 and 46.1 ± 5.4, respectively. Around 70% of the patients in each group had a Type III fracture, and 30% had Type IV. The rate of complications was higher among EF group patients (seven major and seven minor complications) compared to the MP&P (only 4 minor complications), however the difference between two groups regarding the complications and treatment outcome were insignificant, except in extension ROM and the quick[HYPHEN]dash score (only in two and four months follow up visits) and also returning to work (only in two month follow up visit). CONCLUSION: This study introduces a modified P&P technique that protects the transverse palmar curvature, prevents the collapse of the distal radius, and simplifies casting, thereby obviating a full arm cast and mitigating elbow stiffness in patient outcomes. This modified technique could be considered as a more cost[HYPHEN]conscious alternative to external fixation for patients with distal radius fractures.
Authors: R A Rogachefsky; S R Lipson; B Applegate; E A Ouellette; A M Savenor; J A McAuliffe Journal: J Bone Joint Surg Am Date: 2001-04 Impact factor: 5.284
Authors: A A Ismail; S R Pye; W C Cockerill; M Lunt; A J Silman; J Reeve; D Banzer; L I Benevolenskaya; A Bhalla; J Bruges Armas; J B Cannata; C Cooper; P D Delmas; J Dequeker; G Dilsen; J A Falch; B Felsch; D Felsenberg; J D Finn; C Gennari; K Hoszowski; I Jajic; J Janott; O Johnell; J A Kanis; G Kragl; A Lopez Vaz; R Lorenc; G Lyritis; F Marchand; P Masaryk; C Matthis; T Miazgowski; M Naves-Diaz; H A P Pols; G Poor; A Rapado; H H Raspe; D M Reid; W Reisinger; C Scheidt-Nave; J Stepan; C Todd; K Weber; A D Woolf; T W O'Neill Journal: Osteoporos Int Date: 2002-07 Impact factor: 4.507