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Orthopaedic Surgery Oct 2023Open reduction and internal fixation (ORIF) is the standard treatment of unstable Colles fracture among the elderly. Modified percutaneous K-wire fixation is becoming...
OBJECTIVE
Open reduction and internal fixation (ORIF) is the standard treatment of unstable Colles fracture among the elderly. Modified percutaneous K-wire fixation is becoming increasingly popular in recent years. However, there is controversy concerning its appropriate use. This study aimed to compare the early safety and efficacy of the two different treatments and provide an alternative method for the treatment of unstable Colles fracture among the older population.
METHODS
Electronic medical records of 60 consecutive unstable Colles fractures patients who underwent surgery from June 2019 to October 2021, by modified percutaneous K-wire fixation (30 patients) or ORIF (30 patients), were reviewed retrospectively. All cases were followed up for 3 months. The outcomes of patients were assessed with operation time, intraoperative blood loss, visual analog score (VAS) for wrist joint pain, palmar tilt (PT), radial inclination (RI), radial height (RH), Gartland-Werley score, total hospitalization costs, hospital stays, postoperative complications, and patient subjective satisfaction. General patient information was also collected. Independent Student's t-test or Mann-Whitney U test were used to compare continuous data. Pearson's chi-square test or Fisher's exact test were used to analyze the categorical data.
RESULTS
The operation time and intraoperative blood loss were significantly shorter in the K-wire group than in the ORIF group (p < 0.05). Compared with the ORIF group, the VAS of the K-wire group was significantly lower at 1 and 3 days postoperatively (p < 0.05), and no significant differences were observed in VAS between the two groups preoperatively and 7 days postoperatively (p > 0.05). There were no significant differences in the PT, RI, and RH between the two groups preoperatively and at 1, 4, and 8 weeks postoperatively (p > 0.05). Patients in the K-wire group had significantly shorter hospital stays and lower total hospital costs (p < 0.05). All patients were followed up for 3 months, and there was no significant difference in the Gartland-Werley score between the two groups (p > 0.05). Compared with the ORIF group, postoperative complications were lower, and patient subjective satisfaction was higher in the K-wire group, but there were no significant differences (p > 0.05).
CONCLUSIONS
Modified percutaneous K-wire fixation in the treatment of unstable Colles fracture among the elderly is a safe, effective, rapid, and minimally invasive surgical option for surgeons.
Topics: Humans; Aged; Colles' Fracture; Blood Loss, Surgical; Retrospective Studies; Bone Wires; Fracture Fixation, Internal; Postoperative Complications; Treatment Outcome
PubMed: 37620967
DOI: 10.1111/os.13847 -
Cureus Jan 2017Displaced Colles' fractures are treated by manipulation and below elbow cast application. Malunion is a common complication, resulting in pain, mid-carpal instability,...
BACKGROUND
Displaced Colles' fractures are treated by manipulation and below elbow cast application. Malunion is a common complication, resulting in pain, mid-carpal instability, and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique that helps prevent displacement of the fracture, thereby minimizing complications. This study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with Kirschner wires (K-wires) and its correlation with the functional outcome of the wrist after union.
METHODS
A prospective study was conducted from May 2015 to May 2016 in a tertiary orthopedic center. Ninety patients (60 females, 30 males) with an average age of 54.93 years with Type II fractures underwent closed manipulation and percutaneous pinning with crossed K-wires as the primary procedure. Serial radiographs were taken to document the amount of collapse. The functional outcome was assessed using the Cooney Wrist Score.
RESULTS
At the final follow-up at six months, the collapse in the mean dorsal angle was 0.94 and mean ulnar variance was 0.51. Functionally, 48 patients (53.33%) had an excellent outcome, 36 patients (40%) had a good outcome, and six patients (6.67%) had a fair outcome.
CONCLUSIONS
Displaced Colles' fractures should be reduced and stabilized with percutaneous K-wires to achieve an excellent functional outcome.
PubMed: 28191366
DOI: 10.7759/cureus.960 -
Journal of Orthopaedic Research :... Mar 2020Non-steroidal anti-inflammatory drugs (NSAIDs) may delay bone healing. [Therefore, it is important to establish whether NSAID preparations delay bone healing and what... (Randomized Controlled Trial)
Randomized Controlled Trial
Non-steroidal anti-inflammatory drugs (NSAIDs) may delay bone healing. [Therefore, it is important to establish whether NSAID preparations delay bone healing and what correlations, if any, exist between different bone studies-DEXA-scanning, bone markers, roentgenology controls, and histological examination of newly formed bone]. The purpose of this prospective controlled study was to investigate whether ibuprofen affects bone mineral density, turnover biomarkers, and histomorphometric characteristics of the callus after a Colles' fracture. This study was a single-center, triple-blinded, randomized clinical trial. Ninety-five patients (80 females) with displaced Colles' fracture, median age 65 (range 40-85) years were included in the study and operated on by external fixation from June 2012 through to June 2015. Eighty-nine patients received interventional medicine and 83 completed the 1-year follow-up. The 7-day ibuprofen group received 600 mg of ibuprofen three times a day (N = 29), the 3-day ibuprofen group received ibuprofen for 3 days (N = 30) and a placebo for the following 4 days, and finally, the placebo group received a placebo for 7 days (N = 30). The primary outcome was the difference in bone mineral density between the ultra-distal region of the injured and non-injured radius at 3 months after surgery. The histomorphometric outcomes included the assessment of callus tissue volume and surface fractions at 6 weeks postoperatively. The biomarkers Osteocalcin and CrossLaps were measured at baseline, 1 week, 2 weeks, 6 weeks, 3 months, and 1 year. We included the results of the dropped-out patients in the intention to treat analysis. There was no difference between treatment groups in bone mineral density, histomorphometric estimations, and changes in bone biomarkers. These findings may offer an indication of ibuprofen as a bone-safe analgesic treatment in an acute fracture-phase. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:545-554, 2020.
Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Biomarkers; Bone Density; Bone and Bones; Colles' Fracture; Densitometry; Female; Humans; Ibuprofen; Male; Middle Aged; Osteocalcin; Prospective Studies; Treatment Outcome
PubMed: 31646668
DOI: 10.1002/jor.24498 -
Journal of Musculoskeletal & Neuronal... 2008Falls are one of the most common geriatric problems threatening the independence of older persons. Elderly patients tend to fall more often and have a greater tendency... (Review)
Review
Falls are one of the most common geriatric problems threatening the independence of older persons. Elderly patients tend to fall more often and have a greater tendency to fracture their bones. Fractures occur particularly in osteoporotic people due to increased bone fragility, resulting in considerable reduction of quality of life, morbidity, and mortality. This article provides information for the rehabilitation of osteoporotic fractures pertaining to the rehabilitation of the fractured patient, based on personal experience and literature. It also outlines a suggested effective and efficient clinical strategy approach for preventing falls in individual patients.
Topics: Accidental Falls; Aging; Colles' Fracture; Fractures, Bone; Hip Fractures; Humans; Osteoporosis; Practice Guidelines as Topic; Spinal Fractures
PubMed: 18799857
DOI: No ID Found -
Revista Brasileira de Ortopedia Aug 2022The treatment of Colles fracture can deform the wrist. Some studies claim the resulting deformity rarely hinders daily activities, whereas others report the...
The treatment of Colles fracture can deform the wrist. Some studies claim the resulting deformity rarely hinders daily activities, whereas others report the opposite; thus, anatomical reduction is desirable. Our objective was to analyze the anatomical and functional results of Colles fracture to find out the values of individual parameters corresponding to the best functional outcome. The present prospective study included 70 elderly patients with Colles fracture. All patients were managed conservatively. The anatomical parameters were evaluated by measuring dorsal angulation, radial inclination, and radial height, and they were assessed as per Stewart et al. The functional result was assessed by the Mayo wrist score. The results were analyzed using the chi-squared test of association, and a -value < 0.001 was considered statistically significant and to examine strengths of associations; we computed odds ratios (ORs) with 95% confidence intervals (CI). Excellent and good results were obtained in 68.5% of the cases anatomically and 78.5% functionally, which was statistically significant ( = 0.0009). Out of the three anatomical parameter dorsal angulation < 10° and loss of radial inclination < 9° showed statistically significant association with functional results ( = 0.0006), but loss of radial height < 6 mm did not ( = 0.0568), which became significant when loss of radial height was kept < 4 mm ( = 0.00062). Fractures with anatomical reduction have better functional results. The acceptable borderline anatomical parameters for obtaining excellent or good functional results are dorsal angulation < 10°, loss of radial inclination < 9°, and loss of radial height < 4 mm.
PubMed: 35966419
DOI: 10.1055/s-0041-1726062 -
Global Challenges (Hoboken, NJ) Jul 2023This work explores the effect of a Wechat group on follow-up and continuation of nursing for discharged patients with Colles fracture. A total of 96 patients with Colles...
This work explores the effect of a Wechat group on follow-up and continuation of nursing for discharged patients with Colles fracture. A total of 96 patients with Colles fracture are enrolled and randomized into two groups by the random number table method. The control group is followed up and guided by traditional methods. Based on the follow-up method adopted in the control group, a Wechat group is combined with Wechat constant tracking. The regular follow-up rate, a satisfaction of with continuing care, Gartland-Werley wrist score, the exercise of self-care agency score (ESCA score), and complications are compared and analyzed. The regular follow-up rate, satisfaction, Gartland-Werley wrist score, and self-care ability of patients in the Wechat group are significantly higher than those in the control group ( < 0.05). Statistical analysis of postoperative complications showed that although there is no significant difference in the incidence of median nerve irritation and incision infection ( > 0.05), the proportion of joint stiffness in the control group is significantly higher ( < 0.05). The establishment of Wechat groups to follow up and continue nursing for discharged patients with Colles fracture is helpful to achieve better clinical efficacy and improve the effective way for doctor-patient communication, which is worthy of active promotion.
PubMed: 37483417
DOI: 10.1002/gch2.202300070 -
Cureus Apr 2022Background Distal radius fractures account for almost one-sixth of all fractures in a casualty setting. The usual aim of distal radius fracture treatment is to restore...
Background Distal radius fractures account for almost one-sixth of all fractures in a casualty setting. The usual aim of distal radius fracture treatment is to restore the function of the wrist joint, of which the distal radius is an important part. There seems to be no consensus regarding which mode of treatment is optimal for managing distal radius fracture, particularly when it is associated with distal radioulnar joint instability. Objective To describe the functional outcome in patients presenting with displaced distal radius fractures who undergo Joshi's external stabilization system (JESS) fixation. Methods An observational study was done among 32 working-age (18 to 55 years) patients presenting with unilateral displaced distal radius fractures (excluding volar displaced) and subsequently treated with JESS fixation. The outcomes of the patients were assessed using the Green and O'Brien Scoring System modified by Cooney et al. at six months and one year following the surgery. Radiographs were also taken postoperatively and during follow-up. The data were analyzed (using IBM SPSS software version 22 and Microsoft Excel) in terms of the proportion of patients with acceptable clinical and radiological outcomes. Results Acceptable functional outcomes (good and excellent scores in the Green and O'Brien Scoring System) were observed in 78.1% of the study population. Though the functional outcome scores were higher among the younger age group, a statistically significant difference was not obtained. 96.9% of the patients had acceptable radiological reductions, and infection of the pin tracts complicated 9.4% of the cases. A significant improvement in outcome scores (p-value 0.0001) was observed between the outcome scores at six months and one year after surgery. Conclusions JESS fixation is an easy and effective method for treating displaced distal radius fractures to achieve good to excellent clinical outcomes. The functional outcome scores were better in the younger age group and male patients, but no statistically significant difference was observed.
PubMed: 35602785
DOI: 10.7759/cureus.24215 -
Tidsskrift For Den Norske Laegeforening... Apr 2013
Topics: Colles' Fracture; Humans; Research Design; Review Literature as Topic
PubMed: 23612089
DOI: 10.4045/tidsskr.13.0407 -
Journal of Bone and Mineral Research :... Aug 1989To determine whether Colles' fracture, generally considered a manifestation of postmenopausal osteoporosis, is associated with a decrease in bone density at the site of...
To determine whether Colles' fracture, generally considered a manifestation of postmenopausal osteoporosis, is associated with a decrease in bone density at the site of fracture, we measured bone mineral density of the ultradistal radius (UDR-BMD) by single-photon absorptiometry with computer-assisted image processing. In 119 normal women (ages 22-92 years), UDR-BMD decreased by 17% between ages 30 and 75 years. From UDR-BMD measurements in these normal women and in 40 women (ages 53-80 years) with Colles' fracture alone, a population-based analysis was made to estimate fracture risk at different values of UDR-BMD. Colles' fracture was uncommon at UDR-BMD greater than 0.40 g/cm2 (the "fracture threshold"). As bone density decreased below this level, fractures became more frequent (a "gradient of risk").
Topics: Adult; Aged; Aged, 80 and over; Aging; Colles' Fracture; Cross-Sectional Studies; Female; Humans; Middle Aged; Minerals; Radionuclide Imaging; Radius; Radius Fractures; Regression Analysis; Risk Factors
PubMed: 2816507
DOI: 10.1002/jbmr.5650040419 -
California and Western Medicine Nov 1927
PubMed: 18740536
DOI: No ID Found