Journal articles on the topic 'Tilt locking'
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HAO Dong-dong, 郝冬冬, 翟泽辉 ZHAI Ze-hui, 贾鑫 JIA Xin, 刘志强 LIU Zhi-qiang, and 郭娟 GUO Juan. "A Locking Cavity Method Based on Tilt locking Technology." Acta Sinica Quantum Optica 25, no. 2 (2019): 228–33. http://dx.doi.org/10.3788/jqo20192502.0902.
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You, Y., R. Chiche, L. X. Yan, W. H. Huang, C. X. Tang, and F. Zomer. "High finesse pulsed optical cavity locking by tilt-locking technique." Review of Scientific Instruments 85, no. 3 (March 2014): 033102. http://dx.doi.org/10.1063/1.4867247.
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Chabbra, Namisha, Andrew R. Wade, Emily Rose Rees, Andrew J. Sutton, Alberto Stochino, Robert L. Ward, Daniel A. Shaddock, and Kirk McKenzie. "High stability laser locking to an optical cavity using tilt locking." Optics Letters 46, no. 13 (June 28, 2021): 3199. http://dx.doi.org/10.1364/ol.427615.
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Xu, Jing, Guodong Zhang, Zaopeng He, Shizhen Zhong, Yongshao Chen, Chunrong Wei, Yudong Zheng, Haibin Lin, Wei Li, and Wenhua Huang. "Anatomical reduction and precise internal fixation of intra-articular fractures of the distal radius with virtual X-ray and 3D printing." Physical and Engineering Sciences in Medicine 43, no. 1 (October 22, 2019): 35–47. http://dx.doi.org/10.1007/s13246-019-00795-w.
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Abstract To evaluate and precisely internal fix intra-articular distal radial fracture (IDRF) using the virtual X-ray and three-dimensional (3D) printing technologies. Twenty-one patients with IDRF were recruited, and the data from digital design group (DDG) and real surgery group (RSG) were collected and analyzed. In DDG, the data from thin-slice computed tomography scan, virtual X-ray measurement parameters, including volar tilt, palmar tilt, radius length (D1), ulnar variation (D2), locking plate position parameter (D3) and distance between key nail and joint surface (D4) were collected. The bone was virtually fixed with the locking plate, and the final model of radius with the screw was obtained by 3D printing. In RSG, the locking plate was precisely pre-bended and used in surgery. During the surgery, the key K-wire was accurately placed and the locking plate was adjusted with the aid of the U-shaped navigation arm. The C-arm was used to observe the positions of key K-wires and the locking plate, and the same above-mentioned parameters were measured intra- and post-operatively. The data from RSG and DDG were compared statistically by t test. This approach proved to be successful in all 21 patients, and none of the screws pierced through the wrist joint surface. All the measured parameters, including the volar tilt, palmar tilt, D1–4, in RSG were not significantly different from preoperative DDG data. Virtual X-ray measurement of anatomical reduction parameters and 3D printing can help the anatomical reduction and precise internal fixation by providing quantitative references, preoperatively, intraoperatively and postoperatively.
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Slagmolen, B. J. J., D. A. Shaddock, M. B. Gray, and D. E. McClelland. "Frequency stability of spatial mode interference (tilt) locking." IEEE Journal of Quantum Electronics 38, no. 11 (November 2002): 1521–28. http://dx.doi.org/10.1109/jqe.2002.804267.
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Gibson, Bradley M., and Benjamin J. McCall. "Tilt-tuned etalon locking for tunable laser stabilization." Optics Letters 40, no. 12 (June 2, 2015): 2696. http://dx.doi.org/10.1364/ol.40.002696.
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Lv, Qiong Ying, Yu Shi Mei, Yu Sun, and Kun Liu. "Design of a Leveling Device." Advanced Materials Research 945-949 (June 2014): 278–81. http://dx.doi.org/10.4028/www.scientific.net/amr.945-949.278.
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Spiral or wedge-type leveling mechanism used by traditional theodolite, leveling between the cradle and the institutions, agencies and land leveling substrates are often unable to lock, and therefore can not afford to reverse the drive torque, and poor stability of the leveling means. Leveling device of this article, when the tilt table, the table with the solid sphere slider associated spherical rotary swing for the next slider to adjust the three leveling device to achieve leveling table. After leveling the table, under the action of the locking mechanism, the locking slide around the sphere spherical under lock slider rotation, lock nut and locking slider to achieve the sphere spherical self-centering locking to ensure leveling stability state.
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KOSHIMUNE, M., M. KAMANO, K. TAKAMATSU, and H. OHASHI. "A Randomized Comparison of Locking and Non-Locking Palmar Plating for Unstable Colles’ Fractures in the Elderly." Journal of Hand Surgery 30, no. 5 (October 2005): 499–503. http://dx.doi.org/10.1016/j.jhsb.2005.04.018.
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This study compared the effectiveness of locking and non-locking palmar plating for unstable Colles’ fractures in the elderly. The patients treated with locking plates included 4 men and 18 women with a mean age of 68 years (Group A) and those treated with non-locking plates included 3 men and 28 women with a mean age of 74 years (Group B). Radiographic parameters, including palmar tilt, radial inclination and radial length were measured before surgery, after surgery and at final followup. There were no significant differences in respect of any of the radiographic parameters between the two groups pre-operatively. After surgery, all of the radiographic parameters were improved in both groups and there were no significant differences between the two groups at final followup.
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Zhang, Penghai, and Yaolong Chen. "Analysis of error motions of axial locking-prevention hydrostatic spindle." Proceedings of the Institution of Mechanical Engineers, Part J: Journal of Engineering Tribology 233, no. 1 (April 6, 2018): 3–17. http://dx.doi.org/10.1177/1350650118769769.
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Hydrostatic spindles are widely used in precision optical grinder and lathe. Their high precision comes from the error averaging effect of oil film. The purpose of this paper is to give the quantitative analysis of the error averaging effect for a newly developed axial locking-prevention hydrostatic spindle. An approximate error motion model of the hydrostatic spindle is established to analyze the internal relationship between the geometric errors of the shaft and the error motions of the spindle including radial, tilt and axial error motions. The theoretical analysis shows that, the roundness errors of the two journals have a major impact on error motions while the coaxiality errors of two journals, the perpendicularity errors of front thrust plate and the coaxiality errors of the land of back thrust bearing, have no significant influences on error motions. The elliptical component of roundness errors of the two journals has significant influence on the axial error motion but no influence on the pure radial and tilt error motions, resulting into the fourth harmonic component of axial error motion. The trilobal component of roundness errors of the two journals has significant influence on the pure radial and tilt error motions but no influence on the axial error motion, resulting in the third harmonic component of pure radial and tilt error motions. The changes of recess pressures are not necessary condition for the error motions. Additionally, the experiment analysis shows that, the third harmonic component is the main part of the measured radial error motion and the third, fourth harmonic components are the main parts of the measured face error motion, which can be reasonably explained by the theory. The model proposed in this paper can be used to guide the precision design and optimization of hydrostatic spindle.
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Im, Jin-Hyung, and Joo-Yup Lee. "Pearls and Pitfalls of the Volar Locking Plating for Distal Radius Fractures." Journal of Hand Surgery (Asian-Pacific Volume) 21, no. 02 (May 3, 2016): 125–32. http://dx.doi.org/10.1142/s242483551640004x.
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Volar locking plate fixation has been widely accepted method for the treatment of unstable distal radius fractures. Although the results of volar locking plate fixation are encouraging, it may cause implant-related complications such as flexor or extensor tendon injuries. In depth understanding of anatomy of the distal radius is mandatory in order to obtain adequate fixation of the fracture fragments and to avoid these complications. This article will review the anatomic characteristics of the distal radius because selecting proper implant and positioning of the plate is closely related to the volar surface anatomy of the distal radius. The number and the length of distal locking screws are also important to provide adequate fixation strength to maintain fracture fixation. We will discuss the pros and cons of the variable-angle locking plate, which was introduced in an effort to provide surgeons with more freedom for fixation. Finally, we will discuss about correcting radial length and volar tilt by using eccentric drill holes and distal locking first technique.
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Singh, Pankaj Vir, Gagandeep Singh, Tejpal Singh, Abdul Ghani, and Zubair A. Lone. "Comparison of clinic-radiological and functional outcome of intra articular distal end radius fractures managed by volar locking plate versus external fixation." International Journal of Research in Medical Sciences 9, no. 8 (July 28, 2021): 2324. http://dx.doi.org/10.18203/2320-6012.ijrms20213076.
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Background: Distal end radius (DER) fractures are most common fractures in upper limb. Intra articular fractures can be managed either by open reduction and internal fixation by volar locking plate or can be managed by closed reduction and external fixator application or by percutaneous pinning. The purpose of our study was to compare the functional outcome of volar locking plate with that of external fixation.Methods: A prospective cohort study was conducted between June 2019 to June 2020 in Government Medical College, Jammu on 46 patients with intra articular distal end radius fractures. Of which 26 were managed by volar locking plate and 20 were managed by external fixator. the results of both groups were compared on the basis of radiological parameter and range of motion achieved post operatively. The functional outcome was evaluated using DASH score and Gartland–Werley scale. Results: Final range of motion, grip strength were better in patients managed with volar locking plate (VLP) as compared to those who were managed with external fixator (EF). Radiographically, volar tilt, radial height were all better in VLP group than EF.Conclusions: We concluded that VLP is superior method to maintain reduction till the union occurs and prevents the fracture collapse in intra articular distal end radius fractures as compared with external fixator. Thus, giving better functional and radiological outcome than the external fixator.
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Patiño, Juan Martin, Alejandro Felix Rullan Corna, Alejandro Michelini, and Ignacio Abdon. "Distal radius fractures – Treatment with volar locking plates - Functional results according to fracture type." Revista de la Facultad de Ciencias Médicas de Córdoba 77, no. 4 (December 1, 2020): 272–75. http://dx.doi.org/10.31053/1853.0605.v77.n4.26516.
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Background: The aim of this study is to determine if there are differences in functional results in patients presenting fractures of the distal radius treated with volar locking plates and, secondarily, to compare these results according to fracture type (AO).
Methods: 39 patients treated between January 2013 and December 2015 were evaluated. They were 19 women and 20 men, with an average of 60 years old and a range between 18 and 86 years old. The average follow up was of 46 months. We made radiographic postoperative measurements of the ulnar tilt angle of the radius, the volar tilt angle of the radius and styloid height. We evaluated residual pain with VAS (Analogue Visual Scale). The objective and subjective function were evaluated with the DASH inquiry (Disabilities of the Arm, Shoulder, and Hand) and Mayo wrist score.
Results: The mean flexion was of 51º, the extension was 55º, pronation was 80º, and supination was 75º. The mean ulnar tilt angle was 19, 66°, the mean volar tilt angle was 2.07°, and the mean styloid height was 8.97 mm. The average DASH was 14.38 and the average Mayo was of 78.58. There was no significant statistical correlation between the fracture complexity and the analyzed variables.
Conclusions: In this series, volar locking plates were a valid option for the resolution of unstable distal radius fractures in its different patterns and in a wide age range.
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Sreedharan, Sechachalam, Muhammad Farhan Mohd Fadil, and Winston Shang Rong Lim. "INTRA-OPERATIVE CORRECTION OF VOLAR TILT OF DISTAL RADIUS FRACTURES USING VOLAR LOCKING PLATE AS REDUCTION TOOL: REVIEW OF 24 CASES." Hand Surgery 19, no. 03 (January 2014): 363–68. http://dx.doi.org/10.1142/s0218810414500282.
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In surgical fixation of distal radius fractures with metaphyseal comminution, volar tilt can be restored using an anatomical volar locking plate as a reduction tool. The purpose of our study is to assess the degree of over or under correction of volar tilt that can result with our 'lift' technique and to determine the ratio between theoretical and actual angular correction. We retrospectively reviewed 24 patients who underwent distal radius fracture fixation using this technique and assessed intra-operative radiographs for parameters including pre-'lift' and post-'lift' volar tilt and pre-'lift' plate-shaft angles. The ratio between actual angular correction and theoretical angular correction was calculated. The 'lift' technique is found to be reliable in restoring volar tilt in most fractures. Over- or under-correction does occur due to errors in visual estimation and actual angular correction is generally less than the theoretical angular correction.
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PIÑAL, F. DEL, F. J. GARCÍA-BERNAL, A. STUDER, J. REGALADO, H. AYALA, and L. CAGIGAL. "Sagittal Rotational Malunions of the Distal Radius: The Role of Pure Derotational Osteotomy." Journal of Hand Surgery (European Volume) 34, no. 2 (March 12, 2009): 160–65. http://dx.doi.org/10.1177/1753193408097324.
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Sagittal rotational malunion after distal radius fractures was identified in eight patients by the presence of a “hinge” point on the volar cortex on the lateral radiograph, and the ulnar head being shorter than the anterior lip of the radius on the posterior–anterior radiograph. The surgical correction consisted of preplating the distal fragment with a volar locking plate before an osteotomy through the “hinge” point, and correcting the dorsal tilt of the distal fragment. Any dorsal defect was filled with cancellous bone graft from the olecranon. Pain, range of motion and grip all improved. Disabilities of arm, shoulder and hand score changed from 54 to six. Dorsal sagittal tilt improved by 26°, from −23°to +3°. Ulnar variance improved by 3 mm, from +1.5 to −1.5 mm, becoming identical to the opposite side. A pure derotational osteotomy corrected the apparent shortening of the radius and restored the volar tilt.
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Hansen, S. L., P. Thorsen, K. Dybdal, and S. B. Andreasen. "Gain tilt of erbium-doped fiber amplifiers due to signal-induced inversion locking." IEEE Photonics Technology Letters 5, no. 4 (April 1993): 409–11. http://dx.doi.org/10.1109/68.212681.
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Yasuda, Masataka, and Yoshiyuki Ando. "A NEW VARIABLE ANGLED LOCKING VOLAR PLATE SYSTEM FOR COLLES' FRACTURE: OUTCOME STUDY AND TIME-COURSE IMPROVEMENT OF OBJECTIVE CLINICAL VARIABLES." Hand Surgery 14, no. 02n03 (January 2009): 93–98. http://dx.doi.org/10.1142/s021881040900430x.
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Our purposes were to report the radiographic outcomes and complications of patients with Colles' fracture treated with the Nakashima locking volar plate system (variable angled distal screw locking mechanism) prospectively and to report the results of objective clinical variables such as grip strength and range of motion of the wrist prospectively at up to one year. This study consisted of eight men and 32 women for analysis of radiographic parameters (volar tilt, radial inclination and radial length) and complications. Radiographic parameters were measured pre-operatively, immediately post-operatively and at final follow-up visit. The average age at operation was 60.3 years old. Among them, we selected 25 cases (6 men and 19 women) whom we followed up at six weeks, three months, six months and one year post-operatively. The average age at operation in this group was 62 years old. We measured objective clinical variables (grip strength, forearm rotation, wrist extension/flexion) at each visit. Except for volar tilt, radiographic parameters revealed no significant changes between immediately post-operative radiographs and radiographs at final follow-up visit. Complications included loss of reduction in two cases. Objective clinical variables other than pronation measurement showed significant increase at each visit up to one year post-operatively. Satisfactory clinical and radiographic results were obtained by using this system. The variable angled distal fragment plating system appears to be a reliable construct for rigid fixation of Colles' fractures; however, technical errors can occur, as with other fixation systems. We demonstrated that the follow-up of Colles' fracture treated by our volar locking plate less than one year post-operative may be insufficient.
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Wang, Xiong, Xiaolin Wang, Pu Zhou, Rongtao Su, Chao Geng, Xinyang Li, Xiaojun Xu, and Bohong Shu. "350-W Coherent Beam Combining of Fiber Amplifiers With Tilt-Tip and Phase-Locking Control." IEEE Photonics Technology Letters 24, no. 19 (October 2012): 1781–84. http://dx.doi.org/10.1109/lpt.2012.2214769.
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Kang, Han-Vit, Jin-Hyung Im, Jae-Hoon Choi, Joon-Hyuck Oh, Soo-Hwan Kang, and Joo-Yup Lee. "The Effect of Volar Locking Plate Leveraging on Restoring Volar Tilt of Distal Radius Fractures." Archives of Hand and Microsurgery 24, no. 1 (2019): 24. http://dx.doi.org/10.12790/ahm.2019.24.1.24.
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Wang, Xiong, Xiao-Lin Wang, Pu Zhou, Rong-Tao Su, Chao Geng, Xin-Yang Li, Xiao-Jun Xu, and Bo-Hong Shu. "Coherent beam combination of adaptive fiber laser array with tilt-tip and phase-locking control." Chinese Physics B 22, no. 2 (February 2013): 024206. http://dx.doi.org/10.1088/1674-1056/22/2/024206.
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Kim, Jin-Tae, Liu Zhen, Venedikt Kapitanov, Hyun Su Kim, Jong Rak Park, and Si-Hyun Park. "Hyperfine Structure Measurement of Rubidium Atom and Tunable Diode Laser Stabilization by Using Sagnac Interferometer." Journal of Nanoscience and Nanotechnology 6, no. 11 (November 1, 2006): 3559–61. http://dx.doi.org/10.1166/jnn.2006.17982.
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The Rubidium saturated absorption spectra for D2 transition lines are used to measure the Fabry-Perot interferometer free spectral range (FSR). The scale linearity of the laser frequency tuning is determined. The Sagnac interferometer has been used for the laser stabilization. The result shows that the laser frequency is stabilized upto sub-mega Herz level. Also the hyperfine structure [52S1/2 F = 3 → F′ = 2, 3, 4 52P3/2 85Rb] of the rubidium atom has been measured by using the tilt locking method, which shows the same result as the conventional saturation spectroscopy.
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IMATANI, J., T. NODA, Y. MORITO, T. SATO, H. HASHIZUME, and H. INOUE. "Minimally Invasive Plate Osteosynthesis for Comminuted Fractures of the Metaphysis of the Radius." Journal of Hand Surgery 30, no. 2 (April 2005): 220–25. http://dx.doi.org/10.1016/j.jhsb.2004.12.009.
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Five comminuted and displaced fractures of the distal metaphysis of the radius were treated by a technique of minimally invasive plate osteosynthesis (MIPO) with the aim of minimizing soft tissue damage and devascularization of the fracture fragments. This technique used the small AO T-shaped locking compression plate (AO LCP T-plate) and left the pronator quadratus intact. Radial inclination, palmar tilt, and ulnar variance were restored without loss of reduction in all five cases and the fractures healed at an average of 10 weeks, with good to excellent clinical outcomes.
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Abe, Yoshihiro, Masahiro Suzuki, and Hiromasa Wakita. "Dual Plating Technique for Volar Rim Fracture of the Distal Radius Using DePuy-Synthes 2.0 m and 2.4 mm Locking Plates." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 04 (November 9, 2017): 423–28. http://dx.doi.org/10.1142/s0218810417500447.
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Background: To assess the surgical results of distal radius fractures with the involvement of a volar rim fragment using the DePuy-Synthes 2.0 mm and 2.4 mm locking plates.Methods: Subjects were six women and one man of average age 57 years (range, 31–83 y) and a mean follow-up period of 9 months (range, 5–19 mo) with AO B3 (volar shearing) distal radius fractures. Time of the procedure, physical examination of wrist range of motion, grip strength compared with the contralateral healthy wrist, and radiographic evaluation (volar tilt, radial inclination, and ulnar variance) were evaluated. The Visual Analog Scale (VAS: 0 points represents no pain, 100 points represents the worst pain possible) and the Quick Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH, 0 = no disability, 100 = extreme disability) were completed by patients at the final follow-up.Results: The average time of the procedure was 74 min. There were no perioperative complications. Average radiographic measures were: volar tilt, 8°; radial inclination, 23°, and ulnar variance, 0 mm. Wrist range of motion averaged 63° in wrist extension (range, 55–80°) and 55° in wrist flexion (range, 45–65°). Grip strength averaged 81% of the contralateral side at final evaluation (range, 67–100%). The mean QuickDASH score was 3.0 points (range, 0–9.1 points) and the mean VAS for pain was 9.3 at final follow-up.Conclusions: Open reduction internal fixation with the DePuy-Synthes 2.0 mm and 2.4 mm locking plates is an effective means of fixing a distal radius fracture that includes a volar rim fragment without interfering with flexor tendon gliding.
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Uddin, Md Maiyeen, Anadi Ranjan Mondal, Narayan Chandra Karmakar, Md Masudur Rahman, and Syed Asif Ul Alam. "Evaluation of Results of Fixation of Unstable Distal Radial Fractures by Volar Locking Plating System." Faridpur Medical College Journal 11, no. 2 (June 9, 2017): 62–66. http://dx.doi.org/10.3329/fmcj.v11i2.32887.
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Distal radial fractures are most common fractures accounts 15% of whole skeletal injuries, as high as 40% to 49% are considered to be unstable that requires surgical fixation. The purpose of the study was to ascertain good functional hand by using volar locking plate & screws, as with locking system, distal screws are locked to the plate, which stabilized the screws against lateral movement (toggle effect), thus providing a "single bone-plate-screws construct" which producing a scaffold in the mostly cancellous distal radial metaphysis, so preventing from collapse. This study was done from January 2007 to December 2008 at National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR). Total numbers of cases were 17. All patients were admitted in hospital & most of them returned home within 4 days. Most patients were managed early within 1-10 days of injury. Most patients were Fernandez type 1, type 2, and type 3. Most patients were in the age group of 4th decade. All patients were followed up for a period of at least 3 months, mean follow up period was 6 months. Results showed that wrist pain, wrist stiffness, reduced grip strength were minimum with volar locking plate & screws as there is minimal radial shortening, radial angulation, volar tilt & ulnar variance and wrist flexion, wrist extension, ulnar deviation, supination, pronation were very good. So, the trauma surgeons can safely use this procedure.Faridpur Med. Coll. J. Jul 2016;11(2): 62-66
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Al-bayati, Thaqaf Alauldeen Fadhil, Dr Omer Ali Rafiq i. Baraw, and Hasan Mazin Shekheel Mercalose. "Percutaneous Pinning Versus Volar Locking Plate Fixation in the Treatment of Intra_articular Distal Radius Fracture in Adults above 18 Years of Age." Advanced medical journal 7, no. 1 (July 27, 2022): 115–22. http://dx.doi.org/10.56056/amj.2022.167.
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Background and objectives: Distal radius fractures account for more than 20% of all fractures seen in the emergency department, unstable distal radial fractures can be managed by several treatment options including cast immobilization, percutaneous pinning, plate fixation and external fixation, the aim of the study is to compare percutaneous pinning and volar locking plate in the treatment of distal radius fracture AO C1 subtype. Methods: Thirty patients were included and divided into 2 equal groups, group 1 underwent volar locking plate fixation and group 2 underwent percutaneous k wire fixation, the functional and radiological outcomes were assessed by DASH and Stewart’s score respectively and range of motion was measured. Results: Plate group has significantly higher mean flexion at 3 and 12 months than those of the pin group, DASH score at 3 and 6 months was significantly higher in pin group (28.43 and 10.59 respectively) than plate group (20.47 and 16.75 respectively) but no significant difference was showed between the pin and plate groups at 12 months (14.58 vs 13.23 respectively). When the difference between preoperative and 12 months radiographs was measured ulnar variance, radial inclination, and palmar tilt were significantly higher in the plating group, however, the Stewart’s score distribution between both groups showed no significant differences. Conclusions: While there was no functional outcome difference at one year of follow up between patients treated with either treatments modality, patients requiring faster recovery and return to function can be offered open reduction and volar locking plate fixation.
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Florek, Jakub, Ireneusz Kotela, Filip Georgiew, Witold Zieńczuk, and Tomasz Rzeszutek. "Comparison of Radiographic Outcomes of Surgical Treatment in Patients with Distal Radial Fractures." Ortopedia Traumatologia Rehabilitacja 20, no. 6 (December 31, 2018): 461–70. http://dx.doi.org/10.5604/01.3001.0012.8395.
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Background. Unstable and comminuted distal radial fractures require surgical treatment by percutaneous insertion of Kirschner wires, open reduction, and fixation with a non-locking or locking plate or with an external device. Choosing a surgical method that produces “better” outcomes may help select the most efficient treatment method. Material and methods. The study group included 100 patients after surgical treatment by closed reduction and simple fixation with Kirschner wires and by open reduction and LCP locking plate fixation. Radiographic assessment was based on images obtained before the surgery, immediately after fracture reduction, and at 6 weeks, 6 months, and 12 months after the procedure. Results. A comparison of the volar tilt angle in patients after fixation with Kirschner wires and LCP plates did not show any statistically significant differences before the surgery or at 6 weeks. A difference in the outcomes was found at 6 and 12 months and it turned out to be highly statistically significant. A comparison of the inclination angle and radial height in patients after Kirschner wire and LCP plate fixation showed statistically significant differences at 6 weeks, 6 months, and 12 months. A comparison of the radiographic outcomes using the Sarmiento classification in patients after Kirschner wire and LCP plate fixation revealed statistically significant differences at all follow-up time points. Conclusions. The radiographic parameters were superior in patients treated by open reduction and LCP plate fixation. The difference was seen with regard to all the parameters studied.
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Goto, Akira, Tsuyoshi Murase, Kunihiro Oka, and Hideki Yoshikawa. "USE OF THE VOLAR FIXED ANGLE PLATE FOR COMMINUTED DISTAL RADIUS FRACTURES AND AUGMENTATION WITH A HYDROXYAPATITE BONE GRAFT SUBSTITUTE." Hand Surgery 16, no. 01 (January 2011): 29–37. http://dx.doi.org/10.1142/s0218810411005023.
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Treatment of distal radius fractures with a volar fixed angle plate achieves sufficient stabilisation and permits early physical exercise. However, secondary displacement after surgery sometimes occurs in elderly patients with a metaphyseal comminution and/or cases in which the subchondral support pegs were not placed immediately below the subchondral zone.We treated elderly patients suffering from distal radius fractures with metaphyseal comminution, using both volar fixed angle plate with or without augmentation with a hydroxyapatite bone graft substitute to investigate the benefit of augmentation for maintaining a fracture reduction. We evaluated the differences among radiographic parameters including palmar tilt, radial inclination, and ulnar variance on immediate postoperative and final follow-up radiographs to analyse the maintenance of the initial reduction.There were no significant differences between the two groups in terms of palmar tilt (P = 0.80) and radial inclination (P = 0.17); however, ulnar variance increased significantly in the group treated with a volar fixed angle plate without augmentation (P < 0.05).It might be useful to use a combination technique of a locking plate system and the hydroxyapatite bone graft substitute as augmentation to treat distal radius comminuted fractures in elderly patients.
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Opel, S., S. Konan, and E. Sorene. "Corrective distal radius osteotomy following fracture malunion using a fixed-angle volar locking plate." Journal of Hand Surgery (European Volume) 39, no. 4 (September 19, 2013): 431–35. http://dx.doi.org/10.1177/1753193413497636.
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Post-traumatic distal radius deformity may cause severe morbidity, and corrective osteotomy is often necessary to realign the functional axis of the wrist to correct symptomatic malunion. The aim of this retrospective study was to review the short-term results of a single surgeon’s series of distal radius corrective osteotomies following fracture malunion using a fixed-angle volar locking plate for 20 patients (26 women) of an average age of 57 (range 19–83) years. At short-term follow up (average 14 months, range 12–15 months), no complications were noted and radiological union was confirmed in all cases at an average of 3 months. The average post-operative Disability of the Arm, Shoulder and Hand score was 13.48 (range 0–48.33) and an objective improvement was noted in movements at the wrist joint. A statistically significant improvement was achieved in ulnar variance, radial inclination, dorsal tilt, and supination.
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Loveridge, J., N. Ahearn, C. Gee, D. Pearson, S. Sivaloganathan, and R. Bhatia. "TREATMENT OF DISTAL RADIAL FRACTURES WITH THE DVR-A PLATE — THE EARLY BRISTOL EXPERIENCE." Hand Surgery 18, no. 02 (January 2013): 159–67. http://dx.doi.org/10.1142/s0218810413500184.
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Aim: The aim of the study was to assess how adequately distal radial fracture reduction was reproduced and maintained with the distal volar radius anatomic DVR-A (Biomet, Inc) locking plate. Methods: We looked at a consecutive series of 111 patients treated with the DVR-A plate at our institution from 2007–2010. The preoperative, intra-operative, and postoperative films were reviewed. The AO and Frykman classification was recorded. The sagittal tilt, radial inclination, and radial length were measured on intra-operative X-rays and compared with final follow-up X-rays. The last recorded range of motion at follow-up and a functional assessment using the Disabilities of the Arm, Shoulder, and Hand (DASH) score was recorded. Results: At final follow-up a mean radial inclination of 22.22 degrees (11 to 38 degrees), radial height of 11.85 mm (6 to 18 mm), and sagittal tilt of 6.71 degrees volar (-9 to 19 degrees) was achieved. From initial post-operative films, to final follow-up X-rays there was a mean increase of 0.17 degrees in radial inclination, a mean loss of 0.36 mm radial height, and a mean loss of 2.17 degrees volar tilt. The mean extension was 46.8 degrees, flexion 48.3 degrees, pronation 77.4 degrees, supination 74.8 degrees, radial deviation 15.3 degrees and the ulnar deviation 19 degrees. The mean DASH score was 12.8 (0–68). Conclusion: The DVR-A plate achieved a highly satisfactory reduction of radial length and radial inclination, with a small loss of volar sagittal tilt at final follow-up. A good functional outcome was reported, with a satisfactory range of motion achieved. The DVR-A plate is a safe and effective treatment for unstable and intra-articular displaced distal radius fractures, particularly in younger patients, in the short term.
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Zyluk, Andrzej, Piotr Janowski, Zbigniew Szlosser, and Piotr Puchalski. "Percutaneous K-wires vs palmar locking plate fixation for different types of distal radial fractures: a comparison of the outcomes of two methods to controll our guidelines." Handchirurgie · Mikrochirurgie · Plastische Chirurgie 50, no. 05 (September 2018): 319–25. http://dx.doi.org/10.1055/a-0751-2886.
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AbstractThe objective of the study was a comparison of the outcomes of K-wire vs plate fixation for distal radial fractures used according to the proposed institutional algorithm. Fracture configurations A2, A3, B1, B2, C1 and some C2 were operated on with K-wire pinning, whereas B3 and some B2, C3 and some C2 were with locking palmar-plate fixation. Patients and Methods: Four hundred and sixty-seven patients were non-randomly allocated for either K-wire (n = 363) or palmarplate (n = 104) fixation. The results were assessed at 3 and 12 months by the same outcome measures. Results: At the 3-month assessment, statistically significant differences in grip strength and the DASH scores were noted in favour of the plate-fixation group. At the 12-month assessment, statistically significant differences were observed in the wrist palmar and dorsal flexion, favouring the plate-fixation group. Statistically significant differences were noted in radiological measures of the palmar tilt and the ulnar variance, both favouring the plate-fixation method. Meaningful secondary dislocations were noted in ten patients, all in the K-wire-fixation group. Conclusion: We conclude that palmar locking plate fixation in even more severe fractures leads to better radiological and clinical outcomes than K-wire fixation in less severe fractures.
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Egiazaryan, Karen A., Boris I. Maximov, Artur A. Askerov, Nikolay N. Vedernikov, and Maksim I. Matvienko. "Functional and Radiographic Outcomes for Distal Radius Fractures Treated with Volar-Locked Plates and Percutaneous K-Wires: A Comparative Study." Traumatology and Orthopedics of Russia 27, no. 4 (December 29, 2021): 31–41. http://dx.doi.org/10.21823/2311-2905-1696.
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Purpose to evaluate and to compare radiological and functional outcomes of the volar locking plate fixation using pronator-sparing approach and K-wire fixation of distal radius fractures. Materials and Methods. We retrospectively analyzed 41 patients with distal radius fractures (27 female and 14 male) treated in the period from 2016 to 2020 using minimally invasive osteosynthesis via pronator-sparing approach. The mean age was 51 years (31-74 years). The control group consists of 37 patients (19 female and 18 male, mean age 61 years (29-76 years)), who underwent minimally invasive percutaneous K-wire fixation of distal radius fractures during the same period of time. Comparative analysis of radiographic and functional outcomes in both groups of minimally invasive osteosynthesis of distal radius fractures was carried out in the period from 1 to 6 months after the surgery. Results. Primary union of distal radius fractures was confirmed in X-rays in all patients within 6 weeks after the surgery. There were no complications in patients treated by pronator-sparing volar locking plate fixation, whereas in K-wire group we had 6 patients with complications: 4 cases (11%) superficial infection around K-wires and 2 cases (5,4%) intraoperative damage of sensitive branch of radial nerve. There were statistically significant differences in radiographic results (volar tilt, radial inclination, and radial height) between two groups: they all were better in patients treated by pronator-sparing volar locking plate fixation during the whole follow-up period (р0,01). Minimally invasive volar locking plate fixation via pronator-sparing approach also provided significantly better grip strength and range of wrist motion and forearm rotation in the early 6-month postoperative period, compared with percutaneous K-wire fixation (р0,001). Conclusion. Our study demonstrates that both techniques of minimally invasive osteosynthesis of distal radius fractures are effective and relatively safe methods of surgical treatment, but volar plating via pronator-sparing approach leads to a better reconstruction of the distal radius and better functional outcomes compared to percutaneous K-wiring.
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Farshad, M., F. Hess, L. Nagy, and A. Schweizer. "Corrective osteotomy of distal radial deformities: a new method of guided locking fixed screw positioning." Journal of Hand Surgery (European Volume) 38, no. 1 (December 19, 2011): 29–34. http://dx.doi.org/10.1177/1753193411433227.
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Corrective osteotomy for distal radial malunion is a valuable but at times technically challenging operation. We have developed a new device to aid in the performance of the operation. We compared clinical use of the new technique with the standard technique. In 11 patients treated with the new technique the volar locking plate needed repositioning only once. With the standard technique in 17 patients the plate was repositioned in nine cases and needed bending in six cases. The new method corrected radial inclination (SD of 3° vs. 9°) and ulnar variance (SD of 0.9 mm vs. 1.4 mm) more predictably than the standard technique but there was no advantage in correction of volar tilt (SD of 6° vs. 4°). In our experience the new device makes corrective osteotomy of the distal radius easier and more reliable.
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Regar, Chhagan Lal, Siddharath Sharanappa Parmeshwar, Ramesh Chandra Meena, Shyoji Lal Sharma, and Jitesh Kumar Jain. "A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures." International Journal of Research in Orthopaedics 6, no. 6 (October 22, 2020): 1222. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20204588.
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<p><strong>Background:</strong> The current study is conducted to assess and compare the radiological and functional outcomes between variable and fixed angle volar plating in unstable intra-articular distal radius fractures.</p><p><strong>Methods:</strong> A prospective study was conducted from May 2018 to May 2020. A total of 156 patients were randomised into two groups A and B of 78 patients each. The plates were T or oblique fixed angle volar plate in group A and variable angle volar plate in group B. Patients were followed up for minimum 12 months. The functional outcome was measured by patient rated hand wrist evaluation score (PRHWE) and radiological outcome by radial height, volar tilt and radial inclination. The secondary objective was to correlate complications.</p><p><strong>Results:</strong> In our study average PRHWE score was better in group B (p<0.05). Radial height, volar tilt, radial inclination was much closer to anatomical wrist radiology was seen in group B. The most common complication was finger and wrist stiffness in group A.</p><p><strong>Conclusions:</strong> Patients treated with variable angle volar plate showed better results in functional and radiological outcomes at 12 months follow-up but limitations include short duration of follow up.</p>
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Ambulgekar, Rajesh K., and Vishal Gurnani. "Post-operative complications of displaced unstable distal end radius fracture treated by volar plating." International Journal of Research in Orthopaedics 6, no. 5 (August 26, 2020): 1008. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20203722.
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<p class="abstract"><strong>Background:</strong> Fracture of the distal radius (DRF) is one of the most common fractures present in emergency. The most common operative treatments of these fractures are open reduction and internal fixation with volar locking plates. The incidents and types of complications associated with the use of these operations is an ongoing process till date. The objective of the study was to find demographic profile of patients of displaced unstable distal end radius fracture, and to study the post-operative complications among above patients treated by volar plating.</p><p class="abstract"><strong>Methods:</strong> We performed a prospective study documenting types of complications and their occurrence in a group of patients who received open reduction and internal fixation. Our definition of a complication was a case in which the patient had one or more complications which required an intervention medical or surgical.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 33 patients were included, most of the cases, (63.63%) were from the age group 21-40 years. We had 4 cases (12. 12%) females, and 29 cases (87.88%) males. Post-operative complications were noted in 7 individuals 22.2 % and no complications noted in 26 cases (78.8%). In 30 cases there was no any deformity found in postoperative one year follow up, 2 patients develop prominent ulnar styloid found in follow up of one year ,and 1 residual dorsal tilt found after one year.</p><p class="abstract"><strong>Conclusions:</strong> Our finding that 22.2% suffer from complication when treated using a volar locking plate must be taken into consideration when surgeons choose between conservative or operative treatment for DRF treatment. A few other studies have looked at the incidents of complications and have reported similar results.</p>
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Yoshii, Yuichi, Yasukazu Totoki, Wen-lin Tung, Kenichi Akita, and Tomoo Ishii. "A Comparison of Radiographic Outcomes between 3D Preoperative Planning and Conventional Planning in the Osteosynthesis of Distal Radius Fractures." Journal of Hand Surgery (Asian-Pacific Volume) 24, no. 03 (August 23, 2019): 303–10. http://dx.doi.org/10.1142/s2424835519500383.
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Background: To assess the usefulness of three-dimensional (3D) digital pre-operative planning, we compared the radiographic parameters of the distal radius from 3D planning and conventional planning after osteosynthesis of distal radius fractures. We hypothesized that the use of 3D digital planning may improve radiographic outcomes for reduction and decrease the risk of correction loss.Methods: Sixty wrists of 60 distal radius fracture patients were randomly divided into two groups according to the order of hospital visits. Thirty wrists were treated with 3D preoperative planning as the plan group. Another thirty wrists were treated with conventional preoperative planning as the control group. Both groups were treated with volar locking plates. In the plan group, 3D digital preoperative planning and a surgical simulation were performed in order to determine the reduction and placement of the implants in addition to the plate/screw size prior to surgery. In the control group, conventional preoperative planning was performed. Ulnar variance, volar tilt, and radial inclination were measured at one week, three and six months after surgery. Difference of the measurement of radiographic parameters between operated and healthy side wrists were compared between plan and control groups at one week after surgery. Loss of corrections for radiographic parameters were compared between plan and control groups.Results: The differences between the operated and healthy side wrists were significantly smaller in the plan group compared to the control group for the volar tilt and radial inclination (p < 0.05).The loss of corrections for ulnar variance and volar tilt were significantly smaller in the plan group compared to the control group at six months after surgery (p < 0.05).Conclusions: 3D preoperative planning offers better reduction accuracy and reduces correction loss in the osteosynthesis of distal radius fractures.
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Braziulis, Kęstutis, Rytis Rimdeika, Rima Kregždytė, and Šarūnas Tarasevičius. "Associations Between the Fracture Type and Functional Outcomes After Distal Radial Fractures Treated With a Volar Locking Plate." Medicina 49, no. 9 (October 5, 2013): 62. http://dx.doi.org/10.3390/medicina49090062.
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Objective. The aim of this study to investigate the associations of fracture type, age, and gender with hand function after distal radius fractures treated with a volar locking plate at a 6-month follow-up. Material and Methods. A total of 120 patients with displaced distal radius fractures were included into the study. They were operated on using a volar locking plate system. All the fractures were classified according to the AO classification, and the patients were divided into 3 groups by the fracture type. The range of motion and grip strength were evaluated at the 6-month follow-up. Multivariate linear regression analysis was used to evaluate the associations of age, gender, and fracture type with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire was completed as an outcome measure. Results. A total of 28 patients experienced type A fractures; 70 patients, type B fractures; and 22 patients, type C fractures. No statistically significant difference regarding age and sex among the groups was observed. At 6 months after the surgery, the mean DASH score for type A, B, and C fractures was 16, 13, and 32, respectively (P=0.01). After the surgery, the radiographic parameters such as the volar tilt and the ulnar variance were significantly worse in the patients with type C fractures. Grip strength and the range of motion of the contralateral healthy hand at the 6-month follow-up were significantly better than those of the operated hand. The linear regression analysis showed that the type C fracture was the only factor significantly associated with lower DASH score. Conclusions. The patients with type C fractures treated with a volar locking plate had a worse wrist function as compared with the patients type A and B fractures at the 6-month follow-up. The postoperative hand function was significantly associated only with the type C fracture, while age and gender had no significant impact.
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Patel, S., PB Menéndez, FS Hossain, HB Colaço, MH Lee, ED Sorene, and EJ Taylor. "Does the DVR® plate restore bony anatomy following distal radius fractures?" Annals of The Royal College of Surgeons of England 96, no. 1 (January 2014): 49–54. http://dx.doi.org/10.1308/003588414x13824511650254.
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INTRODUCTION Fractures of the distal radius are common. Malreduced fractures are associated with residual functional deficiency. There has been a trend over the last few years for using fixed angle volar locking plates to surgically stabilise this injury. Our unit uses the DVR® plate (DePuy, Warsaw, IN, US). Nevertheless, it is unknown whether the normal bony anatomy is recreated or merely restored to acceptable limits with its usage. The aim of this study was to evaluate the reduction achieved compared with an uninjured population and pre-existing quoted ‘normal’ values. Furthermore, we wanted to identify the percentage of cases that were reduced to acceptable limits, and determine whether the grade of the surgeon and fracture type was a confounding influence on this reduction. METHODS A retrospective review of the 3-month postoperative radiography of 48 eligible patients who underwent open reduction and internal fixation of a distal radius fracture with a DVR® plate was undertaken. RESULTS Volar tilt, radial length and inclination were different to quoted normal values (p<0.01). Despite this, these parameters fell within acceptable limits in 46 cases; this was not influenced by fracture type or grade of operating surgeon. CONCLUSIONS The DVR® plate restores the bony anatomy to within acceptable limits in the majority of patients who have sustained a fracture of the distal radius although of all parameters investigated, the widest variability is seen in volar tilt.
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Martinez-Angulo, Jose Ramon, Eduardo Perez-Careta, Juan Carlos Hernandez-Garcia, Sandra Marquez-Figueroa, Jose Hugo Barron Zambrano, Daniel Jauregui-Vazquez, Jose David Filoteo-Razo, et al. "Automated Data Acquisition System Using a Neural Network for Prediction Response in a Mode-Locked Fiber Laser." Electronics 9, no. 8 (July 22, 2020): 1181. http://dx.doi.org/10.3390/electronics9081181.
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In this paper, we proposed a system to integrate optical and electronic instrumentation devices to predict a mode-locking fiber laser response, using a remote data acquisition with processing through an artificial neural network (ANN). The system is made up of an optical spectrum analyzer (OSA), oscilloscope (OSC), polarimeter (PAX), and the data acquisition automation through transmission control protocol/internet protocol (TCP/IP). A graphic user interface (GUI) was developed for automated data acquisition with the purpose to study the operational characteristics and stability at the passively mode-locked fiber laser (figure-eight laser, F8L) output. Moreover, the evolution of the polarization state and the behavior of the pulses are analyzed when polarization is changed by proper control plate adjustments. The data is processed using deep learning techniques, which provide the characteristics of the pulse at the output. Therefore, the parameter classification-identification is in accordance with the input polarization tilt used for the laser optimization.
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Gavaskar, A. S., S. Muthukumar, and N. Chowdary. "Fragment-specific fixation for complex intra-articular fractures of the distal radius: results of a prospective single-centre trial." Journal of Hand Surgery (European Volume) 37, no. 8 (March 8, 2012): 765–71. http://dx.doi.org/10.1177/1753193412439677.
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The goal was to evaluate the efficacy of 2.4 mm column-specific plating for intra-articular distal radius fractures. In total, 105 patients with AO type C distal radius fractures were operated on using the locking distal radius system, Synthes. Follow-up assessments including clinical (wrist and forearm range of motion, grip strength), radiological (articular step, radial length and inclination, volar tilt, and ulnar variance), and functional scores (Disabilities of the Arm, Shoulder, and Hand; Patient Rated Wrist Evaluation) were made at regular intervals until 1 year. Union was obtained in all patients. Articular surface was anatomically reconstructed in 74 patients (70.5%). Clinical and functional evaluation showed significant continuous improvements over the first year. C1 fractures had a better chance of anatomical reduction compared with C2 and C3 fractures. Fracture type, quality of reduction, and presence of degenerative changes did not show a significant effect on functional outcome scores. Column-specific fixation of the distal radius can achieve satisfactory results in complex intra-articular fractures.
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Hanumanthappa, Prakashappa Thamalehally, Bharath Raja B. S., and Muthu Kishore Marichamy. "Radiological outcomes of AO type B and C distal radius fractures managed with 2.7 mm volar locking plate fixation in geriatric population: a retrospective analysis." International Journal of Research in Orthopaedics 7, no. 4 (June 23, 2021): 768. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20212419.
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<p class="abstract"><strong>Background:</strong> Distal end radius fractures are one of the most common fractures. Compared to younger patients, elderly with distal radius fractures with osteoporosis and higher comminution compromise the treatment outcomes. Anatomic reduction with stable fixation is usually the choice of treatment for displaced intra-articular fractures. While osteoporosis and poor bone quality hamper fracture stabilization, locking compression plates (LCPs) provide enhanced stability and axial loading force as compared to conventional plates. The current study retrospectively analysed the postoperative radiological outcomes in a 2.7 mm volar LCP system used for internal stabilisation of intra articular distal radius fractures.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted in the Sanjay Gandhi institute of trauma and orthopaedics, Bangalore from June 2018 to July 2020. All Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B and C distal radius fractures of patients aged 60 and above who underwent 2.7 mm volar locking plate fixation during that time period were analysed with X-rays at immediate post-operative, six weeks and three months. The radiological outcome was scored based on Sarmiento’s modification of Lindstorm criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean immediate post-operative radial shortening, decrease in radial deviation and loss of palmar tilt were 3.80±1.03, 4.38±1.05 and 3.97±1.02, respectively. The corresponding values at last follow up were 4.31±1.12, 6.19±1.02 and 4.76±0.99, respectively. No statistically significant difference (p=0.949; p=1.0; p=0.996) in radial shortening, loss of radial deviation and decrease in palmar angulation was seen till the final follow up. Sarmiento’s modification of Lindstorm criteria showed a good radiological outcome in 80% and excellent in 20%.</p><p class="abstract"><strong>Conclusions:</strong> Use of 2.7 mm volar LCP showed good to excellent post-operative radiological outcomes in geriatric population. The fracture reduction achieved in the immediate post-operative period is maintained throughout the follow up duration without any significant change.</p>
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Bohl, Daniel D., Nasima Mehraban, Ian Foran, and Kamran S. Hamid. "Routine Fixation of Weber B Fibula Fractures with a Lateral Locking Plate and No Lag Screw." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0014. http://dx.doi.org/10.1177/2473011420s00140.
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Category: Ankle Introduction/Purpose: The current standard of care for management of an unstable ankle fracture that includes an oblique Weber B fibula fracture is open reduction and internal fixation (ORIF) using a plate and screws to anatomically reduce and compress the fractured fibula. The most popular first-line techniques include either a lag screw with neutralization plate or an anti- glide plate with or without a lag screw through the plate. However, these techniques can be technically challenging in osteoporotic bone or within fibulas of smaller diameter, and in some cases can result in fragmentation at the fracture site. The purpose of this study is to examine an alternative first-line method for routine treatment of Weber B fibula fractures. Methods: Fifty-two patients undergoing ORIF of a Weber B fibula fracture by a single surgeon were included in this retrospective study. In every case, reduction and clamping of the fracture was attempted. If successful, a lateral locking plate was slid underneath the clamp(s) and applied with cortical screws proximally and locking screws distally. If clamping was unsuccessful, length/alignment/rotation was achieved by alternative methods (i.e. push-pull technique, use of plate to reduce fracture, etc.), and a lateral locking plate was ultimately applied in a similar manner. No screw crossed the fracture in any case. Per published precedent, nonunion was defined as either a gap of >3mm between fracture surfaces >6 months postoperatively or a fracture line >2-3 mm wide and sclerosing of the fracture surfaces >6 months postoperatively. Similarly, malunion was defined as >=1 of the following: talar tilt >2 degrees, talar subluxation >2 mm, or tibiofibular clear space >=5 mm. Results: The mean (+- standard deviation) age of the 52 included patients was 44.2 +- 16.2 years, the mean body mass index was 27.7 +- 6.6 kg/m2, and 63.5% of patients identified themselves as female. The mean follow-up was 6.2 +- 4.4 months. In addition to undergoing fixation of the lateral malleolus, 21 patients also underwent fixation of the posterior malleolus, 27 underwent fixation of the medial malleolus, 29 underwent fixation across the syndesmosis, and seven underwent repair of the deltoid. In all patients, bony anatomic union of the fibula and congruence of the mortise were achieved, with no cases of malunion or nonunion. Conclusion: Routine fixation of Weber B fibula fractures with a lateral locking plate and no lag screw is an alternative method to treat Weber B fibula fractures with excellent radiographic results.
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Chen, Shih-Nan, Chiou-Jiu Chen, and James A. Lerczak. "On Baroclinic Instability over Continental Shelves: Testing the Utility of Eady-Type Models." Journal of Physical Oceanography 50, no. 1 (January 2020): 3–33. http://dx.doi.org/10.1175/jpo-d-19-0175.1.
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AbstractThis study examines the utility of Eady-type theories as applied to understanding baroclinic instability in coastal flows where depth variations and bottom drag are important. The focus is on the effects of nongeostrophy, boundary dissipation, and bottom slope. The approach compares theoretically derived instability properties against numerical model calculations, for experiments designed to isolate the individual effects and justified to have Eady-like basic states. For the nongeostrophic effect, the theory of Stone (1966) is shown to give reasonable predictions for the most unstable growth rate and wavelength. It is also shown that the growing instability in a fully nonlinear model can be interpreted as boundary-trapped Rossby wave interactions—that is, wave phase locking and westward phase tilt allow waves to be mutually amplified. The analyses demonstrate that both the boundary dissipative and bottom slope effects can be represented by vertical velocities at the lower boundary of the unstable interior, via inducing Ekman pumping and slope-parallel flow, respectively, as proposed by the theories of Williams and Robinson (1974; referred to as the Eady–Ekman problem) and Blumsack and Gierasch (1972). The vertical velocities, characterized by a friction parameter and a slope ratio, modify the bottom wave and thus the scale selection. However, the theories have inherent quantitative limitations. Eady–Ekman neglects boundary layer responses that limit the increase of bottom stress, thereby overestimating the Ekman pumping and growth rate reduction at large drag. Blumsack and Gierasch’s (1972) model ignores slope-induced horizontal shear in the mean flow that tilts the eddies to favor converting energy back to the mean, thus having limited utility over steep slopes.
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Zaigham Habib, Shuja Uddin, Riaz Qadeer Niazi, Muneeb Ur Rehman, Abdul Qadir, and Muhammad Kamran. "Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius." Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University 17, no. 1 (March 31, 2021): 66–70. http://dx.doi.org/10.48036/apims.v17i1.500.
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Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires.
Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by ‘non-probability, consecutive sampling technique’ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire).
Results: The mean age in the group A and group B was 53.7 ± 11.8 years and 55.2 ± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05).
Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 months’ postoperative period.
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Katayama, Takeshi, Hiroshi Ono, and Shohei Omokawa. "Comparison of Five Years Clinical and Radiological Outcomes between Progressive and Non-Progressive Wrist Osteoarthritis after Volar Locking Plate Fixation of Distal Radius Fractures." Journal of Hand Surgery (Asian-Pacific Volume) 24, no. 01 (February 13, 2019): 30–35. http://dx.doi.org/10.1142/s2424835519500061.
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Background: This study aimed to identify the effect of the progression of postoperative wrist osteoarthritis on 5 years clinical and radiological outcomes after volar locking plate fixation of distal radius fractures. Methods: Altogether, 56 patients with distal radius fractures were followed up 5 years after surgery. Clinical assessment was performed using the Mayo modified wrist score, a visual analogue scale of pain, the Japanese version of the Disabilities of the Arm, Shoulder, and Hand score, and Patient-related wrist evaluation. Standardized wrist radiographs were used to assess wrist morphology and the Knirk and Jupiter’s degree of osteoarthritis. Multivariate logistic regression was used to analyze postoperative morphological changes in the wrist and carpal alignment regarding their correlation with progression of wrist osteoarthritis. Results: Progression of postoperative wrist osteoarthritis was recognized in 37 of the 56 cases (66.1%). Compared with the clinical outcomes at the time of the fracture union completion, almost clinical outcomes improved up to 5 years follow-up time as well as at 1 year after surgery. The range of wrist flexion at 5 years follow-up was significantly less in the progressive osteoarthritis group than in those with non-progressive osteoarthritis. The persistent step-off immediately after surgery significantly affected the postoperative progression of wrist osteoarthritis. Changes in the radial inclination, volar tilt, and radioscaphoid angle correlated with progression of wrist osteoarthritis. The highest correlation was with the change of radioscaphoid angle. Conclusions: Good clinical results were maintained at 5 years after surgery, but progression of postoperative wrist osteoarthritis interfered with improvement of wrist flexion. Change in the radioscaphoid angle was the factor that was most highly correlated with progression of postoperative wrist osteoarthritis.
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Wakasugi, Takuma, and Ritsuro Shirasaka. "Intramedullary Nail Fixation for Displaced and Unstable Distal Radial Fractures in Patients Aged 65 Years or Older." Journal of Hand Surgery (Asian-Pacific Volume) 21, no. 01 (February 2016): 59–63. http://dx.doi.org/10.1142/s2424835516500089.
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Background: Distal radius fractures in elderly patients are now commonly treated with a volar locking plate, but flexor pollicis longus dysfunction caused by stripping of the muscle and tendon irritation and rupture caused by prominence of the implant have been reported. Intramedullary implants can stabilize distal radius fractures while minimally affecting the flexor and extensor tendons and muscles around the site, but osteoporosis in elderly patients might affect the radiographic and functional results of distal radius fractures treated by intramedullary implants. We investigated the radiographic and functional results of intramedullary implants for distal radius fractures in patients ≥65 years of age.Methods: We reviewed medical records of 40 patients with extra-articular or simple intra-articular fractures with the sagittal fracture line treated by an intramedullary implant.Results: All fractures achieved bony union, with an average radial inclination of 24.9 degrees, volar tilt of 9.2 degrees, and ulnar variance of 0.7 mm. We encountered one case of postoperative volar displacement of the distal fragment due to the small size of the intramedullary implant. The average range of motion was 69.8 and 59.9 degrees for dorsal and palmar wrist flexion, respectively. Average percentile grip strength of the uninjured side was 97%. The average Mayo modified wrist score at final follow-up was 91.9 points, with 20 patients graded as excellent, 16 as good, and 4 as fair.Conclusions: The findings of this study indicate that intramedullary implants for dorsally displaced extra-articular or simple intraarticular distal radius fractures may offer good radiological and functional outcomes without hardware irritation in elderly patients. Distal radius fractures with an osteoporotic, large medullary canal should be stabilized by implants of an appropriate size.
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Hirasawa, Rui, Eichi Itadera, and Seiji Okamoto. "Changes in the Rate of Postoperative Flexor Tendon Rupture in Patients with Distal Radius Fractures." Journal of Hand Surgery (Asian-Pacific Volume) 25, no. 04 (October 28, 2020): 481–88. http://dx.doi.org/10.1142/s242483552050054x.
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Background: Flexor tendon rupture is a major complication after volar locking plating for distal radius fracture (DRF). Few studies have investigated changes in the rate of postoperative flexor tendon rupture in patients with DRFs. The present study aimed to investigate the changes in the rate of postoperative flexor tendon rupture and to assess plate placement and reduction positions. Methods: We retrospectively reviewed patients in whom more than 24 months had passed since DRF surgery. The patients were interviewed by telephone. Forty-nine patients (50 fractures; 2007–2009) from institution A were included in group 1 and 81 patients (84 fractures; 2013–2016) from institution B were included in group 2. The DRF surgery method was similar between the two groups. The rate of flexor tendon rupture, Soong classification grade, and radiological index (i.e., volar tilt [VT], radial inclination [RI], and ulnar variance [UV]) were statistically investigated in both groups. Results: Patient epidemiology was not significantly different between the two groups. The flexor tendon rupture rates were 2% and 0% in groups 1 and 2, respectively, without a significant difference. With regard to the Soong grade, 44 fractures were grade 2 and 6 were grade 1 in group 1, whereas 18 were grade 2, 38 were grade 1, and 28 were grade 0 in group 2, with a significant difference (p < 0.05). With regard to the radiological index, the mean VT values were 5° and 11° in groups 1 and 2, respectively, with a significant difference (p < 0.05). However, RI and UV showed no significant difference. Conclusions: Plate placement and reduction positions, which are risk factors for flexor tendon ruptures after DRFs, have improved recently when compared with previous findings. With these changes, the rate of flexor tendon rupture is presumed to have decreased.
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Ali, Tanveer, Irfan U. Ashraf, Sayyidah A. T. N. Qadri, and Imtiyaz A. Beigh. "Distal radius fractures: a prospective study of the clinical and radiological outcomes in surgically managed patients." International Journal of Research in Orthopaedics 8, no. 5 (August 25, 2022): 559. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20222186.
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<p class="abstract"><strong>Background:</strong> Objective of the research was to evaluate radiological and functional outcome in fractures of the distal radius treated by various surgical methods.</p><p class="abstract"><strong>Methods:</strong> 89 patients with distal radius fractures were randomly divided into three groups according to a computer-generated table of randomization. 40 patients were managed by K wire fixation. 22 patients were managed by external fixator. 27 patients were managed by volar plating technique. Anatomical restoration was evaluated by posterior-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate radial height (RH), radial inclination (RI) and volar tilt (VT). Functional outcome was evaluated using Mayo scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to Mayo score, in K-wire group 72.5% (n=29) patients had excellent to good outcome, 17.5% (n=7) had fair outcome while as 10% (n=4) patients had poor outcome. In external fixator group 72.7% (n=16) patients had excellent to good outcome while as 27.3% (n=6) had fair outcome. In volar plating group 81.5% (n=22) patients had excellent to good outcome while as 18.5% (n=5) had fair outcome.</p><p class="abstract"><strong>Conclusions:</strong> In our study we found that volar locked plating provides advantage in dorsally or volarly displaced intra-articular fractures with excellent to good radiological outcome. However, in type B (partial intra-articular fractures) fractures, volar locking compression plate (LCP) and external fixator provide almost equivocal results. Percutaneous pinning can be recommended for extra-articular or simple intra-articular fracture patterns, with a loss of volar and/or RI but without significant radial shortening.</p>
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Pande, Ashish, Girish G. Mugdum, and Anil K. Mishra. "A retrospective analysis comparing functional and radiological outcomes after treatment of unstable distal radius fractures using volar locked plate versus percutaneous fixation." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 921. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193836.
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<p class="abstract"><strong>Background:</strong> Distal radius fractures are one of the most routinely encountered injuries in an orthopaedic setting. Despite the wide variety of treatment options available there is still debate about the optimal way to treat these fractures. The aim was to evaluate and compare functional and radiological outcomes of unstable distal radius fractures treated by either by using volar locking compression plating (VLP) or by using percutaneous fixation augmented by Kirschner (K) wires (EF).</p><p class="abstract"><strong>Methods:</strong> A retrospective analysis was carried out on all cases of acute unstable unilateral fracture distal radius who were admitted between January 2015 and December 2017 and were treated either by VLP or EF. QuickDASH score and PRWE were documented at every follow up in OPD at 6 weeks, 6 months and 1 year post-op along with serial X-rays at immediate post-op and 01 year which were then compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 122 cases of fracture distal radius were selected for study which fulfilled the inclusion criteria out of which 49 were treated by VLP and 73 by EF. There was no statistical difference in QuickDASH, PRWE scores or wrist ROM between two groups at1 year follow up. However VLP group was better in maintaining palmar tilt, radial length and inclination at the end of 1 year.</p><p class="abstract"><strong>Conclusions:</strong> Both VLP and EF show comparable and predictable good outcomes in treating unstable distal radius fractures when measured in terms of ROM and clinically validated patient outcome scores at 01 year follow up with similar rate of complications.</p><p> </p>
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Al-Faily, Haider O. Hayat Ali, Hussein Ali Nasir, Thaer Rasim Mohammed, and Mohammed Al-Edanni. "Prospective Descriptive Study of Radiological and Functional Outcomes of Volar Barton’s Fracture Fixed by Volar Locked Plate." Open Access Macedonian Journal of Medical Sciences 10, B (February 21, 2022): 1271–75. http://dx.doi.org/10.3889/oamjms.2022.8615.
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BACKGROUND: Volar Barton’s fracture is a shearing mechanism of injury that results in fracture and subluxation of distal end radius in which volar rim of the distal radius is displaced with hand and carpus. Open reduction and volar plate fixation ensure more stable change of displacement, preservation of reduction, and early mobilization. AIM: This study aims to assess the functional and radiological outcome results of volar Barton’s fracture treated by volar buttress plate using the demerit points system of Gartland and Werley. PATIENTS AND METHODS: This study is a prospective descriptive observational study on 32 patients who were treated with ORIF by volar buttress plate for isolated volar Barton’s fractures between February 2018 and June 2020 in Alkindy teaching hospital/Baghdad/Iraq. All volar Barton’s fracture cases satisfying the inclusion criteria which included patient over 18 years, isolated fracture, medically fit, and <5 days old injuries, while fractures extend to radius shaft, compound fractures, and associated with other injuries were excluded from the study. All fractures are fixed by volar locked plate followed up for 12 week’s duration for functional and radiological assessment using the Demerit points system of Gartland and Werley. RESULTS: Most cases were in the age group below 40 years, average age 38 years (range 19–64 years), male patient was 69%, side of involvement was right wrist in 75% of cases, falling on an outstretched hand account 50%, while roads traffic accidents in 37.5%, fall from a height in 6.25%, and direct trauma in 6.25%. The final sequel of the results was average volar tilt was 11.1°, the radial shortening average was 4 mm, the radial inclination average was 19.9°, and the ulnar variance was 0.3 mm. Functional outcomes depending on Gartland and Werley’s score were 50% as excellent results, 43.75% as good results, 6.25% as fair results, and no poor results in this study. CONCLUSIONS: Volar locking buttress plate provides fracture stability and early mobilization, therefore, recovery of daily live activity in a short time.
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R.G., Madhu, and Manikumar C.J. "Functional Evaluation of Surgical Fixation of Distal Radius Fractures." Journal of Evidence Based Medicine and Healthcare 7, no. 48 (November 30, 2020): 2825–30. http://dx.doi.org/10.18410/jebmh/2020/579.
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BACKGROUND Distal radius fracture is the most common orthopaedic injury in adults. It has an approximate incidence of 1:10,000 people and 16 % are of skeletal and 74 % of forearm fractures. Many fractures of the distal radius are relatively uncomplicated and can be effectively managed with closed reduction and immobilization in a cast. Over the past twenty years, more sophisticated internal and external fixation techniques and devices for the treatment of distal radius fractures have been developed keeping up with the demands of the modern day. Functional outcome seems to follow the surgical treatment which results in more anatomical results. METHODS A total of thirty (n = 30) distal radial fractures were treated surgically by various methods at Government General Hospital, Kakinada. They were evaluated functionally with Quick Dash score at one and half, 3 and 6 months duration. Twenty cases were treated with a volar plate through Henry’s approach. Six cases were treated with per cutaneous k wire fixation and four cases were treated with forearm external fixator application (Ligamentotaxis). Final outcome was evaluated by QUICK DASH evaluation questionnaire. In each patient Quick Dash score were taken at 6 weeks, 3 months & 6 months interval along with range of motion at 6months interval up to 2 years. RESULTS There were 22 (73.3 %) males and 8 (26.6 %) females. The age group ranged between 15 - 80 years. Eleven (36.6 %) patients had right side involvement. Nineteen (63.3 %) had left side involvement. Of the 30 cases, mode of injury was fall on outstretched hand in 21 (70 %) patients and road traffic accident in 9 (30 %) patients. Functional outcome correlated positively with the degree of anatomical reduction. CONCLUSIONS Functional outcome correlated positively with the degree of radial length, volar tilt and radial inclination achieved when compared to normal side. The method of internal fixation with volar locking plate appears to be favoured by many akin to its ability to sustain the reduction. Comminuted intra articular fractures fared less well with more number of complications. However, fracture union time seems to be unaffected by the method of fixation. KEYWORDS Radius A02.835.232.087.090.700, Orthopaedic Procedures E02.718, Range of Motion, Articular E01.370.600.700
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Pardo García, Juan María, Verónica Jiménez Díaz, Amaya Barberia Biurrun, Lorena García Lamas, Miguel Porras Moreno, and David Cecilia López. "Surgical and Protocolized Management of Distal Radius Nonunion." Revista Iberoamericana de Cirugía de la Mano 48, no. 02 (November 2020): 79–86. http://dx.doi.org/10.1055/s-0040-1718454.
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Abstract Introduction Nonunion of the distal radius is an extremely rare and serious complication with unpredictable outcomes. The aim of the present study is to analyze the radiological and functional results after a protocolized surgical treatment. Material and Methods A retrospective review of case series of patients with diagnosis of nonunion of the distal radius surgically treated from 2010 to 2016. The diagnosis of nonunion was made at 6 months without signs of consolidation. According to computed tomography (CT) scan images, we propose a classification of this complication as type I: no deformity or mild deformity, with subchondral metaphyseal bone stock beneath lunate facet greater than 10 mm, with no degenerative changes at the distal radioulnar joint (DRUJ); type II: moderate deformity or degenerative changes in the DRUJ, distinguishing between IIA and IIB based on the subchondral metaphyseal bone stock; and type III: degenerative changes at the midcarpal joint. In all cases, a reconstructive technique consisting of volar locking plate osteosynthesis with autologous tailored iliac crest graft was performed, hence none of the cases were classified as type III. Results In total, six cases were included. Mean follow-up: 58 months (range: 30–108 months). Consolidation was achieved in a mean period of 5 months (range: 3–9 months). Average active range of motion: flexion: 54° (range: 10°–80°); extension: 40° (range: 10°–85°); supination: 82.5° (range: 75°–85°); pronation 80° (range: 55–85°); radial deviation: 15° (range: 5°–20°); and ulnar deviation 15° (range: 5–20°). Mean strength: 24.15 Kg (6.9–35 Kg). The average score on the Visual Analog Scale (VAS) at rest was of 0.6 (0–2), and with movement, it was of 1.8 (0–4). The mean postoperative score on the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was of 18.48 (range: 0–50.8). Average radial height: 9.65 mm (range: 7–12 mm); average radial angulation: 17° (10°–20°); volar tilt: 8.36° (range: 0.2°–21°); average ulnar variance: 1.52 mm (range: 0–3.5 mm). Complications: persistent nonunion, superficial wound infection, acquired residual ulnar club hand deformity, radiocarpal arthritis, and midcarpal arthritis. Nevertheless, no salvage techniques were needed or requested during the follow-up, with all patients in an active work situation or living an active life in complete normality. Conclusions The protocolized surgical treatment of pseudoarthrosis of the the distal radius, based on our proposed classification, offers good functional outcomes in the long-term follow-up.