Diagnosis and Treatment of Distal Radial Fractures—2nd Edition

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 1669

Special Issue Editors


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Guest Editor
Department of General Surgery and Medical Surgical Specialties, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, Catania, Italy
Interests: pediatric orthopaedics; upper limb; deformities; trauma neuromuscular; distal radius fractures
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Guest Editor
Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy
Interests: pediatric orthopedics; knee; sports trauma; shoulder; trauma; upper limb
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Fractures of the distal radius represent the most common orthopedic injuries: one out of every six fractures presented at emergency departments is a distal radius fracture. Almost two-thirds of these fractures are displaced and need to be reduced. Epidemiological studies point out that the age rate curve is bimodal, and that the highest incidences are found in children and the elderly. Osteoporosis is strictly associated with these fractures, leading to an additional investigation with a dual-energy X-ray absorptiometer after trauma. Both conservative and surgical options are available for these fractures, with their own peculiar advantages and complications. The choice of treatment depends on age, lifestyle, functional demands, limb dominance, type of fracture, severity, alignment of the fracture, and condition of the soft tissue. Treatment by closed reduction and cast immobilization is still valid, even if it may lead to poor radiological results and displacement, especially in worst fracture patterns. Several surgical options for distal radius fractures have been described, such as percutaneous pinning and casting, external fixation, and open reduction internal fixation, using the locking plate technique.

Given the frequency of DRF in traumatology in different ages, Medicina is launching this Special Issue.

We encourage you and your co-workers to submit your articles reporting on this topic. We also welcome reviews or original articles, with the aim of updating the diagnosis and treatment of these fractures, while paying attention to new tendencies in clinical practice.

Prof. Dr. Gianluca Testa
Dr. Ludovico Lucenti
Guest Editors

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Keywords

  • wrist fracture
  • Colles fracture
  • Goyrand’s fracture
  • ORIF
  • external fixation
  • casting
  • pediatric fractures

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Published Papers (2 papers)

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Research

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13 pages, 2363 KiB  
Article
Surgical Treatment of Periarticular Distal Radius Fracture in Elderly: A Systematic Review
by Gianluca Testa, Flora Maria Chiara Panvini, Marco Simone Vaccalluzzo, Andrea Giovanni Cristaudo, Marco Sapienza and Vito Pavone
Medicina 2024, 60(10), 1671; https://doi.org/10.3390/medicina60101671 - 11 Oct 2024
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Abstract
Background/Objectives: The treatment of periarticular distal radius fractures remains challenging. Different surgical treatment options have been proposed as alternatives to conservative treatment. This systematic review aims to compare the functional outcomes, radiological outcomes, and complications among volar locking plates (VLPs), Kirschner-wire fixations, [...] Read more.
Background/Objectives: The treatment of periarticular distal radius fractures remains challenging. Different surgical treatment options have been proposed as alternatives to conservative treatment. This systematic review aims to compare the functional outcomes, radiological outcomes, and complications among volar locking plates (VLPs), Kirschner-wire fixations, and external fixations (EFs) for distal radius fractures in patients aged 60 years and older. Methods: We conducted a comprehensive search of PubMed, Cochrane, and Science Direct databases assessing the effects of VLP, EF, and K-wire treatments for distal radius fractures in patients aged 60 years and over. The primary outcome was the evaluation of the range of motion (ROM) degrees after three surgical procedures, trying to assess the best treatment option. The secondary outcome included evaluation of the Disabilities of the Arm, Shoulder, and Hand (DASH) score, quick-DASH score, Patient-Rated Wrist Evaluation (PRWE) score, Visual Analog Scale (VAS) score, grip strength, radiographic assessment, and complications comparing VLPs, EFs and K-wires. Results: A total of 23 studies were included, comparing VLP, EF, and K-wire fixation. The overall population comprised 5618 patients, with 4690 females and 1015 males, of which 4468 patients were treated with VLP, 503 with EF, and 647 with K-wire. The most common complications among the VLP group were complex regional pain syndrome (7.5%) and carpal tunnel syndrome (6.8%); for the EF group, infections (9.8%) and carpal tunnel syndrome (6.8%); and for the K-wire group, carpal tunnel syndrome (7.5%) and infections (6.9%). Conclusions: VLP showed better clinical outcomes in the first few months after treatment. However, these differences decreased over time and became similar after one year. EF and K-wire fixations remain easier to manage during surgery. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Distal Radial Fractures—2nd Edition)
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Review

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9 pages, 264 KiB  
Review
Optimizing Treatment Strategies for Distal Radius Fractures in Osteoporosis: A Comparative Review
by Eric J. Gullborg, Jason H. Kim, Caitlin M. Ward and Xavier C. Simcock
Medicina 2024, 60(11), 1848; https://doi.org/10.3390/medicina60111848 - 10 Nov 2024
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Abstract
Osteoporosis is a common yet underdiagnosed condition that increases the risk of fractures, contributing to substantial morbidity, mortality, and healthcare costs. Distal radius fractures (DRFs) are some of the most common fractures associated with osteoporosis and often precede more severe fractures. Managing DRFs [...] Read more.
Osteoporosis is a common yet underdiagnosed condition that increases the risk of fractures, contributing to substantial morbidity, mortality, and healthcare costs. Distal radius fractures (DRFs) are some of the most common fractures associated with osteoporosis and often precede more severe fractures. Managing DRFs in patients with osteoporosis can be a challenge due to altered bone quality, which can affect healing and surgical fixation. This review examines both operative and nonoperative management strategies for DRFs in osteoporotic patients, emphasizing the importance of individualized treatment. Surgical interventions, like open reduction and internal fixation (ORIF) with plating, can facilitate early mobilization and improved alignment, especially in more active patients. However, osteoporosis poses risks such as hardware failure, infection, and malunion, calling for careful patient selection. Conversely, nonoperative management may be more suitable for patients with lower functional demands or higher surgical risks, despite the increased risk of malunion. By adapting treatment strategies to individual patient characteristics, orthopedic surgeons can optimize outcomes, minimize complications, and potentially prevent future fractures. Both operative and nonoperative treatments can yield positive outcomes when personalized to the patient’s needs. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Distal Radial Fractures—2nd Edition)
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