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Introduction: 3D printing technology advances rapidly in medicine, especially in joint orthoses in Distal Radius Fractures (DRF). We became acquainted that a health technology company uses 3D printers to manufacture orthoses made of polylactic acid (PLA), which are lighter, durable, resistant, waterproof, aerated, and radio transparent. Objective: To verify and compare the level of pain and functionality in patients with stable distal radius fractures wearing plaster cast or 3D-printed orthotics. Method: This is a longitudinal, controlled study, with parallel and prospective treatments. The research involved 10 patients with distal radius fractures (DRF), aged between 20 and 73 years and from different backgrounds. The participants were divided into two groups: one wearing plaster casts, Plaster Group (PG), and the other using 3D-printed orthoses, (G3D Group). They were all sent to an orthopedics and traumatology outpatient clinic at a public Hospital in Campinas. The researcher interviewed the patients at the clinic to analyze their inclusion in the study. The data collection through anamnesis and two surveys to measure pain and functionality (Visual Numeric Paing Scaled and QuickDASH) began after the confirmation of the DRF and the signature of the Informed Consent Form (ICF). The group’s designation PG or G3D was randomly done by RANDOM.ORG, guaranteeing impartiality in the process. Results: The 3D-printed orthotic showed improvement in pain and functionality in patients with DRF (p=0.0367) compared to plaster casts. In the G3D, pain was relieved, while in the PG, pain decreased but persisted with less intensity. Conclusion: This research has advanced in the fields of 3D orthotics in orthopedics, demonstrating benefits over traditional plaster casts. We hope that these results contribute to a better understanding of patients' functionality, comfort, and life quality. Further studies are recommended to compare the effectiveness of 3D orthoses with plaster casts, including healing and complicationS.

This article is from Eplasty , volume 14 . Abstract Objective: The treatment of proximal located scaphoid nonunion is a well-known and common problem. For these patients, we used a vascular pedicled bone graft of the distal radius. Methods: In the last 7 years, 75 patients were treated with the vascular pedicled bone graft. Retrospectively, patients’ data, healing rates, and factors influencing scaphoid healing were analyzed. Results: The overall healing rate in cases with proximal located nonunions (n = 54) was approximately 70%. Out of these 54 patients, 47 patients showed avascular proximal fragments. Multivariate analysis showed no significant impact for the factors age, smoking, duration of disease, or previous operation. Conclusions: In our negative selected patient group, we were able to achieve good results with the usage of a pedicled vascularized bone graft of the distal radius. Our results indicate a favorable outcome for the use of a pedicled vascularized distal radius bone graft in both scaphoid nonunion fractures of the proximal third, with or without an avascular proximal pole.

Introduction: 3D printing technology advances rapidly in medicine, especially in joint orthoses in Distal Radius Fractures (DRF). We became acquainted that a health technology company uses 3D printers to manufacture orthoses made of polylactic acid (PLA), which are lighter, durable, resistant, waterproof, aerated, and radio transparent. Objective: To verify and compare the level of pain and functionality in patients with stable distal radius fractures wearing plaster cast or 3D-printed orthotics. Method: This is a longitudinal, controlled study, with parallel and prospective treatments. The research involved 10 patients with distal radius fractures (DRF), aged between 20 and 73 years and from different backgrounds. The participants were divided into two groups: one wearing plaster casts, Plaster Group (PG), and the other using 3D-printed orthoses, (G3D Group). They were all sent to an orthopedics and traumatology outpatient clinic at a public Hospital in Campinas. The researcher interviewed the patients at the clinic to analyze their inclusion in the study. The data collection through anamnesis and two surveys to measure pain and functionality (Visual Numeric Paing Scaled and QuickDASH) began after the confirmation of the DRF and the signature of the Informed Consent Form (ICF). The group’s designation PG or G3D was randomly done by RANDOM.ORG, guaranteeing impartiality in the process. Results: The 3D-printed orthotic showed improvement in pain and functionality in patients with DRF (p=0.0367) compared to plaster casts. In the G3D, pain was relieved, while in the PG, pain decreased but persisted with less intensity. Conclusion: This research has advanced in the fields of 3D orthotics in orthopedics, demonstrating benefits over traditional plaster casts. We hope that these results contribute to a better understanding of patients' functionality, comfort, and life quality. Further studies are recommended to compare the effectiveness of 3D orthoses with plaster casts, including healing and complications.

This systematic examines the current trends in the use of functional outcome measures across intervention studies in the rehabilitation of people with a distal radius fracture.

This systematic examines the current trends in the use of functional outcome measures across intervention studies in the rehabilitation of people with a distal radius fracture.

This article is from BMC Musculoskeletal Disorders , volume 15 . Abstract Background: Various treatments are available for reducible unstable fractures of the distal radius, such as closed reduction combined with fixation by external fixator (EF), and rigid internal fixation using a locked volar plate (VP). Although there are studies comparing these methods, there is no conclusive evidence indicating which treatment is best. The hypothesis of this study is that surgical treatment with a VP is more effective than EF from the standpoint of functional outcome (patient-reported). Methods/Design: The study is randomized clinical trial with parallel groups and a blinded evaluator and involves the surgical interventions EF and VP. Patients will be randomly assigned (assignment ratio 1:1) using sealed opaque envelopes. This trial will include consecutive adult patients with an acute (up to 15 days) displaced, unstable fracture of the distal end of the radius of type A2, A3, C1, C2 or C3 by the Arbeitsgemeinschaft für Osteosynthesefragen–Association for the Study of Internal Fixation classification and type II or type III by the IDEAL32 classification, without previous surgical treatments of the wrist. The surgical intervention assigned will be performed by three surgical specialists familiar with the techniques described. Evaluations will be performed at 2, and 8 weeks, 3, 6 and 12 months, with the primary outcomes being measured by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and measurement of pain (Visual Analog Pain Scale and digital algometer). Secondary outcomes will include radiographic parameters, objective functional evaluation (goniometry and dynamometry), and the rate of complications and method failure according to the intention-to-treat principle. Final postoperative evaluations (6 and 12 months) will be performed by independent blinded evaluators. For the Student’s t-test, a difference of 10 points in the DASH score, with a 95% confidence interval, a statistical power of 80%, and 20% sampling error results in 36 patients per group. Discussion: Results from this study protocol will improve the current evidence regarding to the surgical treatment these fractures. Trial registration: ISCRTN09599740

This protocol was developed to conduct a systematic review and meta-analysis to evaluate the clinical efficacy and other relevant factors of acupuncture combined with TCM bonesetting in the treatment of distal radius fractures, compared to western medicine therapy such as operation.

This article is from Journal of Orthopaedic Surgery and Research , volume 7 . Abstract Background: Current surgical approaches to the distal radius include dorsal and palmar plate fixation. While palmar plates have gained widespread popularity, few reports have provided data on long term clinical outcomes in comparison. This paper reports the result of a randomised clinical study comparing dorsal Pi plates and palmar, angle-stable plates for treatment of comminuted, intraarticular fractures of the distal radius over the course of twelve months. Methods: 42 patients with unilateral, intraarticular fractures of the distal radius were included and randomised to 2 groups, 22 were treated with a palmar plate, 20 received a dorsal Pi-plate. Results were evaluated after 6 weeks, 3, 6 and 12 months postoperatively focussing on functional recovery as well as radiological results. Results: The palmar plate group demonstrated significantly better results regarding range of motion and grip strength over the course of 12 months. While a comparable increase in function was observed in both groups, the better results from the early postoperative period in the palmar plate group prevailed over the whole course. Radiological results showed a significantly increased palmar tilt and carpal sag in dorsal plates, with other radiological parameters being comparable. Pain levels were decreased in dorsal plates after hardware removal and failed to show significant differences after 12 months. However, complications such as tendon ruptures were more frequent in the dorsal plate group. Conclusions: Functional advantage of palmar plates gained within the first 6 weeks prevails over the course of a year. Both groups demonstrate further gradual increase of function after 6 months, although dorsal plates did not catch up completely. Improved early postoperative function seems to be the cornerstone for the best possible results. Patients with dorsal plates benefit from hardware removal more than palmar plates in terms of reduction of pain levels. The advantage of palmar plates is a faster functional recovery with lower complication rates. This is especially important in the elderly population. Radiological results did not show a superiority of palmar plates over dorsal plates.

This article is from Journal of Orthopaedic Surgery and Research , volume 6 . Abstract Background: Intraarticular distal radius fractures can be treated with many methods. While internal fixation with angle stable implants has become increasingly popular, the use of bone graft substitutes has also been recommended to address comminution zones and thus increase stability. Whether a combination of both methods will improve clinical outcomes was the purpose of the study Methods: The study was thus conducted as a prospective randomized clinical trial. 39 patients with unilateral, intraarticular fractures of the distal radius were included and randomized to 2 groups, one being treated with internal fixation only, while the second group received an additional bone graft substitute. Results: There was no statistical significance between both groups in functional and radiological results. The occurrence of complications did also not show statistical significance. Conclusions: No advantage of additional granular bone graft substitutes could be seen in this study. Granular bone graft substitutes do not seem to provide extra stability if dorsal angle stable implants are used. Dorsal plates have considerable complication rates such as extensor tendon ruptures and development of CRPS.

This protocol was developed to conduct a systematic review and meta-analysis to evaluate the clinical efficacy and other relevant factors of acupuncture combined with TCM bonesetting in the treatment of distal radius fractures, compared to western medicine therapy such as operation.

This article is from Clinics in Orthopedic Surgery , volume 4 . Abstract Background: The purpose of this study is to evaluate the efficacy of computed tomography (CT) scans compared with plain radiographs on detecting the involvement of the sigmoid notch. Methods: This study involved 121 cases diagnosed as the intra-articular distal radius fracture and performed post-reduction CT scans. We determined the presence of the sigmoid notch involvement with both plain radiographs and CT scans and compared findings of plain radiographs with CT scans about the incidence and the pattern of injuries. And the differences of results between arbeitsgemeinschaft für osteosyntheses (AO) type C2 and C3 were compared. Results: The incidences of sigmoid notch involvement detected in plain radiographs were 81 cases (66.9%), whereas CT scans were 99 cases (81.9%). The sensitivity of plain radiographs compared with CT scans was 74.7%, the specificity was 68.2%, the positive predictive value was 91.4%, the negative predictive value was 37.5%, the false negative value was 25.3%, and the false positive value was 31.8%. In comparison between AO type C2 and C3, the incidence of sigmoid notch involvement was not a significant difference, but the displacement of fracture fragment showed a significant difference. Conclusions: The intra-articular distal radius fracture usually accompanies the sigmoid notch involvement. Considering that the evaluation of sigmoid notch involvement by plain radiography often results in misinterpretation or underestimation, performing CT scan in intra-articular distal radius fracture is thought to be beneficial.

This article is from The Open Orthopaedics Journal , volume 8 . Abstract Introduction :: The most commonly used classification for pediatric physeal fractures has been proposed by Salter and Harris. Among the most suitable classification schemes are those proposed by Ogden and Peterson who added several new types of injuries. The purpose of this study was to examine the value of both schemes to classify all different types of physeal injuries of the distal radius that are not included in the Salter-Harris system and to test a new nomenclature to classify and guide treatment for the whole spectrum of these injuries. Methods :: A total of 292 children who were admitted for a physeal fracture of the distal radius that could not be classified according to the Salter-Harris system were identified from the hospital database. All radiographs were carefully examined and classified according to the existing classifications of Ogden and Peterson and a modified classification scheme. The results of the treatment were also evaluated. Results :: Ninety-six physeal injuries could not be classified using the classification schemes of Ogden and Peterson. All injuries could be classified in five types using the new, modified nomenclature. Growth abnormalities of the distal radius were evaluated after an average follow-up time of 11 years. Growth arrest due to a physeal bar was detected only in one patient. Discussion :: The proposed modified scheme is practical, incorporates all previous classification systems, allows classification of all physeal injuries of the distal radius that are not included in the Salter-Harris system and may assist comparison of treatment outcomes.

This article is from Acta Orthopaedica , volume 84 . Abstract Background and purpose: The incidence of fractures of the distal radius may have changed over the last decade, and operative treatment has been commoner during that time. We investigated the incidence of fractures of the distal radius and changing trends in surgical treatment during the period 2004–2010. Patients and methods: Registry data on 42,583 patients with a fracture of the distal radius from 2004 to 2010 were evaluated regarding diagnosis, age, sex, and surgical treatment. Results: The crude incidence rate was 31 per 104 person-years with a bimodal distribution. After the age of 45 years, the incidence rate in women increased rapidly and leveled off first at a very high age. The incidence rate in postmenopausal women was lower than previously reported. In men, the incidence was low and it increased slowly until the age of 80 years, when it amounted to 31 per 104 person-years. The number of surgical procedures increased by more than 40% despite the fact that there was reduced incidence during the study period. In patients ≥ 18 years of age, the proportion of fractures treated with plating increased from 16% to 70% while the use of external fixation decreased by about the same amount. Interpretation: The incidence rate of distal radius fractures in postmenopausal women appears to have decreased over the last few decades. There has been a shift in surgical treatment from external fixation to open reduction and plating.

This article is from Upsala Journal of Medical Sciences , volume 116 . Abstract Background: Open reduction and internal fixation using an interlocking plate system has gained popularity for the treatment of dorsally displaced distal radius fractures. Purpose: To evaluate the functional and radiological results of treating unstable distal radius fractures with the volar locking plate. Patients and methods: A retrospective review was conducted of patients from one institution using the volar locking plate to treat intra-articular and extra-articular distal radius fractures. Unstable distal radius fractures in 15 patients, comprising 3 men and 12 women with a mean age of 64.4 years (34–76 years), were treated with a volar locking compression plate (Acu-Loc distal radius plate system; Acumed, Oregon, USA) and followed up for a minimum of 1 year. Fractures were classified using the AO classification. Radiographic parameters of preoperative, postoperative, and final follow-up radiographs were compared. The time to initiation of active range of motion was determined. Final follow-up range of motion and complications were reported. Results: At final functional assessment, the scores of 5 patients were excellent, 7 patients good, and 3 patients fair according to Cooney's Clinical Scoring Chart. No non-union or infection occurred. Rupture of the flexor pollicis longus tendon occurred in 1 patient. Conclusion: Treatment of unstable distal radius fractures with a volar locking plate leads to satisfactory results, provided the operative technique is carefully performed to prevent complications.