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• W2875223365 abstract "INTRODUCTION: Fractures of the distal radius are among the most commonfractures seen in an emergency departmentThe classic fracture described by SIR ABRAHAM COLLES in1814 – low energy, extra articular, osteoporotic distal radius fracture –often does well with closed reduction and cast immobilization. Highvelocity injuries have resulted in severely comminuted and unstablefractures with intra articular components treatment has becomeincreasingly difficult.Many unstable distal radial fractures are treated by closedreduction and casting with even small degrees of mal alignmentadversely affects functional outcome has stimulated interest in externalfixation and ligamentotaxis.External fixation for distal radius fracture relies on the principle ofLigamentotaxis in which, a distraction force applied to the carpusaligns the fragments by means of intact ligaments. Distraction assistedreduction and maintenance of distal radius fracture is a widely used andreliable treatment method.If the principles of ligamentotaxis are applied rationally thefactors that cause instability are identified clinically and managedsurgically, a satisfactory outcome can be expected.AIM: The aim is to study the functional outcome of unstable distalradius fractures managed by ligamentotaxis with external fixation.MATERIALS AND METHODS: This study was conducted in Government Royapettah Hospital for 2007 – 2009. Patients with unstable distal radius fractures were selected andtreated with external fixator based on the principle of ligamentotaxis.Most of the cases resulted from high velocity injuries and fall onoutstretched hand. The cases presented with swelling, pain of the wrist andpainful movements.All the patients were evaluated with X rays of the wrist postero –anterior view and lateral view. The patients for whom external fixation andligamentotaxis was planned were temporarily given below elbow plastersplint to relieve pain and limb elevated for edema to subside. Injectiontetanus toxoid was given to all the patients.Most of the patients were operated on the day of admission in theemergency operation theater and few cases were delayed due to the medicalconditions and in cases of gross edema to subside. All the patients weregiven per-operative antibiotics.RESULTS: The results of this study were analyzed using the patient evaluationand subjective rating scheme. This system was introduced by Gartland &Werley in 1951 and modified by Sarmiento. This is a functional demeritsystem and allow for comparison of results among several studies and alsodifferent methods of fixation.Bony union was achieved in all patients. DRUJ pain occurred in 2patients and DRUJ instability in 3 patients. At the end of 3 months patientwere evaluated using the Gartland & Werley’s system.CONCLUSION: Fractures of the distal radius though common and appear simple,affect the function of the wrist considerably. It is the commonest fractureseen in the outpatient department and most are treated with plasterimmobilization. Most of these fractures are unstable resulting in loss ofreduction and hence malunion, altered wrist kinematics, poor range ofmotion and early arthritis.The external fixation and ligamentotaxis proved to be a very usefulmethod for treating unstable distal radius fracture. Though an effectivemethod, it is not a panacea for all the injuries as different patterns of injuriesemerge due to increased accidents and high velocity injuries.Our study equalled previous studies on external fixation for unstabledistal radius fractures in results, showing simplicity and superiority ofligamentotaxis with external fixation for the management of thesefracturesThus the distal radius fracture is no longer a simple fracture to treat bycast alone and more aggressive treatment is needed to restore the articularcongruity and functional outcome." @default.
• W2875223365 created "2018-07-19" @default.
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• W2875223365 date "2010-03-01" @default.
• W2875223365 modified "2023-09-26" @default.
• W2875223365 title "Role of ligamentotaxis in Unstable Distal Radius Fractures" @default.
• W2875223365 hasPublicationYear "2010" @default.
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