Distal radius fracture natural history, complications and prognosis: Difference between revisions

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{{Distal radius fracture}}
{{Distal radius fracture}}
{{CMG}} {{AE}} {{VVS}}
{{CMG}} {{AE}} {{Rohan}}
 
==Overview==
If left untreated, majority of patients with [[distal radius fracture]] may progress to develop malunion and loss of [[range of motion]] of the [[wrist]] and [[forearm]]. Common complications of [[distal radius fracture]] include [[Upper limb|upper extremity]] [[stiffness]], malunion, [[carpal tunnel syndrome]] or [[median nerve]] involvement, and [[Radiocarpal joint|radiocarpal]] [[arthritis]]. Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.
 
==Natural History, Complications, and Prognosis==
 
===Natural History===
*If left untreated, majority of patients with [[distal radius fracture]] may progress to develop malunion and loss of [[range of motion]] of the [[wrist]] and [[forearm]].<ref>Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.</ref><ref>Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.</ref>
 
===Complications===
*Common complications of [[distal radius fracture]] include:<ref name="pmid18762124">{{cite journal| author=Henry MH| title=Distal radius fractures: current concepts. | journal=J Hand Surg Am | year= 2008 | volume= 33 | issue= 7 | pages= 1215-27 | pmid=18762124 | doi=10.1016/j.jhsa.2008.07.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18762124  }} </ref><ref name="pmid18678519">{{cite journal| author=van Aaken J, Beaulieu JY, Della Santa D, Kibbel O, Fusetti C| title=High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures. | journal=Chir Main | year= 2008 | volume= 27 | issue= 4 | pages= 160-6 | pmid=18678519 | doi=10.1016/j.main.2008.05.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18678519  }} </ref><ref name="pmid20006247">{{cite journal| author=Turner RG, Faber KJ, Athwal GS| title=Complications of distal radius fractures. | journal=Hand Clin | year= 2010 | volume= 26 | issue= 1 | pages= 85-96 | pmid=20006247 | doi=10.1016/j.hcl.2009.08.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20006247  }} </ref><ref name="pmid17877939">{{cite journal| author=Shin EK, Jupiter JB| title=Current concepts in the management of distal radius fractures. | journal=Acta Chir Orthop Traumatol Cech | year= 2007 | volume= 74 | issue= 4 | pages= 233-46 | pmid=17877939 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17877939  }} </ref><ref>{{cite book | last = Egol | first = Kenneth | title = Handbook of fractures | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2010 | isbn = 9781605477602 }}</ref><ref>Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.</ref>
**[[Upper extremity]] [[stiffness]]
**[[Carpal tunnel syndrome]] or [[median nerve]] involvement
**Malunion
**Injury to the [[radial artery]]
**[[Carpal instability]]
**Distal Radio-Ulnar Joint (DRUJ) dysfunction
**[[Dupuytrens contracture|Dupuytren's disease]]
**[[Radiocarpal]] [[arthritis]]
**[[Tendon]] injuries
**[[Ligament]] injuries
**[[Osteoarthritis|Post-traumatic osteoarthritis]]
**[[Compartment syndrome]]
**[[Infection]] mostly by open [[Bone fracture|fractures]] or after [[Bone fracture|fracture]] fixation
**[[Complex regional pain syndrome]]
 
===Prognosis===
*Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.<ref name="pmid20494751">{{cite journal| author=Kleinman WB| title=Distal radius instability and stiffness: common complications of distal radius fractures. | journal=Hand Clin | year= 2010 | volume= 26 | issue= 2 | pages= 245-64 | pmid=20494751 | doi=10.1016/j.hcl.2010.01.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20494751  }} </ref><ref>Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.</ref>
*Most patients will likely lose a few degrees of final [[flexion]] and [[extension]], and possibly [[supination]] as well; however, these limitations generally do not prevent full function.
*Some patients are unable to resume their prior level of functioning.
*All treatment approaches have a percentage of poor results, with decreased [[supination]], prominent [[Ulnar|ulnar heads]], [[Ligamentous laxity|ligamentous]] problems, [[distal radioulnar instability]], and [[Degenerative joint disease|degenerative joint]] [[disease]].


==References==
==References==
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[[Category:Orthopedics]]
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[[Category:Orthopedic surgery]]
[[Category:Orthopedic surgery]]
[[Category:Primary care]]
[[Category:Fractures]]
[[Category:Fractures]]
[[Category:Bone fractures]]

Latest revision as of 21:25, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

If left untreated, majority of patients with distal radius fracture may progress to develop malunion and loss of range of motion of the wrist and forearm. Common complications of distal radius fracture include upper extremity stiffness, malunion, carpal tunnel syndrome or median nerve involvement, and radiocarpal arthritis. Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

References

  1. ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
  2. ↑ Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.
  3. ↑ Henry MH (2008). "Distal radius fractures: current concepts". J Hand Surg Am. 33 (7): 1215–27. doi:10.1016/j.jhsa.2008.07.013. PMID 18762124.
  4. ↑ van Aaken J, Beaulieu JY, Della Santa D, Kibbel O, Fusetti C (2008). "High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures". Chir Main. 27 (4): 160–6. doi:10.1016/j.main.2008.05.005. PMID 18678519.
  5. ↑ Turner RG, Faber KJ, Athwal GS (2010). "Complications of distal radius fractures". Hand Clin. 26 (1): 85–96. doi:10.1016/j.hcl.2009.08.005. PMID 20006247.
  6. ↑ Shin EK, Jupiter JB (2007). "Current concepts in the management of distal radius fractures". Acta Chir Orthop Traumatol Cech. 74 (4): 233–46. PMID 17877939.
  7. ↑ Egol, Kenneth (2010). Handbook of fractures. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. ISBN 9781605477602.
  8. ↑ Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.
  9. ↑ Kleinman WB (2010). "Distal radius instability and stiffness: common complications of distal radius fractures". Hand Clin. 26 (2): 245–64. doi:10.1016/j.hcl.2010.01.004. PMID 20494751.
  10. ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.

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