Osteosynthesis of distal radial fractures with a volar locking screw plate system.
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We developed a locking screw plate system for the stabilisation of distal radial fractures, which can be inserted through a standard volar approach and in which the locking mechanism allows early post-operative mobilisation. Forty-nine patients with 50 fractures underwent surgical treatment; 66% were type C fractures. The mean follow-up was 26 months. According to the scores of Gartland and Werley and Green and O'Brien, 92% and 68% respectively had an excellent or good outcome; 46% were radiologically identical to the uninjured side and in 42% the reduction remained unchanged after 2 years. The most frequent complication was rupture of the flexor pollicis longus tendon, which occurred in six cases (12%) at a mean of 10 months after operation. (+info)
Internal fixation after intra-articular fracture of the distal ulna.
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We describe a patient who sustained a displaced isolated intra-articular fracture of the distal ulna, causing limitation of rotation of the forearm. The extent of displacement of the fracture which was not evident on plain radiographs was revealed by CT. The fracture was reduced and internally fixed using a standard technique applicable to the fixation of fractures of the radial head. Full movement was restored. An isolated injury to the distal ulna is rare and requires careful clinical and radiological assessment. (+info)
Biomechanical comparison of five external wrist fixators.
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The relative stiffness of five different external wrist fixators currently in use for distal radius fractures was determined using a uniform fracture model consisting of wood dowels to isolate the effects of the fixators themselves. Each construct was loaded in axial compression, eccentric and cantilever modes of bending, and torsion. The stiffest of the fixators varied by a factor of three in compression, five in bending, and three in torsion. Although the ideal stiffness of a wrist fixator is unknown, there is a large variation in the stiffness of existing devices. (+info)
Development of neck and hand-wrist symptoms in relation to duration of computer use at work.
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OBJECTIVES: This study attempted to identify risk factors for musculoskeletal symptoms in the neck and hand-wrist regions among employees using computers at work. METHODS: Computer users (N=5033) first received a questionnaire in the beginning of 1999 (69% response rate, N=3475), and a follow-up questionnaire was mailed in December of 2000 to the 3361 respondents to the baseline survey (77% response rate, N=2576). Health outcome was defined as musculoskeletal symptoms for >7 days within the last year of follow-up among the nonsymptomatic respondents at baseline. RESULTS: Men's and women's previous symptoms, women's low influence at work and high-placed computer screen, and men's short time in the same job and good computer skills were associated with neck symptoms. Hand-wrist symptoms were predicted by previous symptoms and low influence at work for both the men and women and sensorial demands for the women only. The duration of computer use predicted hand-wrist symptoms [eg, odds ratio (OR) of 2.3, 95% confidence interval (95% CI) 1.2-4.3, for almost continual computer use], but not neck symptoms. For those with almost continual computer use, hand-wrist symptoms were associated with mouse use for at least half of the worktime (OR 4.0, 95% CI 1.0-15.5) and not using the mouse at all (OR 4.0, 95% CI 1.1-14.4), as compared with mouse use for one-fourth of the worktime. CONCLUSIONS: Limiting computer use to less than three-fourths of the worktime would help to prevent hand-wrist symptoms. Furthermore, low influence at work predicts both neck and hand-wrist symptoms. (+info)
Highly repetitive work operations in a modern milking system. A case study of wrist positions and movements in a rotary system.
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With the use of electrogoniometers wrist positions and movements were measured in 13 milkers while working in a modern rotary milking system. The rotary system put considerable demands on the wrists and hands regarding both velocities and repetitiveness. Values were found close to those described in other repetitive industrial work with high risk of wrist and hand disorders. For the right hand the repetitiveness was 0.57 Hz and 0.46 Hz for the left hand. In addition, the median value (50th percentile) of the angular velocity distribution was also high, being 36 degrees /s for the right hand and 26 degrees /s for the left, and with respect to the peak value (90th percentile) the corresponding values were 155 degrees /s and 135 degrees /s, respectively. Furthermore, when milking in the rotary system, there was less possibility to hold the hands still than in the other milking systems. The right hand rested only 1.4% of the milking time and the left only 1.0%. The hands were therefore moving throughout almost the entire milking procedure. High velocity, repetitiveness and fewer opportunities for rest are risk factors that might lead to disorders in the wrists and hands. Regarding wrist positions, the left wrist was held in a more dorsiflexed position than the right, 37 degrees and 29 degrees, respectively. Compared with tethering and loose-housing parlour milking, the wrist positions were, however, improved in the rotary system. When introducing new milking systems these negative effects on wrist and hand movements must be borne in mind in order to minimize the prevalence of wrist and hand disorders. (+info)
Pencil-core granuloma of the distal radio-ulnar joint: an unusual presentation as soft-tissue sarcoma after 45 years.
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A case of pencil-gore granuloma occurring 45 years after he initial injury is described. The clinical and radiological presentation was suggestive of a soft-tissue sarcoma. The diagnosis was confirmed by biopsy, which also revealed foreign body fragments which, on spectometric analysis, had high concentrations of carbon and aluminium. (+info)
Don't save the ball!
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OBJECTIVES: To identify, over a period of 12 months, all attendances at an accident and emergency department by children over the age of 5 years with an injury to a wrist, hand, or finger, and to examine those sustained as a result of a blow from a ball. METHODS: The case notes of all children aged 6-13 years attending the Accident and Emergency Department of the Royal Aberdeen Children's Hospital in the year 2001 as a result of a wrist, hand, or finger injury sustained from a blow by a ball were reviewed, and the cause, type, and severity of the injury noted. RESULTS: A total of 187 children were identified; 69% were boys and football was the main sport involved. Most (93%) were radiographed, and 40% were positive; most fractures were sustained outwith school. Hand dominance was not significant. CONCLUSIONS: These injuries are common and may be preventable with modification of rules, equipment, and coaching. A register of youth sporting injuries may show if there are any detrimental long term effects. (+info)
Biodegradable rods versus Kirschner wire fixation of wrist fractures. A randomised trial.
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In a prospective trial, biodegradable polyglycolic acid rods were compared with Kirschner wires for fixation of wrist fractures (Frykman types I, II, V and VI). Fifteen patients were randomly assigned to each treatment group. There was no significant difference between the groups with regard to age, sex ratio and fracture type. Kapandji's pinning technique was used in all cases. There were no significant differences in the results obtained in both groups at final follow-up. At three months and six months the functional results of the Kirschner-wire group were, however, significantly better (p < 0.05), due to numerous transient complications from foreign-body reactions to the polyglycolic acid rods. The use of polyglycolic acid rods is therefore not recommended for the fixation of distal radial fractures. (+info)