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Introduction and Objectives: Lack of consolidation of the distal extremity of the radius (DER) is extremely rare (0.05–0.9%) and no more than 75 cases have been published between 1944 and 2008. We wish to present our experience in the treatment of this condition.
Materials and Methods: This is a prospective study of 13 patients (10 men and 3 women) with non-union of the distal extremity of the radius (DER). Mean age of the patients was 52 years (26–76 years) and 53% were smokers. Initial treatment of the fracture was surgical in 9 cases (70%), 3 were open and there was infection in 4 cases. Treatment of the non-union was surgical in 10 cases (77%) at a mean time of 7.8 months: 70% graft + fixation (5 volar plates, 1 double plate and 1 external fixator) and 30% arthrodesis (2 total and 1 partial). In 80% of cases a Darrach technique was also used. We assessed VAS, DASH, range of mobility, complications, consolidation and work-related results, with a mean 12 month (6–24 months) follow-up.
Results: Mean flexoextension: 72.7°. Pronosupination: 171.2°. Mean VAS: 2.4. DASH questionnaire: 30,75. None of the patients was reoperated. Complete consolidation was achieved in 100% of the operated cases. The off-work period after surgery was 358 days and 80% of the patients returned to the same job with some limitations.
Discussion and Conclusions: No statistically significant differences were found between the treatment performed and the final result. With orthopedic treatment there was more pain and a worse DASH score. Arthrodesis patients had less days off-work than those treated with grafts and osteosynthesis.
Introduction and Objectives: In distal avulsion of the biceps, the treatment of choice is re-attachment of the tendon. The aim of this study is to compare both surgical techniques.
Materials and Methods: Between September 2004 and February 2007, 22 consecutive patients with distal biceps rupture were randomly assigned to one of the 2 treatment groups. In group A, 11 patients underwent tendon reattachment with an Endobutton® through a single anterior incision and in group B, 11 patients underwent tendon reattachment by means of a procedure using 2 bioabsorbable Panaloc® harpoons placed through a double anterior and posterior approach. Mean age and interval between rupture and surgery were similar in both groups.
Results: Mean operation time was 44 minutes in group A and 65 minutes in group B. There were no complications in group A. Two patients in group B suffered transient neurapraxia of the posterior interosseous nerve and 2 presented heterotopic ossification. At 12 months there were no significant differences in the Mayo Elbow Performance Score, mobility, time of return to work or strength.
Discussion and Conclusions: Although both groups had similar functional results, anterior repair using an Endobutton must be considered the technique of choice for distal biceps avulsions because of the shorter operation time and less morbidity.