Distal radius fractures (DRFs) are one of the most common types of fracture and one which is often treated surgically. Standard X-rays are obtained for DRFs, and in most cases that have an intra-articular component, a routine CT is also performed. However, it is estimated that CT is only required in 20% of cases and therefore routine CT's results in the overutilisation of resources burdening radiology and emergency departments. In this study, we explore the feasibility of using deep learning to differentiate intra- and extra-articular DRFs automatically and help streamline which fractures require a CT. Retrospectively x-ray images were retrieved from 615
Distal radius fractures (DRF) are the most common fracture type in all age groups combined. Unstable
Distal radius fractures (DRF) are the most common fracture type in all age groups combined. Unstable
To compare 24-month patient-reported outcomes after surgical treatment or casting in patients age 60 years of age or older with unstable distal radius fractures (DRF's). The Wrist and Radius Injury Surgical Trial (WRIST), is the largest randomized, multicenter trial in Hand Surgery, which enrolled 304 adults with isolated, unstable
Distal radius fractures (DRF) are common and the indication for surgical treatment remain controversial in patients higher than 60 years old. The purpose of the study was to review and analyze the current evidence-based literature. We performed a systematic review and meta-analysis according to PRISMA guidelines in order to evaluate the efficacy of volar locking plating (VLP) and conservative treatment in
Distal radius fractures (DRF) are common and the indication for surgical treatment remain controversial in patients higher than 60 years old. The purpose of the study was to review and analyze the current evidence-based literature. We performed a systematic review and meta-analysis according to PRISMA guidelines in order to evaluate the efficacy of volar locking plating (VLP) and conservative treatment in
Distal radius fractures (DRFs) are common injuries that represent 17% of all adult upper extremity fractures. Some fractures deemed appropriate for nonsurgical management following closed reduction and casting exhibit delayed secondary displacement (greater than two weeks from injury) and require late surgical intervention. This can lead to delayed rehabilitation and functional outcomes. This study aimed to determine which demographic and radiographic features can be used to predict delayed fracture displacement. This is a multicentre retrospective case-control study using radiographs extracted from our Analytics Data Integration, Measurement and Reporting (DIMR) database, using diagnostic and therapeutic codes. Skeletally mature patients aged 18 years of age or older with an isolated
The location of the hip joint center (HJC) allows correct prosthesis aligning and positioning in Computer-Assisted Orthopaedic Surgery (CAOS) applications. For the kinematic HJC localisation, the femur is moved around the pelvis with ad hoc motion trials (“pivoting”). The “Pivoting algorithm” [Siston et al., J Biomech 39 (2006) 125–130] is the functional state-of-the-art method for the hip center localisation. A source of systematic error in HJC localisation algorithms is represented by the pelvis motion during the pivoting. In computer assisted total knee arthroplasty applications, the pelvis pose is not acquired during passive movements. In motion capture applications, Kalman Filter (KF) methodology was used to estimate the pose of hidden segment for rigid body pose estimation. The purpose of this study was to validate the accuracy and robustness of a Kalman Filter algorithm, applied to a state space formulation based on two links model of the hip joint, to track the HJC position during passive movements of the articulation in CAOS procedure. The state space model describes femur and pelvis kinematics under the hypothesis of non-laxity of the articulation (ideal spherical joint). The first link models the femoral bone, while the second link models the pelvis. The femur is tracked with a Dynamic Reference Frame (DRF) attached to the distal end, composed by four active markers, while the pelvis is tracked attaching a marker to it. The kinematic relations between the state vector and the observations are non linear function. The state space has been implemented with II order linear dynamics. The position of HJC in the Femur Reference Frame is modeled with non-dynamic state variables. In order to validate the proposed algorithm, a physical model of the hip joint (femur and pelvis) was realised using SawBones models. An active optical localisation system (Certus, NDI, Ontario, Canada) was used in order to track the coordinates of two
Distal radius fractures are common, yet the long-term functional outcome of these patients is unknown. This study investigated the long-term functional outcomes after distal radius fracture (DRF) in adult patients 16–23 years following injury. Secondary aims were to establish morbidity, mortality and function related to pattern of injury and patient demographics. Methods. 622 consented adult patients with a
Distal radius fracture is one of the most common fractures in older women (∼70,000 cases annually in Canada). Treatment of this fracture has been shifting toward surgery (mainly volar locking plate (VLP) technology), which significantly enhances surgeon's ability to maintain correction. However, current surgical outcomes are far from perfect. There is a need for an implant which maintains the corrected position (reduction), minimizes soft tissue disruption, and is technically easy to perform. A novel internal, composite-based implant was designed to achieve these ends. It is unclear, however, whether this novel implant offers similar fracture fixation as the VLP. As such, the objective of this research was to evaluate the fracture stability (assessed by calculating change in fracture length) of the novel implant and VLP under cyclic fatigue loading. Specimens: Seven radius specimens derived from older female cadavers (mean = 82.3 years, SD = 11.3 years) were used for the experiment. Preparation: A standardized dorsal wedge was removed from the cortex. The distance from the proximal and distal transverse osteotomies was 10 mm and was positioned 20 mm proximal to the tip of the radial styloid. The osteotomy removed all load-bearing capabilities of bone, equivalent to a worst-case-scenario for
Purpose. Conservative treatment of minimally displaced distal radius fractures (DFR) remains controversial. Circumferential casting (CC) in the acute setting is believed to supply superior support compared to splinting, but is generally cautioned due to the limited capacity of a cast to accommodate ongoing limb swelling possibly leading to complications. However, there is no conclusive data on which to base these beliefs. Moreover, the appropriate management of cast complications while minimizing risk to fracture integrity remains unclear. This retrospective study of distal radius fractures treated conservatively with circumferential cast in the acute setting aims to: A. Determine demographic, fracture dependant or management risk factors for CC complications. B. Determine the natural history for both patients with CC and those with CC necessitating cast modification. Method. Hospital records and radiographic data of 316 patients with DRFs treated with CC at a tertiary-care university hospital between the years 2006 to 2009 were reviewed. Our primary outcome was to access risk factors for cast complications including swelling, pressure sores, neuropathies and loss of cast immobilization. Our secondary outcome accessed reduction stability in patients undergoing cast re-manipulation. Results. 31% of patients experienced cast related complications within the first two weeks of treatment. 22% of patients had their cast manipulated (replaced, split, trimmed or windowed). Increasing patient age or polytrauma were both associated with an increased risk of developing cast complications. Polytrauma was also associated with a poor overall rate of fracture reduction following non-operative management. Patient gender, physician specialty placing the cast as well as fracture type (AO classification) did not influence risk. Overall, patients with acute cast complications had no increased risk of losing reduction compared to patients with normal management. However, patients who complained of pressure in cast had a higher risk of loss reduction if their cast was split as opposed to being replaced. Conclusion. Circumferential casting in the acute setting of minimally displaced
The aim of this study was to investigate surgeons’ reported change of treatment preference in response to the results and conclusion from a randomized contolled trial (RCT) and to study patterns of change between subspecialties and nationalities. Two questionnaires were developed through the Delphi process for this cross-sectional survey of surgical preference. The first questionnaire was sent out before the publication of a RCT and the second questionnaire was sent out after publication. The RCT investigated repair or non-repair of the pronator quadratus (PQ) muscle during volar locked plating of distal radial fractures (DRFs). Overall, 380 orthopaedic surgeons were invited to participate in the first questionnaire, of whom 115 replied. One hundred surgeons were invited to participate in the second questionnaire. The primary outcome was the proportion of surgeons for whom a treatment change was warranted, who then reported a change of treatment preference following the RCT. Secondary outcomes included the reasons for repair or non-repair, reasons for and against following the RCT results, and difference of preferred treatment of the PQ muscle between surgeons of different nationalities, qualifications, years of training, and number of procedures performed per year.Aims
Methods