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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 362 - 362
1 Sep 2012
Aparicio García P Izquierdo Corres O Casellas Garcia G Castro Ruiz R Cavanilles Walker JM Costa Tutusaus L Castellanos J Yunta A
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Introduction

Distal radius fractures (DRF) are a common injury in the A&E departments, being a major cause of disability of the upper extremity. The aim of this prospective study is to assess the possible association between objective physical variables such as wrist range of movement (ROM), radiological parameters, and upper extremity disability (measured by the DASH questionnaire), after conservative treatment of DRF.

Patients and methods

44 patients with non-operatively managed DRF were enrolled in a prospective cohort study from July 2007 till September 2009.

Inclusion criteria: unilateral DRF in skeletally mature patients, treated non-operatively with closed reduction and cast. Patients who sustained a previous fracture of the wrist, or bilateral wrist fracture, or with dementia, were excluded.

After the closed reduction and inmovilization of the fracture in the A&E department we asked the patients to complete the DASH questionnaire, referring to their baseline pre-fracture state.

All fractures were classified according to the AO classification.

After one year, 36 patients were still available for follow-up purposes. We assesed the following objective physical variables: ROM of both wrists: flexion/extension arc and pronation/supination arch. We recorded the following radiologic parameters: radial angulation, volar angulation and radial shortening. The patient-perceived results were measured by the DASH questionnaire, while pain was measured using the VAS scale.

Statistical analysis was performed using the SPSS 15.0.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 148 - 148
1 May 2011
Castro J Aparicio P Casellas G Abarca J Matas M Alberti G
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Introduction: Our aim is to analyse the results for the treatment of metatarsalgia comparing, in a retrospective way, Opened surgery (standard Weil osteotomy, group O) and Percutaneous surgery (osteotomies of the metatarsal neck with no internal fixation, group P).

Material and method: We review 30 cases in each group according to demographic data, surgery procedure, complications, time to healing and metatarsal curve. An interview with every patient was performed in order to obtain the AOFAS scale results, time to wear comfort shoes, return to daily activities, analgesia needed, visual analogic scale and global satisfaction.

Results: Group O: 29 women, 1 man. Mean age of 61 years. Mean number of metatarsal osteotomies per patient 2,21. 27 cases associated to hallux valgus surgery.

Group P: 25 women, 5 men. Mean age of 51,5 years. Mean number of metatarsal osteotomies per patient 2,56. 23 cases associated to hallux valgus surgery.

Groups O/P: time to bone healing 4,21/17,5 weeks; AOFAS scale 80,56/88,32 points; VAS 3,0/2,04 points; metatarsal curve in milimeters −0,75/−4,67/−6,67/−12,2 vs +0,72/−5.72/−5,52/−11,52; time to wear comfort shoes 18/11 weeks; return to daily activities 12,4/10,5 weeks; analgesia needed for 9/5 weeks. Global satisfaction was: group O 44% excellent, 24% good, 20% fair and 12% bad; group P 54% excellent, 25% good, 7% fair and 14% bad. Complications: 44.8% in group O (mainly minor problems of wound) and 23,3% in group P (mainly non-unions).

Conclusions: We would like to remark the differences with statistical significance: mean age is lower in group P, time to bone healing is longer in group P but time to wear comfort shoes is shorter in these patients.

There are no statistical differences for metatarsal curve. According to AOFAS scale there are no differences except for the alineation items (better in group O). No differences neither for global satisfaction of the patients nor for visual analogic scale. Complications are predictable for each technique: skin problems in group O and union problems in group P.

We conclude that both procedures are acceptable in the treatment of metatarsalgia with similar objective and subjective results.