الفهرس | Only 14 pages are availabe for public view |
Abstract Fracture of the lower end of radius is the most common forearm fracture. Some authors reported that fracture represents about 60% to 75% of all forearm fractures. The most common cause of the fracture is due to fall on outstretched hand. Fracture eponyms pay tribute to those who initiated the process: Colles, Barton, and Smith. Each described one or more specific fractures that they characterized by clinical evaluation or laboratory dissection, without the aid of X-rays. With this foundation, many investigators progressively contributed to the breadth and depth of understanding of distal radial fractures based on fracture attributes and severity. Hundreds of classifications are present for this fracture( Frykman ,Fernandez, Melone, AO, ………….). The diagnosis of this fracture depends upon history (mechanism of trauma), clinical finding (pain, swelling, tenderness and silver fork deformity) and radiological finding (x ray, CT scan, MRI and ultrasonography). The treatment goal of these fractures is a wrist that provides sufficient pain-free motion and stability to permit daily activity without the propensity for future degenerative changes. The treatment may be non operative treatment for stable fractures in the form of closed reduction and cast application or operative treatment in cases of unstable fractures ,open fractures, bilateral fractures , failure of conservative treatment ,and impaired contralateral extremity. Options for operative treatment include closed reduction and percutaneous pinning, Very important factors were studied in relation to the results and revealed that: open reduction and internal fixation gives better results than percutaneous fixation. 2) Early treatment of the patients makes the reduction easy and gives good results Management Of edema in the form of anti-edema drugs and elevation of the limb make the reduction easy and allow palpation of the radial styloid and Lister’s tubercle during insertion of crossed pins. 3)Results of both groups of the study are comparable and the difference is not so great clinically . 4) Percutaneous pinning is a less invasive procedure can be used effectively in adults with good bone quality with extra articular fractures or intra articular reducible fractures of distal radius , and also can be used in old age when they are unfit for general anaesthesia using haematoma block. 5) volar locking system gives the best results in old patients with osteoporosis. 6) Radiographic measurements are better in cases treated by open reduction and internal fixation. 7) Early rehabilitation and regaining of function and less postoperative complications can be achieved using open reduction and internal fixation by volar plate. |