Osteoarticular allograft reconstruction after distal radius tumor resection: Reoperation and patient reported outcomes

2021 ◽  
Author(s):  
Jonathan Lans ◽  
Sarah E. Ballatori ◽  
René M. Castelein ◽  
Neal C. Chen ◽  
Santiago A. Lozano Calderon
Keyword(s):  
Distal Radius ◽  
Patient Reported Outcomes ◽  
Tumor Resection ◽  
Osteoarticular Allograft ◽  
Allograft Reconstruction ◽  
Patient Reported

Osteoarticular Allograft Reconstruction for an Angiosarcoma of the Distal Radius

2016 ◽  
Vol 26 (1) ◽  
pp. 79-87
Author(s):  
Andreas F. Mavrogenis ◽  
John Galanopoulos ◽  
Christos Vottis ◽  
Panayiotis D. Megaloikonomos ◽  
Emanuela Palmerini ◽  
...  
Keyword(s):  
Distal Radius ◽  
Osteoarticular Allograft ◽  
Allograft Reconstruction

scholarly journals Arthroscopic Management of Intra-articular Ligament Lesions on Distal Radius Fractures

2021 ◽  
Vol 49 (01) ◽  
pp. 024-036
Author(s):  
Marcio Aurelio Aita ◽  
Ricardo Kaempf ◽  
Bruno Gianordoli Biondi ◽  
Gary Alan Montano ◽  
Fernando Towata ◽  
...  
Keyword(s):  
Return To Work ◽  
Distal Radius ◽  
Patient Reported Outcomes ◽  
Distal Radius Fractures ◽  
Joint Surface ◽  
Wrist Arthroscopy ◽  
X Rays ◽  
Radius Fractures ◽  
Patient Reported ◽  
The Mean

AbstractArticular distal radius fractures (DRFs) have increased in incidence in recent years, especially among the economically active population. Most of the treatment approaches are based on plain X- rays, and do not give us any information on how to treat these fractures. In the search for solutions with greater precision in diagnosis, in reducing the joint surface of the fracture, and envolving minimally-invasive techniques, we found arthroscopy as the main tool for these patients. Therefore, an enhanced understanding of the biomechanics of the different types of fracture associated with ligamentous lesions should facilitate the right decision regarding the treatment. The present paper aims at providing a management-oriented concept to diagnose and treat ligamentous lesions associated with intra-articular DRFs based on a arthroscopy-assisted procedure, and showing the objective and patient-reported outcomes and a new classification. The objective and patient-reported outcomes were: the mean range of motion (ROM) was of 94.80% on the non-affected side; the mean score on the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) was of 3.6 (range: 1 to 12). The score on the Visual Analog Scale (VAS) was of 1.66 (range: 1 to 3). Complications were observed in 2 (13.33%) patients: extensor tendon synovitis in 1 patient, and a limitation (stiffness) in ROM in 1 patient, both treated with wrist arthroscopy release. The mean time until the return to work was of 6.4 weeks. In patients with unstable intra-articular DRFs associated with ligamentous lesions, the fixation of specific osseous-ligamentous fragments and ligamentous repair/reconstruction by wrist arthroscopy prove to be a safe and reliable treatment. The clinical and functional results predict that the patients can return to work more quickly.

scholarly journals The Functional Outcomes and Complications of Different Reconstruction Methods for Giant Cell Tumor of the Distal Radius: Comparison of Osteoarticular Allograft and Three-Dimensional-Printed Prosthesis

2020 ◽  
Author(s):  
Yitian Wang ◽  
Li Min ◽  
Minxun Lu ◽  
Yong Zhou ◽  
Jie Wang ◽  
...  
Keyword(s):  
Grip Strength ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Three Dimensional ◽  
Osteoarticular Allograft ◽  
Allograft Reconstruction ◽  
Mayo Score ◽  
3D Printed ◽  
Wrist Function

Abstract Background: En bloc excision has been increasingly used for the management of giant cell tumors(GCTs) in the distal radius. An osteoarticular allograft has been used extensively for decades, and custom-made prosthesis reconstruction has been more recently applied. We aimed to compare the clinical outcomes of the two procedures. Methods: We retrospectively analyzed 30 patients with Campanacci III or recurrent GCTs of the distal radius for follow-up at a mean of 33.2 months. In total, 15 underwent osteoarticular allograft reconstruction (allograft group) and 15 received cementless three-dimensional(3D)-printed prosthesis reconstruction (prosthesis group) between March 18, 2013, and May 20, 2018. All patients underwent by clinical and radiological examinations, including pre- and postoperative active range of motion (ROM) of the wrist, VAS score, grip strength, degenerative change of wrist, Mayo wrist score and Musculoskeletal Tumor Society (MSTS) score. Complications were evaluated using the Henderson classification. Results: Both groups showed significantly increased ROM, grip strength, Mayo score and MSTS score postoperatively. Furthermore, the extension, flexion, MSTS, and Mayo score were significantly higher in the prosthesis group. There was no significant difference in grip strength and VAS between the groups. In allograft group, one patient had a late infection one had resorption of allograft without allograft bone fracture. and four had wrist subluxation. All patients had degenerative changes (mean 9 months). In the prosthesis group, three patients developed wrist subluxation, three had separation of the distal radioulnar joint, and none of the patients developed wrist degeneration. Conclusions: Our study compared the objective functional outcomes and complications of two reconstructive methods for Campanacci III or recurrent GCT in the distal radius. 3D-printed prosthesis replacement can partially preserve wrist function better than allograft reconstruction in the short-term. During the design of 3D-printed prosthesis, preoperative morphological assessment of the affected proximal row carpal is helpful to control postoperative dislocation. After allograft reconstruction, wrist degeneration, which has been demonstrated in all patients, severely influence their wrist function. Therefore, compared to allograft reconstruction, 3D-printed prosthesis reconstruction has irreplaceable advantages at early-stage application, especially in wrist function, however, further studied with a larger number of cases and longer follow-up.

scholarly journals Polytrauma and High-energy Injury Mechanisms are Associated with Worse Patient-reported Outcomes After Distal Radius Fractures

2019 ◽  
Vol 477 (10) ◽  
pp. 2267-2275 ◽  
Author(s):  
Q. M. J. van der Vliet ◽  
A. A. R. Sweet ◽  
A. R. Bhashyam ◽  
S. Ferree ◽  
M. van Heijl ◽  
...  
Keyword(s):  
Distal Radius ◽  
Patient Reported Outcomes ◽  
High Energy ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Injury Mechanisms ◽  
Patient Reported

scholarly journals Patient-Reported Outcomes after Acute Carpal Tunnel Release in Patients with Distal Radius Open Reduction Internal Fixation

Hand ◽  
2012 ◽  
Vol 7 (2) ◽  
pp. 147-150 ◽  
Author(s):  
Aakash Chauhan ◽  
Timothy C. Bowlin ◽  
Alexander D. Mih ◽  
Gregory A. Merrell
Keyword(s):  
Functional Status ◽  
Distal Radius ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Patient Reported Outcomes ◽  
Carpal Tunnel Release ◽  
Patient Reported ◽  
Group A ◽  
The Mean ◽  
Group B

Background Acute carpal tunnel syndrome (CTS) is a complication that can develop after distal radius fractures. Our hypothesis tested whether patient-reported outcomes after acute carpal tunnel release (CTR) performed in combination with distal radius fracture open reduction internal fixation (ORIF) are worse than patient-reported outcomes with only elective CTR as measured by the symptom severity and functional status scales of the Boston carpal tunnel questionnaire (BCTQ). Methods A retrospective assessment identified 26 patients treated with acute CTR at the same time as distal radius ORIF, no history of pre-existing CTS or CTR, no other injuries, and >12 months follow-up. Sixteen of these patients (Group A) could be contacted and answered the BCTQ. Group A was age- and sex-matched to control patients (Group B) treated with only elective CTR. A case–control study was performed comparing outcomes of both groups. Results The average age of patients was 51±15 years, with an average follow-up of Group A at 49±21 months versus Group B at 55±20 months. The mean symptom severity scale score for Group A was 1.4±0.4 and for Group B was 1.4±0.4. The mean functional status scale score for Group A was 1.4±0.5 and for Group B was 1.3±0.4. The mean total BCTQ score for Group Awas 26.5±7.5 and for Group B was 24.9±7.5. There were no statistical or clinically significant differences between Group A and Group B for symptom severity, functional status, and total BCTQ scores. Conclusions Patients with acute CTR performed at the same time with distal radius ORIF do as well in the long-term as those patients with only elective CTR as measured by the BCTQ. Patients should expect similar recovery of subjective nerve function from acute median nerve dysfunction when CTR is performed with distal radius ORIF as patients with only elective CTR.

scholarly journals The Functional Outcomes and Complications of Different Reconstruction Methods for Giant Cell Tumor of the Distal Radius: Comparison of Osteoarticular Allograft and Three-Dimensional-Printed Prosthesis

2019 ◽  
Author(s):  
Yitian Wang ◽  
Li Min ◽  
Minxun Lu ◽  
Yong Zhou ◽  
Jie Wang ◽  
...  
Keyword(s):  
Grip Strength ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Three Dimensional ◽  
Osteoarticular Allograft ◽  
Allograft Reconstruction ◽  
Mayo Score ◽  
3D Printed ◽  
Wrist Function

Abstract Background: En bloc excision is increasingly used for the management of giant cell tumor in the distal radius. Osteoarticular allograft is extensively used for decades, also custom-made prosthesis reconstruction is recently applied widely. We aimed to firstly compare the clinical outcomes of the two procedures. Methods: We retrospectively analyzed thirty-two patients with Campanacci III or recurrent GCT of the distal radius for follow-up at a mean of 33.2 months. Sixteen underwent osteoarticular allograft reconstruction (allograft group) and sixteen received cementless three-dimensional(3D)-printed prosthesis reconstruction (prosthesis group) between March 18, 2013, and May 20, 2018. All patients were assessed by clinical and radiological examinations, including pre- and postoperative active range of motion (ROM) of the wrist, VAS score, grip strength, degenerative change of wrist, Mayo wrist score and Musculoskeletal Tumor Society (MSTS) score. Complications were evaluated on the Henderson classification. Results: Both groups showed significantly increased ROM, grip strength, Mayo score and MSTS score postoperatively. MSTS and Mayo score were significantly higher in prosthesis group. There was no significant difference in grip strength and VAS between two groups. In allograft group, one had a local recurrence; one had a late infection; four had wrist subluxation. All patients had degenerative changes (mean 9 months, 95% CI: 8.03-9.97). One had resorption of allograft without allograft bone fracture. In the prosthesis group, one had a local recurrence. Three developed wrist subluxation. Three had separation of the distal radioulnar joint. None of the patients developed degeneration of wrist. Conclusions: Our study firstly compared the objective functional outcomes and complications of two reconstructive methods for the Campanacci III or recurrent GCT in the distal radius. 3D-printed prosthesis replacement can preserve better wrist function than allograft reconstruction at short-term. During 3D-printed prosthesis design, preoperative morphological assessment of affected proximal row carpal is helpful to control the postoperative dislocation. After allograft reconstruction, degeneration of wrist, which has been proved in all patients, severely influence their wrist function. Therefore, compared with allograft reconstruction, 3D-printed prosthesis reconstruction shows its irreplaceable advantages at early-stage application, especially in wrist function, but its larger cases research at longer follow-up are needed.

scholarly journals Patient-reported outcomes after a distal radius fracture in adults: a 3–4 years follow-up

2019 ◽  
Vol 90 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Roderick H van Leerdam ◽  
Floortje Huizing ◽  
Frank Termaat ◽  
Sanne Kleinveld ◽  
Steven J Rhemrev ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Patient Reported Outcomes ◽  
Radius Fracture ◽  
Patient Reported

scholarly journals The CAST study protocol: a cluster randomized trial assessing the effect of circumferential casting versus plaster splinting on fracture redisplacement in reduced distal radius fractures in adults

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Britt Barvelink ◽  
◽  
Max Reijman ◽  
Niels W. L. Schep ◽  
Vanessa Brown ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Distal Radius ◽  
Closed Reduction ◽  
Patient Reported Outcomes ◽  
Distal Radius Fractures ◽  
Adult Patients ◽  
Primary Study ◽  
Radius Fractures ◽  
Patient Reported ◽  
Cluster Randomized

Abstract Background There is no consensus concerning the optimal casting technique for displaced distal radius fractures (DRFs) following closed reduction. This study evaluates whether a splint or a circumferential cast is most optimal to prevent fracture redisplacement in adult patients with a reduced DRF. Additionally, the cost-effectiveness of both cast types will be calculated. Methods/design This multicenter cluster randomized controlled trial will compare initial immobilization with a circumferential below-elbow cast versus a below-elbow plaster splint in reduced DRFs. Randomization will take place on hospital-level (cluster, n = 10) with a cross-over point halfway the inclusion of the needed number of patients per hospital. Inclusion criteria comprise adult patients (≥ 18 years) with a primary displaced DRF which is treated conservatively after closed reduction. Multiple trauma patients (Injury Severity Score ≥ 16), concomitant ulnar fractures (except styloid process fractures) and patients with concomitant injury on the ipsilateral arm or inability to complete study forms will be excluded. Primary study outcome is fracture redisplacement of the initial reduced DRF. Secondary outcomes are patient-reported outcomes assessed with the Disability Arm Shoulder Hand score (DASH) and Patient-Rated Wrist Evaluation score (PRWE), comfort of the cast, quality of life assessed with the EQ-5D-5L questionnaire, analgesics use, cost-effectiveness and (serious) adverse events occurence. In total, 560 patients will be included and followed for 1 year. The estimated time required for inclusion will be 18 months. Discussion The CAST study will provide evidence whether the type of cast immobilization is of influence on fracture redisplacement in distal radius fractures. Extensive follow-up during one year concerning radiographic, functional and patient reported outcomes will give a broad view on DRF recovery. Trial registration Registered in the Dutch Trial Registry on January 14th 2020. Registration number: NL8311.

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