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Summary: Grip strength measurement, as a surrogate of sarcopenia diagnosis, effectively predicts secondary fracture risk in distal radius fracture patients. This simple tool enhances clinical practice by identifying high-risk patients for targeted interventions, potentially preventing or reversing functional decline and recurrent fractures. Purpose: To evaluate grip strength and hand muscle cross-sectional area as predictors of secondary fracture risk in patients with a history of distal radius fracture (DRF), serving as surrogates of the diagnosis of sarcopenia. Methods: A retrospective cohort study of 745 DRF patients was analyzed with their grip strength data using Cox proportional hazards regression, receiver operating characteristic analysis, and Kaplan–Meier analysis to predict secondary fracture risk over an average of 12 years. Hand muscle cross-sectional area was similarly analyzed. Results: Patients with a history of DRF were predicted to have a 4.1% higher likelihood of experiencing a secondary fracture per kilogram reduction in their grip strength (p < 0.008), independent of age and sex. Patients were categorized as high-risk (≤ 16 kg), moderate-risk (17–24 kg), or low–risk (≥ 25 kg) (p < 0.001). High-risk patients showed a 2.2-fold (95% CI = 1.55–3.17) higher recurrent fracture risk compared to low-risk patients. Cumulative secondary fracture probabilities of the high-risk group patients at 5, 10, and 15 years were estimated to be 16%, 30%, and 54%, respectively. Conclusions: Grip strength measurement, as a surrogate of sarcopenia diagnosis, effectively predicts secondary fracture risk in patients with DRF. This simple tool could improve clinical practice by identifying high-risk patients for targeted interventions to prevent recurrent fractures or even reverse functional decline. [ABSTRACT FROM AUTHOR]

Distal radius fractures with severely osteoporotic bone or articular comminution can provide challenges to fixation with traditional volar locked plating alone. The purpose of this study was to evaluate the clinical, radiographic, and patient reported outcomes of patients undergoing distal radius fixation with volar locked plating and adjunctive dorsal bridge plating. We retrospectively identified 16 patients with distal radius fractures who underwent our preferred surgical technique for fixation. Patients underwent volar locked plate fixation as well as dorsal bridge fixation at time of surgery. Seven patients were indicated for severe articular comminution with volar rim fragmentation (44%), three patients were revised for nonunion after previous volar locked late fixation (19%), and six patients had severely osteoporotic bone with articular comminution (38%). Two patients (13%) sustained AO/OTA 23-A3 distal radius fracture, two patients (13%) had a 23-B3 fracture, two patients (13%) had a 23-C2 fracture and ten patients (63%) had a 23-C3 fracture. The average patient age was 51.8 years ± 20.6. Patients were followed for an average of 12.2±6.3 months. The dorsal bridge plate was removed at an average of 11.1±2.4 weeks. The average post-operative radial inclination was 18.9±2.4°, radial height 12.4 mm ± 2.6 mm, and volar tilt 7.1±1.9°. There were no cases of deep or superficial infection. After dorsal bridge plate removal, patients demonstrated an average wrist extension of 55.3±9.5°, flexion 54.4±12.8°, radial deviation 15.7±3.2°, 25.2±3.9 degrees of ulnar deviation. Distal radius fractures in the setting of severely osteoporotic bone, salvage procedures, articular comminution, volar rim fractures, and revision surgery present uniquely difficult surgical challenges. Volar locked plating with adjunctive dorsal bridge plating can be used with good short- and long-term results. [ABSTRACT FROM AUTHOR]

Introductions: Multiple treatments for complex regional pain syndrome (CRPS) have been promoted, although the degrees of supporting evidence vary and are often limited. This updated review aims to critically examine the data for treating Complex Regional Pain Syndrome (CRPS) from current randomized controlled trials (RCTs) and non-RCTs. Methods: A systematic literature search was conducted to identify all randomized controlled trials and non-randomized controlled trials addressing the rehabilitation of CRPS conducted on human subjects and published in English between 2018 and 2022 using The Cochrane Library, PubMed, and ScienceDirect (Elsevier). Results: The search yielded 6 RCTs and two non-RCTs of varying quality regarding the treatment of CRPS. 6 studies evaluate the treatment of CRPS, and two studies evaluate the prevention of CRPS. Conclusions: In conclusion, both manual manipulation and physical modality are safe and reliable procedures that provide good pain relief and functional improvement as treatment and prevention of CRPS. [ABSTRACT FROM AUTHOR]

Background: Distal radius fractures are common fractures in older adults and associated with increased risk of future functional decline and hip fracture. Whether lower limb muscle strength and balance are impaired in this patient population is uncertain. To help inform rehabilitation requirements, this systematic review aimed to compare lower limb muscle strength and balance between older adults with a distal radius fracture with matched controls, and to synthesise lower limb muscle strength and balance outcomes in older adults with a distal radius fracture. Methods: We searched Embase, MEDLINE, and CINAHL (1990 to 25 May 2022) for randomised and non-randomised controlled clinical trials and observational studies that measured lower limb muscle strength and/or balance using instrumented measurements or validated tests, in adults aged ≥ 50 years enrolled within one year after distal radius fracture. We appraised included observational studies using a modified Newcastle-Ottawa Scale and included randomised controlled trials using the Cochrane risk-of-bias tool. Due to the clinical and methodological heterogeneity in included studies, we synthesised results narratively in tables and text. Results: Nineteen studies (10 case-control studies, five case series, and four randomised controlled trials) of variable methodological quality and including 1835 participants (96% women, mean age 55–73 years, median sample size 82) were included. Twelve included studies (63%) assessed strength using 10 different methods with knee extension strength most commonly assessed (6/12 (50%) studies). Five included case-control studies (50%) assessed lower limb strength. Cases demonstrated impaired strength during functional tests (two studies), but knee extension strength assessment findings were conflicting (three studies). Eighteen included studies (95%) assessed balance using 14 different methods. Single leg balance was most commonly assessed (6/18 (33%) studies). All case-control studies assessed balance with inconsistent findings. Conclusion: Compared to controls, there is some evidence that older adults with a distal radius fracture have impaired lower limb muscle strength and balance. A cautious interpretation is required due to inconsistent findings across studies and/or outcome measures. Heterogeneity in control participants' characteristics, study design, study quality, and assessment methods limited synthesis of results. Robust case-control and/or prospective observational studies are needed. Registration: International prospective register of systematic reviews (date of registration: 02 July 2020, registration identifier: CRD42020196274). [ABSTRACT FROM AUTHOR]

This work explores the effect of a Wechat group on follow‐up and continuation of nursing for discharged patients with Colles fracture. A total of 96 patients with Colles fracture are enrolled and randomized into two groups by the random number table method. The control group is followed up and guided by traditional methods. Based on the follow‐up method adopted in the control group, a Wechat group is combined with Wechat constant tracking. The regular follow‐up rate, a satisfaction of with continuing care, Gartland–Werley wrist score, the exercise of self‐care agency score (ESCA score), and complications are compared and analyzed. The regular follow‐up rate, satisfaction, Gartland–Werley wrist score, and self‐care ability of patients in the Wechat group are significantly higher than those in the control group (p < 0.05). Statistical analysis of postoperative complications showed that although there is no significant difference in the incidence of median nerve irritation and incision infection (p > 0.05), the proportion of joint stiffness in the control group is significantly higher (p < 0.05). The establishment of Wechat groups to follow up and continue nursing for discharged patients with Colles fracture is helpful to achieve better clinical efficacy and improve the effective way for doctor–patient communication, which is worthy of active promotion. [ABSTRACT FROM AUTHOR]

Abstract This work explores the effect of a Wechat group on follow‐up and continuation of nursing for discharged patients with Colles fracture. A total of 96 patients with Colles fracture are enrolled and randomized into two groups by the random number table method. The control group is followed up and guided by traditional methods. Based on the follow‐up method adopted in the control group, a Wechat group is combined with Wechat constant tracking. The regular follow‐up rate, a satisfaction of with continuing care, Gartland–Werley wrist score, the exercise of self‐care agency score (ESCA score), and complications are compared and analyzed. The regular follow‐up rate, satisfaction, Gartland–Werley wrist score, and self‐care ability of patients in the Wechat group are significantly higher than those in the control group (p < 0.05). Statistical analysis of postoperative complications showed that although there is no significant difference in the incidence of median nerve irritation and incision infection (p > 0.05), the proportion of joint stiffness in the control group is significantly higher (p < 0.05). The establishment of Wechat groups to follow up and continue nursing for discharged patients with Colles fracture is helpful to achieve better clinical efficacy and improve the effective way for doctor–patient communication, which is worthy of active promotion.

Colles fracture is the commonest fracture encountered in orthopedic practice that demands prompt therapeutic intervention, and adequate follow-up to ensure complete healing. Various types of fractures, methods of reduction, and healing have been explained in the classical Ayurveda texts. These techniques are scientific and time-tested. This paper aims to report the successful management of Colles fracture case using Ayurveda and modern techniques with the use of Murivenna (an oil-based herbal formulation mentioned in the contemporary texts of Ayurveda), half-cast POP, and aluminum splinted bandage along with the internal medicine Abha Guggulu. A 75-year-old moderately built woman diagnosed with Colles fracture was treated with a closed manipulative reduction technique followed by a below-elbow half-cast POP and an aluminum splint. Murivenna was poured anteriorly to the fractured site and Abha Guggulu was administered internally. Re-bandaging was done on the 7th day and 21st day. The bandage was removed on the 35th day. The patient's condition improved considerably with a good range of wrist movements and then she was advised to commence rehabilitation. This integrative method, adhering to Ayurvedic principles and modern techniques is unique, patient-friendly, and without adverse events.

Introduction: Fractures at the distal end of the radius are among the most frequent fractures. Fracture classifications are widely used to define treatment and prognosis. Methods: radiographs were selected from 14 patients with fractures of the distal end of the radius in anteroposterior and profile views, and one case was repeated on purpose. Twelve participants at different stages of professional training (four residents and eight orthopedists) evaluated all the images at two different times, with an interval of 1 week. The inter and intraobserver concordance was analyzed using the weighted Kappa coefficient. The Student's t-test for paired samples was applied to verify if there was a significant difference in the degree of inter-observer concordance between the instruments. Results: Universal classification showed great intra-observer reproducibility (k = 0.72) and moderate interobserver reproducibility (k = 0.48). Frykman had moderate and mild intra and interobserver reproducibility, respectively (k = 0.51 and 0.36). The classification of the group A.O. demonstrated mild intraobserver and interobserver reproducibility (k = 0.38 and 0.25, respectively). Conclusion: The highest intra and interobserver concordance was observed in the Universal classification, followed by Frykman and, finally, that of the group A.O. The reproducibility of the classification did not vary significantly with the degree of experience of the evaluator.

Colles fracture is 15% of the whole fracture incidents in adults, and joint stiffness is the most common complication. Anxiety is one of a variety of factors strongly associated with an increased risk of disability and pain intensity in patients with musculoskeletal disorders. This study aims to identify the relationship between anxiety and the level of joint stiffness in Colles fracture patients. This research is an observational analytic study with a cross-sectional design. Data collection was carried out in the physiotherapy of PKU Muhammadiyah Gamping Hospital from March to October 2018 by interview using a questionnaire. Data were analyzed using the Spearman correlation test. The result of the study with 13 respondents showed 9 people (69.2%) did not experience anxiety, one person (7.7%) experienced mild anxiety, one person (7.7%) was in moderate anxiety, and two others were in severe anxiety (15.4%). Meanwhile, in terms of the level of joint stiffness, three people (23.1%) were in mild stiffness, three people (23.1%) were in moderate stiffness, six people (46.2%) were in severe stiffness, and one person (7.7%) was in highly severe stiffness. Statistical test of the relationship between anxiety and the level of joint stiffness in patients with Colles fracture showed no significant correlation (p=0.808). It can be concluded that there was no relationship between anxiety and the level of joint stiffness in fracture patients.

Necrotizing soft tissue infections (NSTIs), characterized by extensive soft tissue destruction, are rare but life-threatening. We present a case of a NSTI in a healthy 65-year-old woman following a closed distal radius fracture. The patient presented with severe pain, fever, and lethargy 4 days after her index injury, with physical examination of the right upper limb revealing erythema and swelling to the mid-humeral level and blisters of the fingers and hand. Multiple surgical debridements were required to control the infection, which was caused by Streptococcus pyogenes . This case highlights the rapid progression and devastating consequences of NSTI, which can occur even in the setting of closed injuries in patients without comorbidities. Prompt diagnosis, early surgical intervention, and appropriate antimicrobial therapy are crucial in managing this pathology. Level of Evidence: Level 5., Competing Interests: Statement of Human and Animal RightsThere are no conflicts regarding human and animal rights with respect to this manuscript. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In one Roman funerary area (1st-2nd centuries AD) of Augusta Emerita, an adult female skeleton was found, showing multiple healed trauma, being one the first evidences of this kind documented in the capital of Lusitania. This study describes those lesions, reconstructs the possible events responsible and hypothetical impact on the subject’s quality of life. Macroscopic and radiological observation revealed fractures of the left distal third of the radius and the ulnar styloid process, as well as of the distal third of the left fibula. Those of the forearm, caused a shortening of about one centimetre, probably resulting from a fall during growth. The fracture of the fibula would have occurred from an underfoot accident resulting also in a heterotopic ossification of the distal anterior ligament. Since both fractures are well consolidated and without degenerative articular lesions, this woman probably did not suffer significant sequelae thereafter. ______________________________________________________________________________ En un área funeraria romana (siglos I-II d.C.) de Augusta Emerita fue descubierto el esqueleto de una mujer adulta mostrando un trauma múltiple cicatrizado, siendo una de las primeras evidencias de este tipo documentadas en la capital de la provincia Lusitania. Este estudio describe las lesiones, reconstruye los posibles eventos responsables y su hipotético impacto en la calidad de vida del individuo. Las observaciones macroscópicas y radiológicas revelan fracturas del tercio distal del radio y del proceso estiloide del cúbito izquierdos, así como del tercio distal del peroné izquierdo. Las del antebrazo ocasionaron un acortamiento de cerca de un centímetro, fruto posiblemente de una caída durante su desarrollo. La fractura de peroné habrá sido consecuencia de un accidente del pie que provocó, además, una osificación heterotópica del ligamento anterior distal. Dado que las fracturas se presentan bien consolidadas y sin lesiones articulares degenerativas, esta mujer probablemente no tuvo secuelas significativas.

Objective:To evaluate the clinical efficacy of extracorporeal shock wave therapy (ESWT) on the hand function recovery on patients with Colles fracture after conservative therapy.Methods:A total of 24 patients with Colles fractures who had treated with manipulative reduction and gypsum bandage fixation were randomly divided into ESWT group and control group, with 12 cases in each group. The control group was trained with general hand function recovery rehabilitation approach, the ESWT group was treated with extracorporeal shock wave therapy on the basis of the control group.Results:After treatment, the AROM and TAM scores of wrists of the two groups were significantly improved than those before treatment, with statistically significant differences (PPPP

Pain is a complex symptom to assess properly and it is often poorly managed in the Emergency Department. The majority of research has focused on exploring oligoanalgesia in samples of patients with heterogeneous injuries. The occurrence of oligoanalgesia in a homogeneous injury, such as Colles fracture, has yet to be explored. A retrospective chart review was conducted to determine the incidence of oligoanalgesia in adults with Colles fractures admitted to two urban Emergency Departments in Western Canada. Data were collected from one hundred fifty charts from a 5-year period (2009-2014). Age and gender predicted of pain assessment (p =.019), but were not significantly associated with receipt of an opioid or pain reassessment. Pain reassessment was only completed in 47% of patients who received an initial pain assessment; this was significantly different from current best practice standards (p =.0002). [ABSTRACT FROM AUTHOR]

Off‐axis loading associated with a fall onto the outstretched hand has been hypothesized to induce distal radius failure at lower magnitudes than axially directed loading commonly used in biomechanical models for estimating fracture risk. However, this hypothesis has not been tested with side‐to‐side experimental testing. The objective of this study was to compare distal radius failure loads between forearm pairs experimentally tested in an axial or off‐axis loading configuration. We acquired 18 pairs of cadaveric forearms from 18 female donors (mean age (standard deviation): 84.4 (7.9) years). Each forearm pair was tested to failure using either an axial compression test (vertical orientation with 0° dorsal inclination, 3°‐6° radial inclination) or an off‐axis test corresponding to the hand position during a fall (15° dorsal inclination, 3°‐6° radial inclination). Failure testing was performed at 3 mm/s onto the palm of the hand until fracture occurred. Of the 18 pairs, 11 sustained a distal radius fracture. We compared failure loads between the two groups using a paired t test. Results indicated that failure load under off‐axis loading was 29% lower than failure load under axial compressive loading (mean difference: −0.31 kN; 95% confidence interval: −0.47 to −0.16 kN, P =.001). In conclusion, off‐axis loading associated with a fall onto the outstretched hand resulted in a 29% lower failure load. Integrating an off‐axis loading configuration into current biomechanical models of distal radius bone strength may prevent overestimating of failure load and may offer a clinically relevant option to estimate distal radius fracture risk and monitor therapy efficacy. [ABSTRACT FROM AUTHOR]

Background: Understanding risk factors for readmission may help decrease the rate of these costly events. The purpose of this study is to define the incidence of 30-day readmission and unscheduled health care contact (UHC) after distal radius fracture (DRF). In addition, we aim to define risk factors for readmission and UHC. Methods: A retrospective review of patients who sustained a DRF at our trauma center was performed. We recorded baseline demographics, fracture characteristics, and treatment. Any UHC or readmission (including emergency department [ED] visits) was documented. Reasons for readmission and UHC were stratified by cause. We utilized a case-control design comparing patients readmitted within 30 days after DRF versus those who were not, as well as patients with and without UHC. Results: About 353 patients were identified. The 30-day incidence of readmission after DRF was 7% with 2% of patients readmitted for reasons related to their fracture. Twenty percent of patients had UHC within 30 days, most frequently due to pain. Patients with anxiety or depression and those with open fractures were more likely to be readmitted. Patients with UHC were younger, more likely to have depression or anxiety, and more likely to have undergone operative treatment. Conclusions: For patients sustaining DRF, we report a 30-day readmission rate of 7% with 20% of patients having UHC. Patients with depression or anxiety were more likely to be both readmitted and have UHC. Identifying risk factors for readmission during initial presentation may help reduce readmissions. Improving pain relief strategies early may aid in decreasing the burden of UHC. [ABSTRACT FROM AUTHOR]

With the rapid development of digital research in clinical orthopedics, the efficacy and safety of splint fixation can be better evaluated through biomechanical analysis based on a three-dimensional (3D) finite element model. It is essential to address the current gap in understanding the biomechanical implications of anatomical splint fixation for Colles fractures. By employing advanced 3D finite element analysis, the present study aimed to provide a comprehensive evaluation, offering valuable insights that can contribute to enhancing the effectiveness of anatomical splint fixation in the clinical management of Colles fractures. The 3D finite element models of the forearm and hand were constructed using Mimics 15.0 according to data from computed tomography of a patient with a Colles fracture. After the validity of the model was verified, the corresponding material properties of the models were adjusted to simulate a Colles fracture. Subsequently, the reduction functions, such as radial inclination and ulnar deviation, of the simulated fracture were completed and the mechanical changes of the tissues surrounding the fracture were calculated. Anatomical splints were then placed on the surfaces of the 3D finite element models of Colles fractures at various positions to analyze the changes in the stress cloud diagram, such as for the soft tissue and anatomical splints. In the present study, the constructed 3D finite element models were accurate and valid. The maximum stress of the anatomical splints and soft tissues was 2.346 and 0.106 MPa in pronation, 1.780 and 0.069 MPa in median rotation and 3.045 and 0.057 MPa in supination, respectively. Splint stress reached the highest level in supination and soft tissue stress achieved the highest level in pronation. The peak of splint stress occurred during supination, which contrasts to the peak of soft tissue stress observed in pronation, suggesting splint fixation median rotation can effectively avoid compression of the local soft tissue. [ABSTRACT FROM AUTHOR]

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BACKGROUND: The new medical thermoplastic plate brace has been widely used for the external fixation of limb fractures, and has achieved some curative effects. But there is still no prospective randomized controlled study on its efficacy in the distal radius fractures needing for manual reduction. OBJECTIVE: To compare the clinical efficacy of manual closed reduction thermoplastic plate brace and gypsum external fixation in the treatment of Colles fracture by prospective randomized control. METHODS: One hundred and twenty patients with Colles fractures from January 2016 to January 2018 at the Department of Orthopedics, Central South University Xiangya School of Medicine Affiliated Haikou Hospital were enrolled, including 52 males and 68 females, aged 18-65 years. The patients were randomly divided into two groups and treated with manual closed reduction and thermoplastic plate brace external fixation (thermoplastic plate group, n=60) and manual closed reduction gypsum external fixation (gypsum group, n=60). The complications during treatment were recorded. At 3 and 6 months after treatment, the Visual Analog Scale scores were assessed. At 6 months after treatment, the Gartland-Werley scoring system was used to assess the wrist function and to assess patient satisfaction. Imaging assessment of reduction and fracture healing was performed at immediately, 6 weeks and 6 months after treatment. The study was approved by the Ethics Committee of Central South University Xiangya School of Medicine Affiliated Haikou Hospital, approval number: 2014-308. RESULTS AND CONCLUSION: (1) The incidence of reactions to the host in the thermoplastic plate group was lower than that in the gypsum group (13.3%, 36.7%, P < 0.05). (2) The Visual Analog Scale scores at 3 and 6 months after treatment in the thermoplastic plate group were lower than those in the gypsum group (P < 0.05). (3) The excellent rate of wrist function and patient satisfaction in the thermoplastic plate group were higher than those in the gypsum group (excellent rate: 88.3%, 73.3%; satisfaction: 91.7%, 65.0%, P < 0.05). (4) The imaging examination showed that the radial height, palmar tilt angle, and ulnar inclination angle in the two groups were significantly better than before treatment, and there was no significant difference between two groups (P > 0.05). (5) These results show that the use of thermoplastic plate brace and gypsum external fixation for treating Colles fracture can obtain satisfactory reduction effect, but the thermoplastic plate has the advantages of simple operation, low incidence of complications, good recovery of wrist function and high patient satisfaction. [ABSTRACT FROM AUTHOR]

Eponyms, whereas commonly used in hand surgery, are perhaps misused as often as they are used correctly. Many commonly used eponyms, such as Colles fracture, Barton fracture, Smith fracture, and Bennett fracture, were actually described decades before the development of radiographs. The goal of this article is to revisit the original descriptions of commonly used eponymous terms for distal radius and first metacarpal base fractures to provide clarity and enhance understanding of what these eponyms actually mean. [ABSTRACT FROM AUTHOR]

Background: To compare the outcome in Colles’ fracture treated with thermoplastic splint versus conventional Colles cast. Methods: In this observational study 62 patients having Colles fracture were included. Patients were placed in two groups; group A were treated with Colles’ cast while group B with Thermoplastic splint. Radiographic evaluation was done, using Antero-posterior and lateral view wrist radiographs. Functional outcome assessed with Gartland and Werley Score demerit system. Results: Out of 62 patients, 28 (45.1%) were male with mean age of 38.67 and 34(54.8%) were female patients having mean age of 47.20. The total number of patients that had excellent functional outcome was 34 out of 62 (54.8). The excellent functional outcome was achieved in 16(50%) patients treated with colles brace. However, in patients treated with thermoplastic splint the functional outcome was excellent in 18(60%) patients. Conclusion: Best functional outcome after the treatment of Colles’ fracture is achieved by the use of thermoplastic splint.

Objective: To retrospectively assess the advantages of the modified Uhl technique in the treatment of Colles' fracture guided by the principles of Chinese osteosynthesis (CO) concept., Methods: A retrospective study was conducted on 358 patients with Colles' fracture treated with the modified Uhl technique of closed reduction and percutaneous pin between January 2016 and June 2021. Out of these, 120 eligible cases were selected and categorized into two groups according to different surgical methods:the closed reduction and percutaneous pin group, and the open reduction group. Sixty-eight patients in the closed reduction and percutaneous pin group were treated with the modified Uhl technique, while fifty-two patients in the open reduction group were treated with open reduction and internal fixation using plates. The modified Sarmiento imaging score, Gartland-Werley wrist score, operation time, hospital stay, and treatment costs between the two groups were compared at a 6-month postoperative follow-up., Results: There were no significant differences in terms of gender, age, affected side, injure factors, time of injury to surgery, Sarmiento imaging score, and Gartland-Werley wrist joint score ( P >0.05). The closed reduction and percutaneous pin group exhibited an operation time of (35.88±14.11) minutes, hospitalization stay of (9.78±2.48) days, and treatment costs of (16 074.91±1 964.48) yuan, while the open reduction group demonstrated comparatively longer operation time of (65.48±14.26) minutes, hospitalization stay of (15.88±2.00) days, and treatment costs of (20 451.27±1 760.22) yuan ( P <0.01)., Conclusion: The modified Uhl technique presents notable advantages in the management of Colles' fracture, including reliable fixation, less trauma, shorter operation time, less pain, shorter hospital stay, and cost-effectiveness. This technique exhibits promising potential for broader clinical application. However, it is important to note that the pin could potentially damage tendons, and in cases of Colles' fractures with osteoporosis and comminuted fragments, additional techniques may be required for reliable fixation.

William G BlakeneyDepartment of Orthopedic Surgery, Sir Charles Gairdner Hospital and Royal Perth Hospital, Perth, WA, AustraliaAbstract: Colles’ fractures (fractures of the distal radius) are extremely common in the elderly. These fractures tend to result in displacement in elderly people because they have osteoporotic bone. Fracture displacement in the elderly, however, does not necessarily result in functional impairment. This review looks at the current literature on distal radius fractures in the elderly and the treatment options for stabilization of these fractures. These include conservative management with cast immobilization or surgical options: internal fixation, external fixation, percutaneous pinning, and bone substitutes.Keywords: Colles’ fracture, distal radius, elderly, osteoporosis, treatment

Introduction & Objective: Postoperative acute pain is a complex reaction to tissue injury , visceral distention or a disease that causes harmful physiologic effects on several organs. It seems that with more epidemiologic and pathologic knowledge of postoperative pain, patients can be relieved more and hospital expenses reduced. One of the methods to reduce postoperative analgesics requirement is the preemptive analgesia. Many drugs like NSAIDs and narcotics have been used. The aim of this article was to study the effect of a single dose Indomethacin suppository given before operating colles fracture to reduce postoperative analgesics requirement. Materials & Methods: In this clinical study patients were divided into two groups randomly. The case group (55 people) received 100 mg indomethacin thirty minutes before anesthesia , while the control group (45 people) received nothing . All had the same kind of anesthesia , which lasted less than an hour for all . After operation they received NSAIDs or narcotics according to the Flacc pain scale. Results: The average NSAID received after the operation in the case group was 16.8±23.1 mg, and 30.5±33.6 mg in the control group. Studying these values with t- test illustrates that using preoperative indomethacin causes less postoperative NSAID requirement (P

In the distal radius fracture requires radiographic views that allow you to see the articular surface without interposition. The objective was to determine whether lateral radiographic projections 7 and 22° improve the analysis of this surface. Method: Case series study with radiographs of healthy and operated patients, in order to identify the lunate and scaphoid facets in lateral and anteroposterior projections. Qualitative analysis was made on the radiographs of the distal radius with wedges of 7 and 22° in the lateral views and 11° in the anteroposterior view. Results: There were evaluated 14 radiographs of the distal radius of healthy volunteers and 10 patients with distal radius fractures who recieved surgery with internal fixation, and also two anatomical models. In 14 healthy and 10 patients, it was found that the views at 7 and 22° can be better appreciated radio lunate and radio scaphoid surface respectively, observing images with less overlapping in the radiograph of 22° in both groups. Discussion: Radiographic views are important to determine the immediate results of fixation on a distal radius fracture. We observe that the lateral view at 7° is better to show the screws on the lunate facet of the radius. The lateral view at 22° is better to show the facet of the radius with the scaphoid. Finally, the anteroposterior projection at 11° allows us to see the radio carpal joint with lower image overlay. [ABSTRACT FROM AUTHOR]

Purpose: In Denmark, guidelines from the Danish Orthopedic Society recommend that patients older than 65 years who sustain a Colles' fracture should be referred to assessment of underlying osteoporosis. An assessment of referral rates at our hospital during the period October 2010-September 2013 showed that none were referred. Due to this, an automatic out-patient referral system for assessment of underlying osteoporosis was established. With this system, patients are referred directly from the Emergency Department (ED). The purpose of this study was to assess how effective this new referral system was at improving referral rates for assessment of osteoporosis and to evaluate how many more cases of osteoporosis that was identified with this practice during the period October 2013-September 2014.Method: The automatic referral system for evaluation of osteoporosis in patients 65 years and above without known osteoporosis, living in the catchment area and sustaining a low energy distal forearm fracture was established in October 2013. With the new system, patients were referred directly from the ED for evaluation of osteoporosis at the osteoporosis out-patient department at the hospital. The system was evaluated for the period October 2013-September 2014. For comparison data was collected on the same patient group for the 3 years preceding the system.Results: Before the automatic system none were referred for evaluation of osteoporosis and thus none were diagnosed. After introduction of the system 100% were referred, 73.26% were examined and 65.08% of these were found to have osteoporosis. Anti-osteoporotic treatment was initiated in all but 4.88% of the patients.Conclusion: The results show that this type of automatic referral system can be an effective way of increasing the number of patients diagnosed with and treated for osteoporosis. It also shows that involvement of the ED in the screening for osteoporosis can be an effective way of increasing referral rates leading to higher rates of diagnosed osteoporosis. The early identification and initiating of treatment might result in a lower rate of secondary and potentially more severe osteoporotic fractures. [ABSTRACT FROM AUTHOR]

Background Cast immobilisation after successful closed reduction is a standard treatment for displaced extra-articular fractures of lower end radius. The position of the wrist during immobilisation is controversial. Immobilisation in dorsiflexion prevents redisplacement after closed reduction. Our aim is to determine the effectiveness of immobilization of wrist in dorsiflexion in such cases and evaluate anatomical and functional outcome. Materials and methods Study included 54 patients, above 19 years of age with closed extra-articular fractures of lower end radius treated conservatively with below elbow cast application. The wrist was maintained in 15° of dorsiflexion during plaster immobilisation. At 24 weeks, functional results were evaluated with subjective symptoms and objective signs, as per modified Demerit Point Score System. Anatomical result was evaluated based on the scheme devised by Lidstrom (1959) and modified by Sarmiento et al. (1980). Results 76% patients had Excellent to Good subjective symptoms. Out of 42 patients that had residual dorsal angulation of less than 10°, 37 had excellent to good functional outcome. 39 of the 43 patients who had loss of radial length less than 6 mm had excellent to good functional outcome. 40 out of 49 patients having loss of radial angulation less than 9° showed excellent to good functional outcome. Functional result was directly proportional to anatomical outcome. Conclusion Cast immobilization of extra articular fractures of lower end radius with wrist in dorsiflexion prevents re-displacement of the fragments resulting in satisfactory anatomical & functional outcome. [ABSTRACT FROM AUTHOR]

Colles fracture is the fracture of distal radius occurring most commonly in elderly because of the osteoprotic bone. Objectives: To compare outcome in fracture treated with Colles Plaster Case and Colles Junctional Brace. Study Design: Observational Study. Period: February 2013 to August 2013. Setting: Department of Orthopedics Bainazir Bhutto Shaheed Hospital, Rawalpindi. Methods: A study was conducted on 140 patients suffering from Colles fracture in a period of 6 months. Patients were divided in 2 groups. In group A conventional Colles cast for 6 weeks was administered and in group B Colles cast was replaced be a functional brace after 2 weeks. Functional outcome was recorded in both groups at the end of 12 weeks. Functional outcome was analyzed as given on the performa. Results: Out of 140 patients 78(55.7%) were male with a mean age of 35.87.The total number of female patients were 62(44.3%) with a mean age of 46.10 The total number of patients that had excellent functional outcome at 6 weeks were 92 out of 140 patients. The excellent functional outcome was achieved in 57(40.7%) patients treated with colles brace. However, in patients treated with colles cast the functional outcome was excellent in 35(25%) patients. Conclusions: The best functional outcome after the treatment of colles fracture is achieved by the use of colles functional brace. [ABSTRACT FROM AUTHOR]

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The distal radius bone fracture most often affects elderly people, who trying to avoid injury, protect themselves by falling on the outstretched hand. The main risk factors are here: age, sex, osteoporotic changes as well as diet impoverished in calcium and vitamin D. In order to provide the patient with an appropriate treatment, one must concentrate on the fracture location. Such ailments like pain, parenthesis, decreased joint mobility, weakening of the muscle strength are experienced by patients even after having completed the treatment process. Very often these patients shall have significant problems with performing many everyday tasks, which in effect will make them victims dependent on the other. Unfortunately, despite the enormous medical progress, these fractures are still a vast socioeconomic problem. In addition, the patients are frequently afraid of a potential next fall which should be classified as a separate psychosocial problem, leading to isolation and a huge limitation of the social roles available to these patients. [ABSTRACT FROM AUTHOR]

A therapeutic intervention in 50 patients with consolidated Colles fractures; assisted in "Dr. Joaquín Castillo Duany" Teaching Clinical Surgical Hospital in Santiago de Cuba was carried out in the period 2007-2008, in order to evaluate the result of the comprehensive rehabilitative treatment. Two groups were formed (control and study groups) of 25 members each --selected in an alternating way-- who received conventional and integrative treatment, respectively. After having applied the functional scales, a better therapeutic result was evidenced in the patients of the second group, given by smaller complications, better functional state of the wrist and affected hand and shorter time of recovery. [ABSTRACT FROM AUTHOR]

Abstract: A distal radius fracture in middle-age and older adults is often considered a sentinel indicator of osteoporosis. Mechanical testing of cadaveric specimens is often used to quantify bone strength and develop insight for relating in-vivo measures to fracture force. Mechanical testing protocols using an intact forearm have been successful at replicating a Colles fracture, however, excised isolated radius protocols based on the intact forearm testing protocol have not been as successful. One protocol originally designed to replicate the physiological condition of a fall on an outstretched hand was reproduced in our laboratory, yet surprisingly the produced distal radius fracture patterns were not consistent among specimens nor was dorsal angulation of the distal fragment that is characteristic of a Colles fracture observed. The purpose of this study was to perform a mechanics-based analysis of the excised radius loading protocol in order to quantify the imposed and internal forces on the radius. An idealized beam model of the excised radius revealed that in the area of the distal radius where Colles fractures occur, 99.99% of the maximum strain on the bone outer surface was the result of pure compressive loading. This loading condition is in direct contrast to the accepted mechanics of a Colles fracture, which is characterized as a metaphyseal bending fracture with the volar cortex failing due to tensile stresses and the dorsal cortex exhibiting compression and comminution. The results suggest that additional research, particularly related to overcoming the difficulties of reliably supporting and applying a force to the distal end of the radius, is necessary for clinical fracture patterns to be reliably reproduced with an excised radius mechanical testing protocol. [Copyright &y& Elsevier]