Prospective Study of Distal Radial Fractures Treated with an Intramedullary Nail

Nishiwaki, Masao; Tazaki, Kenichi; Shimizu, Hidenori; Ilyas, Asif M.
August 2011
Journal of Bone & Joint Surgery, American Volume;8/3/2011, Vol. 93-A Issue 15, p1436
Academic Journal
Background: Intramedullary nailing for the treatment of unstable distal radial fractures is reported to provide stable fixation with minimal soft-tissue complications, but there is a paucity of data documenting the results of this technique. The purpose of this study was to prospectively determine the functional outcomes of treatment of unstable distal radial fractures with an intramedullary nail. Methods: Patients aged fifty years and older with a dorsally displaced unstable distal radial fracture-an extra-articular or simple intra-articular fracture-that was amenable to closed or percutaneous reduction were offered treatment with intramedullary nail fixation (MICRONAIL). Thirty-one patients were enrolled in the study, and twenty-nine patients with a mean age of sixty-seven years (range, fifty-one to eighty-five years) were available for one-year follow-up. According to the AO classification, there was one type-A2, twenty-four type-A3, and four type-C2 distal radial fractures. The patients were evaluated at six weeks, three months, six months, and one year after surgery. Outcome measures included standard radiographic parameters, active wrist range of motion, grip strength, a modified Mayo wrist score, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results: At the final one-year follow-up evaluation, the active range of motion of the injured wrist relative to that on the uninjured side averaged 95% of flexion, 95% of extension, 93% of ulnar deviation, 91% of radial deviation, 99% of pronation, and 99% of supination. The mean grip strength was 96% of that on the uninjured side. According to the modified Mayo wrist score, there were twenty excellent and nine good results. The mean DASH score was 4.8 points. The final radiographic measurements demonstrated, on average, 25° of radial inclination, 11° of volar tilt, 10mm of radial length, and +1 mm of ulnar variance. Loss of reduction occurred in two patients. One patient developed transient superficial radial sensory neuritis, which resolved within two months. Conclusions: Intramedullary nailing can be a safe and effective treatment with minimal complications for dorsally displaced unstable extra-articular or simple intra-articular distal radial fractures. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • STATIC VERSUS DYNAMIC INTERLOCKING INTRAMEDULLARY NAILING IN FRACTURES SHAFT OF FEMUR. Khan, Irfan Aziz; Ahmad, Sajjad; Shah, Muhammad Ali; Ahmad, Shakeel; Shafiq, Muhammad; Shafaq, Shafiq Ahmad // Gomal Journal of Medical Sciences;Apr-Jun2015, Vol. 13 Issue 2, p104 

    Background: Fractures of shaft of femur are a major cause of morbidity and mortality. The objective of this study was to compare outcome of static and dynamic interlocking nailing in closed femoral shaft fractures. Material & Methods: This descriptive study was carried out at Department of...

  • Evaluation of the Effectiveness of the Angular Stable Locking System in Patients with Distal Tibial Fractures Treated with Intramedullary Nailing. Höntzsch, Dankward; Schaser, Klaus-Dieter; Hofmann, Gunther O.; Pohlemann, Tim; Hem, Einar Sturla; Rothenbach, Erik; Krettek, Christian; Attal, René // Journal of Bone & Joint Surgery, American Volume;11/19/2014, Vol. 96 Issue 22, p1889 

    Background: Angular stable locking of intramedullary nails has been shown to enhance fixation stability of tibial fractures in biomechanical and animal studies. The aim of our study was to assess whether use of the angular stable locking system or conventional locking resulted in earlier full...

  • Modified Mandibulotomy Technique to Reduce Postoperative Complications: 5-Year Results. Hye-Young Na; Eun-Joo Choi; Eun-Chang Choi; Hyung Jun Kim; In-Ho Cha; Woong Nam // Yonsei Medical Journal;Sep2013, Vol. 54 Issue 5, p1248 

    Purpose: To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. Materials and Methods: During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step...

  • Preoperative classification assessment reliability and influence on the length of intertrochanteric fracture operations. Shen, Jing; Hu, FangKe; Zhang, LiHai; Tang, PeiFu; Bi, ZhengGang // International Orthopaedics;Apr2013, Vol. 37 Issue 4, p681 

    Purpose: The accuracy of intertrochanteric fracture classification is important; indeed, the patient outcomes are dependent on their classification. The aim of this study was to use the AO classification system to evaluate the variation in classification between X-ray and computed tomography...

  • Functional Outcome Following Intramedullary Nailing of the Femur. Stannard, James P.; Bankston, Larry; Futch, Ldia A.; McGwin, Gerald; Volgas, David A. // Journal of Bone & Joint Surgery, American Volume;8/3/2011, Vol. 93-A Issue 15, p1385 

    Background: The purpose of the study was to prospectively compare the functional outcome of intramedullary nailing of the femur performed with use of a trochanteric and a piriformis fossa entry portal. Methods: One hundred and ten patients with a femoral shaft fracture were enrolled in a...

  • Surgeons' Preferences for the Operative Treatment of Fractures of the Tibial Shaft. Bhandari, Mohit; Guyatt, Gordon H.; Swiontkowski, Marc F.; Tornetta III, Paul; Hanson, Beate; Weaver, Bruce; Sprague, Sheila; Schemitsch, Emil H. // Journal of Bone & Joint Surgery, American Volume;Nov2001, Vol. 83-A Issue 11, p1746 

    Details a study conducted among practicing orthopedic surgeons focused on their preferences for the operative treatment of fractures of the tibial shaft. Hypothesis that there was variability in the operative treatment of fractures of the tibial shaft; Finding that majority of surgeons...

  • Musculoskeletal function and quality of life after an unstable trochanteric fracture treated with the trochanteric gamma nail. Miedel, Ricard; Törnkvist, Hans; Ponzer, Sari; Tidermark, Jan // Archives of Orthopaedic & Trauma Surgery;Oct2012, Vol. 132 Issue 10, p1495 

    Purpose: The aim of the study was to report the musculoskeletal function and health-related quality of life (HRQoL) after an unstable trochanteric fracture treated with a cephalomedullary nail. Methods: One hundred and seventeen patients, mean age 84.1 years, were included in a 1-year...

  • Treating intertrochanteric hip fractures: Nails or plates? Leahy, Maureen // AAOS Now;Jan2011, Vol. 5 Issue 1, p18 

    The article focuses on the difference in the outcomes of patients with intertrochanteric hip fractures treated with Intramedullary (IM) nails or plate fixation. It states that patients treated with IM nails were found to have higher risks of having pulmonary embolism (PE) and mortality at 90...

  • AO Tubular External Fixation vs. Unreamed Intramedullary Nailing in Open Grade IIIA-IIIB Tibial Shaft Fractures: A Single-center Randomized Clinical Trial. Mohseni, Mohammad Ali; Soleimanpour, Jafar; Mohammadpour, Hossein; Shahsavari, Abolfazal // Pakistan Journal of Biological Sciences;2011, Vol. 14 Issue 8, p490 

    Although the intramedullary nailing is thought to be the method of choice for treatment of closed tibial shaft, there is ongoing debate on the optimal surgical approach in patients with open types of these fractures. In addition, choosing between the reamed and unreamed intramedullary nailing is...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics