Date: Sun, 28 Feb 1999 20:20:08 +0530
Subject: Distal Radius fracture
Dear All,
Seeking advice on management of 1 month old untreated distal radius fracture in non dominant hand of a 64 years old watchman. Pictures and xrays attached.
TIA - Rajat Varma FRCS, Indore, India.
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Date: Mon, 01 Mar 1999 19:04:54 -0500
From: Brent Bamberger
I have had two cases like this.
If there is Pain and the patient can live without motion then , I would do a wrist fusion with resection of the distal Ulna. I would stabilize the distal ulnar resection with an FCU or ECU sling. If he would like to maintain some ROM, then do a distal ulnar resection (with tendon sling). and Pin the Radius, in the best position you can get.
Date: Mon, 1 Mar 1999 21:51:18 +0530
I was planning to excise head of ulna , use it to bone graft the distal radius, maintain position by K wire and plaster for 6 weeks. Is this a reasonable approach in a 64 years old ?
TIA - Rajat Varma FRCS, Indore, India.
Date: Tue, 02 Mar 1999 09:15:16 -0400
I don't think this is the right thing to do. The joint is intact ? Fix it. You can always do the ulnar procedure later on for DRUJ incongruity if it is a problem. Doing the ulna procedure without aligning the distal radius is a little bit of a crap shoot.
Ed Harvey, McGill University Health Center, Montreal Canada
Date: Tue, 02 Mar 1999 13:31:30 -0500
From: Brent Bamberger
I agree that the radial carpal joint needs to be reconstructed. I feel that doing an ulnar procedure , will allow only one surgery and a shorter time of morbidity. The DRUJ is an unsolved problem ,and an arthritic unstable DRUJ is worse.
I agree that fusion should the last resort , however it should be considered