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Article: Comparison of AO type-B and type-C volar shearing fractures of the distal part of the radius

TitleComparison of AO type-B and type-C volar shearing fractures of the distal part of the radius
Authors
Issue Date2009
PublisherJournal of Bone and Joint Surgery. The Journal's web site is located at http://www.jbjs.org
Citation
Journal Of Bone And Joint Surgery - Series A, 2009, v. 91 n. 11, p. 2605-2611 How to Cite?
AbstractBackground: Fractures of the volar articular margin of the distal part of the radius with volar radiocarpal subluxation (volar shearing, or Barton, fractures) can be accompanied by a fracture of the dorsal metaphyseal cortex. We tested the null hypothesis that there is no difference in wrist function or health status after open reduction and plate-and-screw fixation between volar shearing fractures with a dorsal cortical fracture (complete articular, AO Type C) and those without a dorsal cortical fracture (partial articular, AO Type B). Methods: In a multicenter cohort study, fifty-seven patients with a volar marginal shearing fracture of the distal part of the radius and volar radiocarpal subluxation were followed for at least one year following plate-and-screw fixation. Thirtyseven patients who also had a dorsal metaphyseal cortical fracture (Type-C fracture) were compared with twenty patients who had a partial articular (Type-B) fracture. The two cohorts were analyzed for differences in wrist and forearm motion, grip strength, pain, and the Gartland and Werley, Disabilities of the Arm, Shoulder and Hand (DASH), and Short Form-36 (SF-36) scores at six, twelve, and twenty-four months postoperatively. Differences in mean values and their change over time were determined. Results: There were no significant differences between patients with a Type-B fracture and those with a Type-C fracture with respect to motion, grip strength, or the Gartland and Werley or DASH score at any time point. At six months after the surgery, the patients with a Type-B volar shearing fracture reported a mean score for pain in motion of 0.5 point on a 10-point visual analogue scale compared with 2.2 points for patients with a Type-C fracture (difference in means, 1.7 points [95% confidence interval, 0.7 to 2.6 points]; p < 0.001), but no significant difference was seen at twelve or twenty-four months. Conclusions: Volar shearing fractures are usually complete articular, Type-C injuries. Patients with a Type-C volar shearing fracture experience more pain during early recovery, but ultimately their outcome is comparable with that for patients with a Type-B (partial articular) volar shearing fracture. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2009 by The Journal of Bone and Joint Surgery, Incorporated.
Persistent Identifierhttp://hdl.handle.net/10722/178237
ISSN
2015 Impact Factor: 5.163
2015 SCImago Journal Rankings: 2.938
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSouer, JSen_US
dc.contributor.authorRing, Den_US
dc.contributor.authorJupiter, JBen_US
dc.contributor.authorMatschke, Sen_US
dc.contributor.authorAudige, Len_US
dc.contributor.authorMarentHuber, Men_US
dc.contributor.authorHanson, Ben_US
dc.contributor.authorRikli, Den_US
dc.contributor.authorSiebert, HRen_US
dc.contributor.authorCampbell, DAen_US
dc.contributor.authorTeoh, LCen_US
dc.contributor.authorTorretta, Fen_US
dc.contributor.authorLauri, Gen_US
dc.contributor.authorHintringer, Wen_US
dc.contributor.authorDrobetz, Hen_US
dc.contributor.authorPlecko, Men_US
dc.contributor.authorWentzensen, Aen_US
dc.contributor.authorHöntzsch, Den_US
dc.contributor.authorNeugebauer, RHen_US
dc.contributor.authorHaas, NPen_US
dc.contributor.authorRehm, KEen_US
dc.contributor.authorWinker, KHen_US
dc.contributor.authorErtel, Wen_US
dc.contributor.authorSommer, Chren_US
dc.contributor.authorWagner, Men_US
dc.contributor.authorChow, SPen_US
dc.date.accessioned2012-12-19T09:43:38Z-
dc.date.available2012-12-19T09:43:38Z-
dc.date.issued2009en_US
dc.identifier.citationJournal Of Bone And Joint Surgery - Series A, 2009, v. 91 n. 11, p. 2605-2611en_US
dc.identifier.issn0021-9355en_US
dc.identifier.urihttp://hdl.handle.net/10722/178237-
dc.description.abstractBackground: Fractures of the volar articular margin of the distal part of the radius with volar radiocarpal subluxation (volar shearing, or Barton, fractures) can be accompanied by a fracture of the dorsal metaphyseal cortex. We tested the null hypothesis that there is no difference in wrist function or health status after open reduction and plate-and-screw fixation between volar shearing fractures with a dorsal cortical fracture (complete articular, AO Type C) and those without a dorsal cortical fracture (partial articular, AO Type B). Methods: In a multicenter cohort study, fifty-seven patients with a volar marginal shearing fracture of the distal part of the radius and volar radiocarpal subluxation were followed for at least one year following plate-and-screw fixation. Thirtyseven patients who also had a dorsal metaphyseal cortical fracture (Type-C fracture) were compared with twenty patients who had a partial articular (Type-B) fracture. The two cohorts were analyzed for differences in wrist and forearm motion, grip strength, pain, and the Gartland and Werley, Disabilities of the Arm, Shoulder and Hand (DASH), and Short Form-36 (SF-36) scores at six, twelve, and twenty-four months postoperatively. Differences in mean values and their change over time were determined. Results: There were no significant differences between patients with a Type-B fracture and those with a Type-C fracture with respect to motion, grip strength, or the Gartland and Werley or DASH score at any time point. At six months after the surgery, the patients with a Type-B volar shearing fracture reported a mean score for pain in motion of 0.5 point on a 10-point visual analogue scale compared with 2.2 points for patients with a Type-C fracture (difference in means, 1.7 points [95% confidence interval, 0.7 to 2.6 points]; p < 0.001), but no significant difference was seen at twelve or twenty-four months. Conclusions: Volar shearing fractures are usually complete articular, Type-C injuries. Patients with a Type-C volar shearing fracture experience more pain during early recovery, but ultimately their outcome is comparable with that for patients with a Type-B (partial articular) volar shearing fracture. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2009 by The Journal of Bone and Joint Surgery, Incorporated.en_US
dc.languageengen_US
dc.publisherJournal of Bone and Joint Surgery. The Journal's web site is located at http://www.jbjs.orgen_US
dc.relation.ispartofJournal of Bone and Joint Surgery - Series Aen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBone Platesen_US
dc.subject.meshBone Screwsen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOrthopedic Proceduresen_US
dc.subject.meshRadius Fractures - Classification - Surgeryen_US
dc.subject.meshRecovery Of Functionen_US
dc.subject.meshWrist Injuries - Classification - Surgeryen_US
dc.subject.meshYoung Adulten_US
dc.titleComparison of AO type-B and type-C volar shearing fractures of the distal part of the radiusen_US
dc.typeArticleen_US
dc.identifier.emailChow, SP: spchow@hku.hken_US
dc.identifier.authorityChow, SP=rp00064en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.2106/JBJS.H.01479en_US
dc.identifier.pmid19884434-
dc.identifier.scopuseid_2-s2.0-70449762939en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-70449762939&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume91en_US
dc.identifier.issue11en_US
dc.identifier.spage2605en_US
dc.identifier.epage2611en_US
dc.identifier.isiWOS:000271671800011-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridSouer, JS=15760637000en_US
dc.identifier.scopusauthoridRing, D=7102468527en_US
dc.identifier.scopusauthoridJupiter, JB=7101870548en_US
dc.identifier.scopusauthoridMatschke, S=36137423200en_US
dc.identifier.scopusauthoridAudige, L=7006531178en_US
dc.identifier.scopusauthoridMarentHuber, M=26021947200en_US
dc.identifier.scopusauthoridHanson, B=7102036346en_US
dc.identifier.scopusauthoridRikli, D=7004266801en_US
dc.identifier.scopusauthoridSiebert, HR=24788677800en_US
dc.identifier.scopusauthoridCampbell, DA=7404497549en_US
dc.identifier.scopusauthoridTeoh, LC=7007040259en_US
dc.identifier.scopusauthoridTorretta, F=6601985857en_US
dc.identifier.scopusauthoridLauri, G=26024737800en_US
dc.identifier.scopusauthoridHintringer, W=6603464140en_US
dc.identifier.scopusauthoridDrobetz, H=6507652341en_US
dc.identifier.scopusauthoridPlecko, M=16639526900en_US
dc.identifier.scopusauthoridWentzensen, A=7005505052en_US
dc.identifier.scopusauthoridHöntzsch, D=7003380086en_US
dc.identifier.scopusauthoridNeugebauer, RH=7006253802en_US
dc.identifier.scopusauthoridHaas, NP=7103216817en_US
dc.identifier.scopusauthoridRehm, KE=7101963879en_US
dc.identifier.scopusauthoridWinker, KH=7003768969en_US
dc.identifier.scopusauthoridErtel, W=7005083070en_US
dc.identifier.scopusauthoridSommer, Chr=7103256495en_US
dc.identifier.scopusauthoridWagner, M=7404050259en_US
dc.identifier.scopusauthoridChow, SP=7201828376en_US

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