Classification and management of intra-articular fractures of the distal radius.


:A classification of distal radial articular fractures is described, based on observations of consistent patterns of fracture fragmentation and displacement. The classification categorizes articular fractures into four types, with the medial complex assuming a pivotal position as the cornerstone of both the radiocarpal and distal radioulnar joints. The purpose of this classification is four-fold: (1) to afford identification and an understanding of the displacement characteristics of the major fracture components, (2) to provide practical and rational guidelines for the management of these injuries based on specific fracture patterns, (3) to emphasize the frequency of concurrent soft tissue and other skeletal injuries associated with the more severe types of articular disruption, and (4) to serve as a prognostic gauge for the varied spectrum of distal radius articular injury. Optimal management of distal radius fractures necessitates the differentiation of articular from extra-articular fractures as well as prompt detection of unstable injuries. While the majority of unstable fractures can be successfully managed by closed methods, a substantial and increasing number require open treatment for restoration of articular congruity as well as repair of concomitant soft tissue and skeletal injuries. In all cases, precise reduction of the key medial fragments is essential to maximum recovery.


Hand Clin


Hand clinics


Isani A,Melone CP Jr


Has Abstract


1988-08-01 00:00:00












  • Management of chronic pain following nerve injuries/CRPS type II.

    abstract::Chronic pain affects quality of life and adversely affects functional outcomes. Chronic postoperative pain is a frustrating problem for the surgeon because it ruins a technically perfect procedure, and the surgeon may be unsure of treatment strategies. There is much information on chronic pain and its treatment, but i...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Carroll I,Curtin CM

    更新日期:2013-08-01 00:00:00

  • Treatment of Recurrent Dupuytren Disease.

    abstract::Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Percutaneous and enzymatic techniques are best reserved for patients with well-defin...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Kaplan FTD,Crosby NE

    更新日期:2018-08-01 00:00:00

  • Nonoperative carpal tunnel syndrome treatment.

    abstract::Many factors influence the development of CTS; therefore, nonoperative treatment should not be limited to only one intervention. Nonoperative treatment is most effective in the early stages, prior to irreparable damage to the nerve. Early intervention combined with a comprehensive treatment plan can help improve effec...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Osterman AL,Whitman M,Porta LD

    更新日期:2002-05-01 00:00:00

  • Nerve Transfers in Birth Related Brachial Plexus Injuries: Where Do We Stand?

    abstract::This article reviews the assessment and management of obstetrical brachial plexus palsy. The potential role of distal nerve transfers in the treatment of infants with Erb's palsy is discussed. Current evidence for motor outcomes after traditional reconstruction via interpositional nerve grafting and extraplexal nerve ...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Davidge KM,Clarke HM,Borschel GH

    更新日期:2016-05-01 00:00:00

  • Digital replantations including fingertip and ring avulsion.

    abstract::To reduce ischemic time and yet achieve a high-quality repair, the replantation team should be well organized. The team should be conversant with microvascular techniques and employ efficient methods of tendon repair and bone fixation. Developments in instrumentation and technique in recent years have improved success...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Lim BH,Tan BK,Peng YP

    更新日期:2001-08-01 00:00:00

  • Evaluation and staging of musculoskeletal neoplasia.

    abstract::Musculoskeletal neoplasia are rare and can present in a highly variable fashion. Maintaining an index of suspicion for the presence of neoplasia is important. A standard approach to evaluation with history, physical, and appropriate imaging studies is mandatory. This information then can be synthesized to properly sta...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Parsons TW 3rd,Filzen TW

    更新日期:2004-05-01 00:00:00

  • Pediatric mutilating hand injuries.

    abstract::Mutilating hand injuries in children are a devastating problem. With aggressive efforts at replantation and revascularization, methodic debridement, timely soft tissue coverage, and early mobilization, however, the results in these unfortunate children can be quite rewarding. The child often does well with the functio...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Buncke GM,Buntic RF,Romeo O

    更新日期:2003-02-01 00:00:00

  • Microvascular Toe Joint for Proximal Interphalangeal Joint Replacement: Indications, Technique, and Outcomes.

    abstract::Microvascular toe interphalangeal joint transfer can serve as a means of autogenous digit proximal interphalangeal joint (PIPJ) arthroplasty. Among surgical options for treating dysfunctional, absent, or destroyed PIPJs, free toe joint transfer is the most technically challenging and carries the greatest donor site co...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Katz RD,Higgins JP

    更新日期:2018-05-01 00:00:00

  • Complex injuries of the forearm. Coverage considerations.

    abstract::Complex forearm injuries involve damage to the skin and underlying tissues. The best results are obtained when a multidisciplinary approach is taken to their management. Management of the acute injury should be done in a manner that takes into consideration late reconstructive procedures and best possible final functi...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Bray PW,Boyer MI,Bowen CV

    更新日期:1997-05-01 00:00:00

  • Rehabilitation following motor nerve transfers.

    abstract::Cortical mapping and relearning are key factors in optimizing patient outcome following motor nerve transfers. To maximize function following nerve transfers, the rehabilitation program must include motor reeducation to initiate recruitment of the weak reinnervated muscles and to establish new motor patterns and corti...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Novak CB

    更新日期:2008-11-01 00:00:00

  • Free vascularized nerve transfer in the upper extremity.

    abstract::Free vascularized nerve transfer using microsurgical techniques for upper limb reconstruction should be considered as an alternative to conventional nonvascularized cable nerve grafts when the recipient bed is heavily scarred, as occurs in Volkmann's ischemia, when the nerve gap is exceptionally long, or when the free...

    journal_title:Hand clinics

    pub_type: 杂志文章


    authors: Taylor GI

    更新日期:1999-11-01 00:00:00

  • Flexor tenolysis.

    abstract::Flexor tenolysis is a challenging procedure with valuable clinical usefulness in the restitution and enhancement of digital function in the appropriate patient. In the absence of complications, improvement in digital flexion can be expected. The requisites for success are a skilled surgeon, a motivated and well inform...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Azari KK,Meals RA

    更新日期:2005-05-01 00:00:00

  • Thoracic outlet syndrome.

    abstract::"Thoracic outlet syndrome" is a term ascribed to a complex clinical entity encompassing complicated neurovascular signs, symptoms and pathology of the upper extremity. Controversies exist concerning its causes, diagnosis, and treatment despite years of intense study of hundreds of patients. Although there is no univer...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Oates SD,Daley RA

    更新日期:1996-11-01 00:00:00

  • Skin Coverage Considerations in a Mutilating Hand Injury.

    abstract::The foremost goal of managing a mutilated hand is provision of adequate skin coverage. The most suitable method is free tissue transfer. The specific role of volar surface requires replacement tissue to have similar texture for aesthetically satisfactory and functionally acceptable outcomes. Hand surgeons must approac...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Lee K,Roh S,Lee D,Kim J

    更新日期:2016-11-01 00:00:00

  • Diagnosis and treatment of congenital thumb hypoplasia.

    abstract::The hypoplastic thumb has a variety of presentations, which have been generalized into a formal classification system that has treatment implications. In most cases, the spectrum of hypoplasia has predictable deficits in terms of tendon and bone absence. The ultimate goal is always the same--to enhance usage of the ra...

    journal_title:Hand clinics

    pub_type: 杂志文章


    authors: Plancher KD,Kahlon RS

    更新日期:1998-02-01 00:00:00

  • The management of complications of small joint arthrodesis and arthroplasty.

    abstract::Arthrodesis and arthroplasty are surgical options used for the management of pain, stiffness, deformity, and instability related to arthritis and traumatic injury of the small joints of the hand. Arthrodesis and arthroplasty come with a risk of postoperative infection. Superficial soft tissue infections can often be m...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Satteson ES,Langford MA,Li Z

    更新日期:2015-05-01 00:00:00

  • Management of nerve compression syndrome in musicians.

    abstract::Nerve compression syndromes are common in the general population, and they are also common in musicians. As many as 30% of musicians who have a recognized musculoskeletal disorder are diagnosed with a nerve compression syndrome. Thus, it is important to consider the diagnosis of nerve compression syndromes in all musi...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Amadio PC

    更新日期:2003-05-01 00:00:00

  • Proximal interphalangeal joint dislocations without fractures.

    abstract::Injuries to the proximal interphalangeal joint are extremely common. An understanding of the complex anatomy of this joint is essential for diagnosis and treatment of proximal interphalangeal joint sprains and dislocations. Lateral injuries are among the commonest injuries in the hand. These are often stable after red...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Vicar AJ

    更新日期:1988-02-01 00:00:00

  • Rheumatoid arthritis: silicone metacarpophalangeal joint arthroplasty indications, technique, and outcomes.

    abstract::Silicone implant arthroplasty has been used for more than 40 years for severe rheumatoid disease at the metacarpophalangeal (MCP) joint. Multiple investigations have shown that silicone arthroplasty places the MCP joint in a more extended posture, with some improvement in the total arc of motion. Ulnar drift is also i...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Goldfarb CA,Dovan TT

    更新日期:2006-05-01 00:00:00

  • Psychological evaluation of patients with industrial hand injuries.

    abstract::Psychological evaluations with hand injury patients provide diagnostic information and treatment recommendations that can be included with the findings from physical and neurologic examinations. Assessment of psychosocial factors that can either complicate recovery from injury or aid in rehabilitation is discussed. Fo...

    journal_title:Hand clinics

    pub_type: 杂志文章


    authors: Johnson RK

    更新日期:1986-08-01 00:00:00

  • Hand and wrist injuries in young athletes.

    abstract::Successful treatments of musculoskeletal injuries in the pediatric population demand a thorough understanding of the basic anatomy and its biomechanics, and the physiology of growth and development of the immature skeleton. In addition, good treatment outcomes rely on the treating physician being an effective teacher ...

    journal_title:Hand clinics

    pub_type: 杂志文章


    authors: Le TB,Hentz VR

    更新日期:2000-11-01 00:00:00

  • Malunions of the finger metacarpals and phalanges.

    abstract::Many malunions of the finger metacarpals are mild and do not require or justify operative intervention. Early recreation of the fracture or osteotomy is more likely to be rewarded with favorable results than late operation. Rotational malunions of the metacarpals or proximal phalanges may be treated by transverse extr...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Freeland AE,Lindley SG

    更新日期:2006-08-01 00:00:00

  • Carpometacarpal joint injuries of the fingers.

    abstract::Injuries to the carpometacarpal joints are uncommon and are sometimes overlooked on initial radiographs. Their recognition depends on a careful physical and radiographic examination that may require trispiral tomograms and CT scans. Most injuries can be treated successfully by closed reduction and percutaneous fixatio...

    journal_title:Hand clinics

    pub_type: 杂志文章


    authors: Gurland M

    更新日期:1992-11-01 00:00:00

  • Flap Coverage of Dysvascular Digits Including Venous Flow-Through Flaps.

    abstract::A dysvascular digit is defined as a threatened circulatory condition of a digit caused owing to multiple reasons, such as medical illness or trauma. A dysvascular digit always needs surgical manipulation of the vessel in trauma cases. The revascularization of the digit is a priority in such conditions, after which rec...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Lee DC,Kim JS,Roh SY,Lee KJ,Kim YW

    更新日期:2019-05-01 00:00:00

  • Clinical strategies to enhance nerve regeneration in composite tissue allotransplantation.

    abstract::Reinnervation of a hand transplant ultimately dictates functional recovery but provides a significant regenerative challenge. This article highlights interventions to enhance nerve regeneration through acceleration of axonal regeneration or augmentation of Schwann cell support and discuss their relevance to composite ...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Glaus SW,Johnson PJ,Mackinnon SE

    更新日期:2011-11-01 00:00:00

  • Outcomes analysis in hand surgery patients--get your project started!

    abstract::Once there are answers to the research questions, the results must be used in clinical practice to alter treatment plans, giving patients the most appropriate choices and the highest quality outcomes based on scientific data. Daily clinical practice can be improved by applying the results of outcomes studies to altern...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Arslanian C

    更新日期:2003-08-01 00:00:00

  • Does Anyone Need a Vascularized Graft?

    abstract::Many hand surgeons argue that vascularized bone grafting is indicated in proximal pole avascular necrosis, prior failed surgery, or long-standing scaphoid nonunion. However, the available evidence does not support improved treatment outcomes for vascularized bone grafting rather than traditional nonvascularized techni...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Rancy SK,Schmidle G,Wolfe SW

    更新日期:2019-08-01 00:00:00

  • Long-term evaluation of brachial plexus surgery in obstetrical palsy.

    abstract::The author reviews the long-term results of a large series of obstetrical brachial plexuses. The results of direct repair and secondary tendon transfers are reviewed. ...

    journal_title:Hand clinics

    pub_type: 杂志文章


    authors: Gilbert A

    更新日期:1995-11-01 00:00:00

  • Necrotizing Soft Tissue Infections of the Upper Extremity.

    abstract::Necrotizing soft tissue infections of the upper extremity have varying microbiologies and etiologies. Risk factors for development include diabetes mellitus, intravenous drug use, peripheral arterial disease, smoking, alcohol abuse, and immunocompromised state. Although clinical examination is the mainstay of diagnosi...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Melillo A,Addagatla K,Jarrett NJ

    更新日期:2020-08-01 00:00:00

  • Comparative effectiveness research in hand surgery.

    abstract::Comparative effectiveness research (CER) is a concept initiated by the Institute of Medicine and financially supported by the federal government. The primary objective of CER is to improve decision making in medicine. This research is intended to evaluate the effectiveness, benefits, and harmful effects of alternative...

    journal_title:Hand clinics

    pub_type: 杂志文章,评审


    authors: Johnson SP,Chung KC

    更新日期:2014-08-01 00:00:00