Document Detail


Ligamentotaxis for Barton's and paediatric distal radial fractures.
MedLine Citation:
PMID:  19398789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To establish a consensus regarding immobilisation of the wrist following reduction of Barton's and paediatric distal radial fractures. METHODS: Questionnaires were distributed to orthopaedic surgeons at the European Federation of National Associations of Orthopaedics and Traumatology meeting in Lisbon in 2005. Questions included the surgeon's country of practice, hospital, professional grade, years of experience, sub-specialty, and preferred position of wrist immobilisation after (1) a volar Barton's fracture, (2) a dorsal Barton's fracture, (3) a paediatric Salter-Harris type-II injury to the distal radius with volar displacement, and (4) the same injury but with dorsal displacement. RESULTS: Of 148 questionnaires distributed, 118 were returned. The specialist-to-trainee ratio was 45:73. In volar Barton's fractures, only 20% (29% specialists and 15% trainees) would immobilize the wrist in palmar flexion, as per recommendations. In dorsal Barton's fractures, only 25% (33% specialists and 21% trainees) would immobilize the wrist in dorsiflexion, as per recommendation. In paediatric Salter Harris type-II injury to the distal radius with volar displacement, 87% (100% specialists and 79% trainees) would immobilize the wrist in dorsiflexion or in a neutral position, as per recommendation. In the same injury but with dorsal displacement, 84% (89% specialists and 81% trainees) would immobilize the wrist in palmar flexion or in a neutral position, as per recommendation. In all 4 types of fractures, 26% to 30% of respondents would immobilize the wrist in a neutral position. CONCLUSION: Most respondents deviate from the recommended immobilisation positions in treating Barton's fractures. Understanding of the anatomy or biomechanics of ligamentotaxis are crucial for conservative treatments.
Authors:
P Lakshmanan; M K Sayana; B Purushothaman; J L Sher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic surgery (Hong Kong)     Volume:  17     ISSN:  1022-5536     ISO Abbreviation:  J Orthop Surg (Hong Kong)     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-28     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440382     Medline TA:  J Orthop Surg (Hong Kong)     Country:  China    
Other Details:
Languages:  eng     Pagination:  28-30     Citation Subset:  IM    
Affiliation:
Wansbeck General Hospital, Ashington, United Kingdom. lakunns@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel*
Casts, Surgical*
Europe
Humans
Immobilization*
Ligaments, Articular*
Physician's Practice Patterns
Questionnaires
Radius Fractures / therapy*
Treatment Outcome
Wrist Joint*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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