By David J. Slutsky MD FRCS

Famous specialists from all over the world deliver you "cutting-edge" counsel at the remedy of distal radius fractures and carpal accidents. sensible and accomplished, you can find distinctive assurance of the therapy and reasons of ulnar sided wrist discomfort, in addition to the most recent arthroscopic and mini-invasive thoughts for the fixation of either distal radius fractures and scaphoid fractures. The basic layout beneficial properties sensible counsel, pearls, and strength pitfalls to aid optimize results. better of all, intraoperative movies of forty four innovations on hand on DVD and on-line make this a good multimedia advisor for the remedy of those hard fractures.Uses actual situations to demonstrate diagnostic decision-making, nonsurgical and surgical administration and care, and results size for various advanced distal radius fractures, in addition to forty four videos-over hours-of systems all at the DVD and website.Includes the fully-searchable textual content on-line for speedy and straightforward entry to the knowledge you need.Covers distal radius fractures from imaging and type to the recent locking plate designs, rising nonplate possible choices reminiscent of intramedullary and T-pin fixation, and more moderen nonbridging exterior fixators for intra-articular fractures to supply you with the most recent advancements within the field.Presents fabric in a concise, useful layout for a fantastic overview ahead of surgery.Provides a visible exhibit of intraoperative approaches via full-color photos and photographs.Features extra chapters-Role of complicated Imaging in Distal Radius Fractures, Patient-focused Wrist final result device, Biomechanics and Biology of Plate Fixation of Distal Radius Fractures, Micronail, Rehabilitation Following Distal Radius Fractures: a biomechanical/procedure particular method, Use of Thermal Shrinkage - Biology and functions, Arthroscopic Thermal Shrinkage for Scapholunate Ligament accidents, Rehabilitation following Carpal damage, Reconstruction of the Distal Radius side by way of a loose Vascularized Ostechondral Graft-online for much more worth.

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ACKNOWLEDGMENTS The author would like to thank James Chen, MD, for the research and assistance he provided in the preparation of this chapter. REFERENCES 1. Medoff R: Essential radiographic evaluation for distal radius fractures. Hand Clin 2005; 21:279-288. 2. Boyer M, Korcek K, et al: Anatomic tilt x-rays of the distal radius: an ex vivo analysis of surgical fixation. J Hand Surg [Am] 2004; 29:116-122. 3. Pennock A, Phillips C, et al: The effects of forearm rotation on three wrist measurements: radial inclination, radial height and palmar tilt.

20 The position of metal fixation devices, even when artifact is present, also is more accurately evaluated with CT, particularly with MDCT. Malunited distal radius fractures may be complicated by intra-articular incongruity and ulnar-positive variance, findings easily assessed with MDCT. 21 MDCT with three-dimensional surface rendered images is increasingly used not only for appreciation of malunion, but also as a road map for surgery (Fig. W1-2). CT virtual preoperative planning, including virtual osteotomy of the distal radius, prediction of final positioning, and computer-assisted manufac- FIGURE W1-2 Anterior volume-rendered 3D reformatted image from a multidetector CT examination allows improved appreciation of the degree of fracture displacement of the distal radius, allowing the clinician to anticipate surgical findings.

Although radial inclination and volar tilt are well-known parameters used to assess the angulation of the distal fragment in the coronal and sagittal planes, several other landmarks and parameters should be routinely evaluated as part of every injury assessment. On the PA view, the carpal facet horizon can help distinguish whether a fragment on the ulnar border of the radius is actually the volar or dorsal corner. Radial translation of the carpus or excessive widening of the DRUJ can imply instability along the FIGURE 3-21 Radial Shear Fracture.

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