[Translated article] Immobilisation with compression bandage vs. antebraquial splint in distal radius fractures operated by open reduction and locking plate. Randomised clinical trial.

INTRODUCTION: Currently, there is a lack of prospective studies to unify criteria about type and time for postoperative immobilisation in surgical distal radius fractures. The aim of this study is to compare functional and radiological results in two groups of distal radius fractures treated with internal fixation with locking plate, and immobilised with antebrachial splint or compression bandage for 3 weeks. MATERIAL AND METHOD: A randomised clinical trial was carried out with two parallel groups with 3, 6, and 12 weeks of follow-up. Main and secondary functional variables were measured, such as pain on VAS scale, values on PRWE, DASH and MRS scale, range of motion in flexion-extension, complications, etc. In addition, some radiological variables were measured at preoperative period and one week after surgery, such as union time, dorsal displacement, shortening, ulnar variance, etc. RESULTS: A total of 62 patients were evaluated: 27 immobilised with bandage and 35 with splint. Analysis of the results obtained showed significant differences in both groups for almost all radiological variables from pre to postoperative period, and for all functional variables from 3 to 12 weeks after surgery. No significant differences were found between the two groups for any of the radiological and functional variables evaluated (VAS 3-12 weeks: p=.584; PWRE 3-12 weeks: p=.248; flexion range of motion 3-12 weeks: p=.959; extension range of motion: p=.50; union time: p=.89). CONCLUSIONS: We do not find clinical or radiological differences between immobilisation with antebrachial splint or compression bandage for distal radius fractures operated with locking plate. A greater number of patients and follow-up are necessary to extrapolate the results to the general population and to establish criteria for good postoperative management of these fractures.

Immobilization with compression bandage vs antebraquial splint in distal radius fractures operated by open reduction and locking plate. Randomized clinical trial. / Inmovilización con vendaje compresivo vs férula antebraquial en fracturas de radio distal intervenidas mediante reducción abierta y placa bloqueada. Ensayo clínico aleatorizado.

INTRODUCTION: Currently, there is a lack of prospective studies to unify criteria about type and time for postoperative immobilization in surgical distal radius fractures. The aim of this study is to compare functional and radiological results in two groups of distal radius fractures treated with internal fixation with locking plate, and immobilized with antebrachial splint or compression bandage for 3weeks. MATERIAL AND METHOD: A randomized clinical trial was carried out with two parallel groups with 3, 6, and 12weeks of follow-up. Main and secondary functional variables were measured, such as pain on VAS scale, values on PRWE, DASH and MRS scale, range of motion in flexion-extension, complications, etc. In addition, some radiological variables were measured at preoperative period and one week after surgery, such as union time, dorsal displacement, shortening, ulnar variance, etc. RESULTS: A total of 62 patients were evaluated: 27 immobilized with bandage and 35 with splint. Analysis of the results obtained showed significant differences in both groups for almost all radiological variables from pre to postoperative period, and for all functional variables from 3 to 12weeks after surgery. No significant differences were found between the two groups for any of the radiological and functional variables evaluated (VAS 3-12weeks: P=.584; PWRE 3-12weeks: P=.248; flexion range of motion 3-12weeks: P=.959; extension range of motion: P=.50; union time: P=.89). CONCLUSIONS: We do not find clinical or radiological differences between immobilization with antebrachial splint or compression bandage for distal radius fractures operated with locking plate. A greater number of patients and follow-up are necessary to extrapolate the results to the general population and to establish criteria for good postoperative management of these fractures.

La artroplastia invertida de hombro ante defectos óseos glenoideos / Reverse shoulder arthroplasty due to glenoid bone defects

Objetivo. La artroplastia invertida se está convirtiendo en una herramienta útil para afecciones muy variadas en el hombro. Un defecto óseo importante de la glena puede afectar a la fijación del componente glenoideo. El propósito de nuestro estudio es evaluar a medio plazo los resultados de la artroplastia invertida de hombro asociados a una glenoplastia. Material y métodos. Se realizó un estudio retrospectivo de 5 pacientes de nuestro hospital con defectos glenoideos de distinta etiología que fueron tratados mediante artroplastia invertida de hombro asociada a glenoplastia. Resultados. El seguimiento mínimo de estos pacientes fue de un año (con una media de 30,4 meses). Todos los injertos estaban radiológicamente integrados, sin observarse signos de resorción o necrosis. A los 12 meses el test de Constant era de 66,75 de media y el EVA medio era de 1. Discusión. La glenoplastia es una intervención de alta demanda técnica que consigue restaurar el remanente óseo en pacientes con defectos estructurales, permitiendo así implantar una artroplastia invertida. De esa forma podemos mejorar la función y la clínica en pacientes con diversas afecciones glenohumerales, proporcionándoles una solución (AU)

Objective. Reverse shoulder arthroplasty is becoming a useful tool for many diseases of the shoulder. Any severe glenoid bone defect may affect the fixing of the glenoid component. The aim of this paper is to evaluate the medium-term outcomes of reverse shoulder arthroplasty associated with a glenoplasty. Materials and methods. A retrospective study was conducted on 5 patients from our hospital, selected due to glenoid defects of different etiology. All of them where treated with reverse shoulder arthroplasty associated with glenoplasty with bone graft. Results. The minimum follow-up was one year (mean 30.4 months). All grafts were radiologically integrated, with no signs of resorption or necrosis being observed. At 12 months, the Constant score was 66.75 and the mean EVA score was 1. Discussion. Glenoplasty surgery is technically demanding for restoring original bone size in patients with glenoid structural defects, enabling a reverse shoulder arthroplasty to be implanted. Thus improving both the function and clinical outcomes in selected patients with glenohumeral pathology and providing them with a solution (AU)

Reverse shoulder arthroplasty due to glenoid bone defects. / La artroplastia invertida de hombro ante defectos óseos glenoideos.

OBJECTIVE: Reverse shoulder arthroplasty is becoming a useful tool for many diseases of the shoulder. Any severe glenoid bone defect may affect the fixing of the glenoid component. The aim of this paper is to evaluate the medium-term outcomes of reverse shoulder arthroplasty associated with a glenoplasty. MATERIALS AND METHODS: A retrospective study was conducted on 5 patients from our hospital, selected due to glenoid defects of different etiology. All of them where treated with reverse shoulder arthroplasty associated with glenoplasty with bone graft. RESULTS: The minimum follow-up was one year (mean 30.4 months). All grafts were radiologically integrated, with no signs of resorption or necrosis being observed. At 12 months, the Constant score was 66.75 and the mean EVA score was 1. DISCUSSION: Glenoplasty surgery is technically demanding for restoring original bone size in patients with glenoid structural defects, enabling a reverse shoulder arthroplasty to be implanted. Thus improving both the function and clinical outcomes in selected patients with glenohumeral pathology and providing them with a solution.