[show abstract][hide abstract] ABSTRACT: Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate.
180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation=10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union.
The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%).
This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention.
Journal of Orthopaedic Surgery and Research 01/2012; 7:4. · 1.01 Impact Factor
[show abstract][hide abstract] ABSTRACT: Caloric vestibular stimulation (CVS) has been demonstrated to transiently modulate a variety of cognitive functions. These effects are associated with the brain activation induced by CVS, involving the temporal-parietal cortex, anterior cingulate cortex and insular cortex, which are thought to form a multimodal vestibular cortical network. The present study investigated the effect of CVS upon tinnitus. Twenty patients undergoing vestibular function tests for symptoms of imbalance and who reported tinnitus were asked to rate their tinnitus using visual analogue measures of pitch and intensity immediately before and after CVS (H(2)O at 44°C) in the ear ipsilateral to the tinnitus. One patient was excluded due to test findings indicative of a central vestibular abnormality. The mean VAS pitch (pre-post) changed from 5.65 to 5.28 (95% confidence interval (-0.87, 0.12), p-value 0.13) and the mean change in intensity changed from 5.21 to 4.43 (95% confidence interval (-1.60, 0.04), p-value 0.06). The findings indicate that there is no consistent influence of CVS upon tinnitus, and we propose that perceived pitch and intensity of tinnitus are independent of the multimodal vestibular network that is activated by CVS.