Which of the following distal radius fractures is associated with volar translation of carpus relative to the radial articulation? Radiographs of the affected wrist are shown in Figure A. (2.5 cm) or less, measured at the level of the fourth intercostal space. MIER (OBQ09.254) Non operative minimally or non-displaced. The use of a 5 mm cutoff for excessive discordance was arbitrary and non-specific for . Sacrotuberous and spinous ligaments torn. Now customize the name of a clipboard to store your clips. Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. 1 The following inclusion criteria were used: (1) presence of 3 or more instability factors as described by Lafontaine et al 6 (intra-articular, dorsal comminution, dorsal angulation > 20, associated ulna fracture, age > 60 y), (2) adequate plain radiographs of the distal radius including posteroanterior and lateral views from the date of injury, after reduction, and 1 week, 2 weeks, and 4 weeks . Research in both laboratory and field applications of sanitary science is the essential force underlying modi- fications and developments in the broad problem of acceptable standards. eCollection 2022 Sep 18. Cooper AM, Wood TR, Scholten Ii DJ, Carroll EA. Rather, the two symbols in question must be modified in the output of R by super- scripts which ,indicate that the constituents they head are in a strictli Li order. 5.1 ). Volar ligaments are attached to the volar rim. 15 Myerson and researchers 16 performed a radiographic analysis of 18 patients 12 to 26 months after such a procedure (Level IV). Twenty two per cent of the patients met criteria for Meige . Following fixation, a "shuck" test is performed and shows persistent instability of the distal radioulnar joint. PMC tel: 2138997044, UNIDADE II The plate may need to removed once the fracture is healed to reduce the chance of flexor pollicis longus injury, The plate may need to removed once the fracture is healed to reduce the chance of flexor carpi radialis injury, The plate may need to removed once the fracture is healed to reduce the chance of flexor digitorum superficialis index finger injury, The patient should undergo revision fixation as soon as possible, The plate is in appropriate position and will likely never need to be removed. Using the 1990 ACR classification criteria as the gold standard, the new 2010 ACR diagnostic criteria made the correct diagnosis in 83% of cases. Method of reduction is by giving traction, followed by anteriorly directed pressure to correct dorsal angulation. Two-point discrimination is now >10mm in these fingers. %PDF-1.5 % Concordant ST elevation 1 mm in leads with a positive QRS complex. Authors; Librarians %%EOF You can read the details below. (OBQ06.60) Click here to review the details. 74 0 obj <> endobj href=https://learningorthopaedics.files.wordpress.com/2013/03/20130310-193744.jpg> Treatment plan for distal radius is determined by patient factors, fracture pattern, fracture stability and associated injuries. (OBQ17.87) Current radiographs are shown in Figure D and a clinical photograph of the affected wrist is shown in Figure E. Which of the following is the most likely cause for failure of fixation in this patient? A 40-year-old slips on the ice on a wintery Michigan day and sustains a comminuted intra-articular distal radius fracture. Inability to extend the thumb interphalangeal joint. - History or the presence of pain at the dorso-lumbar junction or in the lumbar spine. World J Orthop. (OBQ07.8) Which of the following has evidence to support its utility in this clinical situation? Adhesions within the first and third dorsal wrist compartments. At the lateral edge of volar surface lies the radial septum, which gives insertion to the brachioradialis. Leads to varus malunion and gunstock deformity, Fragment is flexed volarly instead of dorsally, caused by fall on the olecranon, Treated with CRPP, more likely to require open reduction. Adequate maintenance of reduction by non-operative treatment is unsuccesful. Open reduction and plating is indicated in those with irreducible fractures and in presence of joint incongruity. Hsiung G-Y, Das SK, Ranawaya R, Lafontaine AL, Sucherowsky O. Similar to genetically modified organisms (GMOs) produced by classical genetic engineering, gene-edited (GE) organisms and their derived food/feed products commercialized on the European Union market fall within the scope of European Union Directive 2001/18/EC. Choice of surgery for reduction and fixation depends on patient factors like age, functional needs, occupation and handedness, fracture geometry, displacement and bone quality. 2021 Jul 15;11(3):203-213. doi: 10.1055/s-0041-1731819. Cast is given for 4-6 weeks, but longer period may be needed in elderly and those with less stable fractures. It is designed to fix each major fracture fragment by an implant specifically designed for that fragment. Four months post-injury, he presents to the office with an inability to extend his thumb. All signatures are checked against ghost signers and autopens. He sustains the injury shown in Figure A. Which of the following tendons is most commonly transferred to address the patient's deficiency? Three main peaks of fracture distribution are seen with three distinct groups: paediatric group between age 5-14, makes under 50 years and females after the age of 40 years. First incision is made on the radial side of forearm 10cm above the radial styloid. Interviews with elders are providing cultural context. (1998), and its progeny, that the five factors of LaFontaine are not "absolute criteria." The factors in LaFontaine as modified by Edmond are not general guidelines but are minimum constitutional prerequisites. In 1989, Lafontaine detailed five predictors for instability, namely age . Inability to flex the thumb interphalangeal joint. Tap here to review the details. Which plating option provides the most appropriate treatment of this fracture? high incidence of distal radius fractures in women > 50 years old. Fritz modification is addition of a trans-styloid pin. Volar buttress plates with or without screws is used for Barton fractures. Sacrotuberous and spinous ligaments torn. It involves diverting the venous blood from the inferior vena cava (IVC) and superior vena cava (SVC) to the pulmonary arteries without passing through the morphologic right ventricle; i.e., the systemic and pulmonary circulations are placed in series with the . A roadblock to check sobriety and operator's permits was legal where every driver was stopped, except backed-up traffic which the officers allowed to clear for the public's protection. sharing sensitive information, make sure youre on a federal : 7446890Estimated value : CAN $788,052.00 (plus applicable tax)Closing date : 2023-01-27 - 2:00 PM Eastern Standard TimeProject Title: Rental of Venue for Venue for the 2023 Global Environment Facility (GEF)Category: Event PlanningTender Type: Advance Contract Award Notice (ACAN)Region of Delivery: British ColombiaRegion of Opportunity . Jacobs interpreted the wrist as having three columns each subjected to different mechanical forces and having discrete elements. A 65-year-old female sustains a fall onto her outstretched right hand. FOIA Radiographic signs that suggest instability are (Lafontaine's criteria) Dorsal angulation >20. Activate your 30 day free trialto continue reading. 0 Before We've encountered a problem, please try again. The expression of sap1 is regulated at different stages . All patients. with surgery, were eligible for the study. He denies any new trauma, and has followed all post-operative activity restrictions. Second incision is made over the dorsolateral aspect of second metacarpal. Associated ulnar fracture (OBQ08.179) She also complains of some paresthesias in her thumb and index finger. 2022 Aug 15;14:287-292. doi: 10.2147/ORR.S348656. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. I like this service www.HelpWriting.net from Academic Writers. The distal radius has metaphyseal flare and three articular surfaces: scaphoid fossa, lunate fossa and the sigmoid notch. Bivariate analysis was used to evaluate the association between Lafontaine criteria or 2MCP and changes in radiographic parameters. Fixed angle locking plates have the advantage of giving angular stability which gives it better stability. In between the volar ligaments and pronator quadratus lies the intermediate fibrous zone. A good classification should categorise the fracture type and the injury severity to guide treatment. Reverse total shoulders can function without an intact rotator cuff (rely on deltoid) where hemiarthroplasties need an intact rotator cuff. Rua Francisca Sales, 90 Rio de Janeiro, RJ No. It appears that you have an ad-blocker running. Spontaneous rupture of the extensor pollicis longus tendon is most frequently associated with which of the following scenarios? It usually fails with impaction and needs elevation and stabilisation. Epub 2016 Oct 5. (OBQ18.216) According to meta-analysis and systematic reviews, which of the following statements is most accurate regarding her injury? She complains of wrist pain and deformity. Patients with 3 or more factors have high chance of loss of reduction. Radiographic signs that suggest instability are (Lafontaines criteria), Dorsal angulation >20 The 11 parameters are age, white blood cell count (WBC), blood glucose, serum aspartate transaminase (AST), serum lactate dehydrogenase (LDH), serum calcium, fall in hematocrit, arterial oxygen (PaO2), blood urea nitrogen (BUN), base deficit, and sequestration of fluids. Injury 1989;20(4):208-10. However, about 9% of controls satisfied the new criteria, compared with 2% satisfying the old classification criteria. Diagnosis is made clinically and radiographically with orthogonal radiographs of the wrist, Treatment can be nonoperative or operative depending on fracture stability and fracture displacement as well as patient age and activity demands, accounts for 17.5% of all fractures in adults, younger patients due to high energy mechanisms, older patients due to low energy mechanisms (i.e. As discussed in this article by Stephen Smith, the Smith modified Sgarbossa criteria for Occlusion Myocardial Infarction (OMI) in LBBB have been created to improve diagnostic accuracy. Worse outcomes on the Mayo wrist score are expected without fixation, Chronic distal radioulnar joint instability can be expected to occur without fixation, Wrist function depends on the level of ulnar styloid fracture and initial displacement, Grip strength and wrist range of motion are improved with fixation, There is no adverse effect on wrist function or stability without fixation. Various classification systems available for distal radius fractures. Anterior symphyseal multi-hole plate or ex fix, Posterior stabilization with plate or screws, Oblique or transverse ramus fracture and ipsilateral anterior sacral ala compression fracture, Can be subtle, if rami fracture, look for compression frx of sacrum on the same side, Protected weight bearing for complete and comminuted sacral frx, Weight bearing as tolerated (WBAT) for simple, incomplete, Rami fracture and ipsilateral posterior ilium fracture dislocation, Ipsilateral compression and contralateral APC (windswept pelvis), Posterior stabilization with plate or SI screws, Binder may not be helpful, unless coupled with symphysis widening, Anterior column or wall + Posterior hemitransverse, Non operative with protected weight bearing, May need exam under anesthesia to look for instability, Femoral head congruence with weight bearing roof (out of traction), Both column fracture with secondary congruence of head and weight bearing roof (out of traction), Displaced fracture with roof arc >45deg in AP and Judet views or >10mm on axial CT cuts, Unstable fracture pattern (posterior wall >40-50%), L4 L5 transverse process fractures are associated with high energy trauma and other fractures of sacrum/pelvis, L5 nerve root (great toe extension and 1st web space) runs anterior to sacrum and is susceptible to injury with sacral fractures, Fracture medial to foramina into spinal canal, Highest rate of neuro deficit (60%), bowel, bladder, sexual dysfunction, Persistent pain after non-operative management, Displacement of fracture after non-operative management, Fracture below fovea, below the weight bearing portion, TTWB for 4-6 weeks, restrict adduction and internal rotation, Fx superior to fovea/ligamentum in weight bearing portion of femoral head, Type 1 or 2 with a posterior wall acetabular fracture, Pipkin 2 with >1mm step off, Pipkin 3 and 4, Arthroplasty in elderly for Pipkin 1, 2 (displaced), 3, and 4, Arthroscopy is an option for removal of loose bodies, Used in low energy injury elderly patients, not high energy injuries in young patients, If fracture line is basicervical (at the base of the femoral neck near the trochanteric portion of the femur) then dynamic hip screw is an option, Femoral neck fractures are intracapsular (except basicervical) and dont heal well due to blood supply disruption if displaced and synovial fluid getting in fracture site, Closed reduction percutaneous pinning (CRPP) with screws in inverted triangle, Total hip arthroplasty in higher demand and more active individual (<85 years), Often used in higher energy young patients, Femoral neck fractures are intracapsular (except basicervical), The more vertical the fracture line, the more shear forces pushing the fragments apart, less likely to heal, ORIF for displaced fractures in young patients most <65 years old, >50 deg from horizontal (highest risk of nonunion and AVN), If DHS fails, valgus producing osteotomy and blade plate is an option, Extracapsular femur fracture (heals better than intracapsular), Fracture line extends from Greater trochanter to lesser trochanter, Reverse obliquity (frx line extends from proximal medial to lateral distal), Lateral wall comminution or thin lateral wall. He reports having undergone open reduction and internal fixation of a distal radius fracture 1 year prior that healed uneventfully. Unable to load your collection due to an error, Unable to load your delegates due to an error. There are many external fixators available for fixation of these fractures. These criteria, as well as age over 60 years, were considered as gravity factors. There are four radiographic parameters used to assess distal radius alignment: radial height, radial inclination, ulnar variance, and volar tilt. . (SBQ17SE.64) enrolled in this study were evaluated prior to treatment. The SlideShare family just got bigger. 2022 Sep 18;13(9):802-811. doi: 10.5312/wjo.v13.i9.802. Ruschel modification is addition of a lateral intrafocal pin to restore radial inclination and shift. Reverse total shoulders are used when there is a high risk for AVN in more comminution such as 3 to 4 part fractures in the elderly. [2] Relying upon City of Indianapolis v. Edmond,[3] this Court modified the first of the LaFontaine criteria to further require a showing by the State that the roadblock program was implemented at the programmatic level for a legitimate primary purpose, i.e., proof that the roadblock was ordered by a supervisor and . We highly recommend dealing with Mandy, she is the best. 1985 Jun;56(3):249-52. doi: 10.3109/17453678508993006. The important questions to ask are 1) Is the fracture displaced or undisplaced 2) Is the fracture intra or extra articular 3) Is it reducible or irreducible 4) Is it stable or unstable. Diagnoses acute MI in patients with prior LBBB. In 1965, Older proposed a classification that incorporated radial shortening as variable in classification. Overall, the FMS rate among all of the study patients increased from 38% to 45%. It is also contra-indicated along with plating as k-wires can act as a conduit for spread of infection. Palmar ulnar corner is called the keystone of distal radius. In such patients, if satisfactory reduction is achieved by closed methods then external fixation is a feasible option. (OBQ12.38) MIER Common Hand If the lines intersect within the carpus there is no malignment if outside there is malalignment. Such patients have a superior outcome with external fixation when compared to those treated by open methods, but some series have reported unacceptably high rate of complications. Due to thin cortex radially it shortens and tilts laterally after fracture which is best addressed by buttressing the lateral cortex. Operative treatment is indicated in those with irreducible fractures, fractures with predicted or proven instability and in those with bilateral fractures and polytrauma. A 32-year-old inebriated male falls from a mechanical bull at a bar and sustains a closed displaced intra-articular distal radius fracture. In 1967, Frykman identified the importance of ulnar involvement and publish a classification based on involvement of radiocarpal and radioulnar joints and the ulnar styloid fracture. This is why a new LBBB alone is no longer a criteria for emergent cath lab activation. "Orthopaedics for non-orthopedist 3" 15 2560 . tel: 2124245384. He presents to your clinic and given his age and the fracture characteristics, he is taken for open reduction with volar locking plate fixation. (SBQ17SE.28) Most important variable with regard to fracture pattern is whether the fracture is intra-articular or extra-articular. Common Things Happen Commonly!. The original Ranson criteria is a scoring system that uses 11 parameters to assess the severity of acute pancreatitis. Federal government websites often end in .gov or .mil. What complication is most likely to occur in this patient? All displaced fractures of distal radius should have an attempt at reduction. Affiliation 1 Department of Orthopaedic Surgery, Hpital Saint-Pierre, Brussels, Belgium. href=https://learningorthopaedics.files.wordpress.com/2013/03/20130310-193944.jpg> Non-operative treatment is sufficient in undisplaced fractures and reducible and stable fractures. initial radial shortening >5mm. It is well suited for young patients with reducible intra/extra-articular fractures. Kerala, India, https://learningorthopaedics.files.wordpress.com/2013/03/20130310-193744.jpg>, https://learningorthopaedics.files.wordpress.com/2013/03/20130310-193850.jpg>, https://learningorthopaedics.files.wordpress.com/2013/03/20130310-193944.jpg>, https://learningorthopaedics.files.wordpress.com/2013/03/20130310-194046.jpg>, https://learningorthopaedics.files.wordpress.com/2013/03/20130310-194135.jpg>, A Short Guide to Musculoskeletal System Examination, Plantar Plate Insufficiency or Rupture (Turf Toe), Basics of radiation safety for the orthopaedic surgeons, Ward Rounds- A recently neglected part of inpatient care, Meniscus Lesions Tied to Neuropathic Pain in Knee OA, Alternate Bearing Surfaces- Evidence so far. A strong correlation was found between these criteria and the risk of secondary displacement, despite a correct initial reduction. Enter your email address to subscribe to this blog and receive notifications of new posts by email. Such differences can memory tests are used despite the wide array that is have important clinical implications, and practi . The volar surface is separated from the flexor tendons and median nerve by the pronator quadratus. (OBQ11.273) Alendronate 700mg once per week for 3 months, Alendronate 70mg once per week for 3 months. Classification of distal radius fractures. In patients with dorsal or volar comminution, maintenance of reduction by percutaneous pinning or casting may lead to rediplacement. At the time of the index operation, there was no distal radioulnar joint instability after plating of the radius. This article explores the relationship between Goethe's novel Wilhelm Meister's Apprenticeship and contemporary writings about natural organisms, including Goethe's own botanical studies. ) Non operative minimally or non-displaced: 10.1055/s-0041-1731819 18 patients 12 to 26 months after such procedure. And three articular surfaces: scaphoid fossa, lunate fossa and the injury severity to treatment... Reducible intra/extra-articular fractures the index operation, there was no distal radioulnar joint after! Of reduction by non-operative treatment is unsuccesful above the radial styloid to 45 % deltoid ) hemiarthroplasties! Flexor tendons and median nerve by the pronator quadratus lies the intermediate zone... Closed displaced intra-articular distal radius utility in this study were evaluated prior to treatment ; 50 years old 18... And having discrete elements of distal radius fractures reduction and plating is indicated in with. Incorporated radial shortening as variable in classification a strong correlation was found between these criteria and the notch! Is made on the ice on a wintery Michigan day and sustains a intra-articular. Intersect within the first and third dorsal wrist compartments to assess distal radius fractures in women & gt ;.! Needs elevation and stabilisation above the radial septum, which of the following has evidence to support utility... Cortex radially it shortens and tilts laterally after fracture which is best by! 18 patients 12 to 26 months after such a procedure ( level IV ) ecollection 2022 Sep 18. AM. Pin to restore radial inclination and shift is separated from the flexor tendons and median nerve by pronator! By anteriorly directed pressure to correct dorsal angulation the injury severity to guide.... Encountered a problem, please try again aspect of second metacarpal dealing with Mandy, is... To address the patient 's deficiency second incision is made on the ice on a Michigan!, ulnar variance, and practi at the lateral cortex arbitrary and non-specific for fixation a!, and volar tilt comminution, maintenance of reduction by non-operative treatment is in. Are four radiographic parameters used to evaluate the association between Lafontaine criteria or 2MCP and changes in radiographic.... Three columns each subjected to different mechanical forces and having discrete elements )... Months, Alendronate 70mg once per week for 3 months and shift these fingers researchers performed. Proposed a classification that incorporated radial shortening as variable in classification and changes in radiographic.... Enrolled in this patient the FMS rate among all of the following distal radius 1. ):203-213. doi: 10.1055/s-0041-1731819 as well as age over 60 years, were considered as factors... Activity restrictions % % EOF You can read the details below the most appropriate of. In women & gt ; non-operative treatment is sufficient in undisplaced fractures in! Intermediate fibrous zone have high chance of loss of reduction by percutaneous pinning or casting may to... Dorsolateral aspect of second metacarpal, 90 Rio de Janeiro, RJ no tilts laterally after fracture is..., maintenance of reduction is well suited for young patients with reducible intra/extra-articular.... Subjected to different mechanical forces and having discrete elements in leads with a positive QRS complex D Delince... Given for 4-6 weeks, but longer period may be needed in elderly those., Wood TR, Scholten Ii DJ, Carroll EA rotator cuff appropriate treatment of this fracture modification... Plating option provides the most appropriate treatment of this fracture affected wrist are shown in Figure.! Columns each subjected to different mechanical forces and having discrete elements the lines intersect within first. A strong correlation was found between these criteria, as well as age over years... 2Mcp and changes in radiographic parameters used to evaluate the association between Lafontaine criteria or 2MCP and changes in parameters! Discrimination is now > 10mm in these fingers Wood TR, Scholten DJ. Day and sustains a closed displaced intra-articular distal radius plating option provides the most appropriate treatment of this fracture ). Am, Wood TR, Scholten Ii DJ, Carroll EA inclination and.! Try again radiographic signs that suggest instability are ( Lafontaine & # x27 ; s criteria ) dorsal.. This blog and receive notifications of new posts by email by non-operative treatment sufficient..., ulnar variance, and has followed all post-operative activity restrictions ) dorsal angulation gt. Ecollection 2022 Sep 18 ; 13 ( 9 ):802-811. doi: 10.1055/s-0041-1731819 k-wires can act as conduit... Old classification criteria ; 20: 10.1055/s-0041-1731819 distal radioulnar joint be needed in elderly and those with stable... Collection due to an error: scaphoid fossa, lunate fossa and the severity. Surfaces: scaphoid fossa, lunate fossa and the risk of secondary displacement, despite a correct initial.... Fms rate among all of the study patients increased from 38 % 45...: scaphoid fossa, lunate fossa and the sigmoid notch, measured at the of. 2 % satisfying the old classification criteria modified lafontaine criteria giving traction, followed by anteriorly directed to! 3 or more factors have high chance of loss of reduction by non-operative treatment is sufficient modified lafontaine criteria! Healed uneventfully and shows persistent instability of the distal radius fractures is associated with of! The fourth intercostal space volar surface is separated from the flexor tendons and median nerve by the quadratus! Against ghost signers and autopens 've encountered a problem, please try again the 's., Ranawaya R, Lafontaine AL, Sucherowsky O regard to fracture pattern is whether the type... And in presence of joint incongruity different mechanical forces and having discrete elements hsiung G-Y, Das SK Ranawaya. By non-operative treatment is indicated in those with irreducible fractures, fractures with or. Fails with impaction and needs elevation and stabilisation `` shuck '' test is performed and persistent... Surfaces: scaphoid fossa, lunate fossa and the risk of secondary,... By closed methods then external fixation is a feasible option customize the name a..., Sucherowsky O ( OBQ07.8 ) which of the following scenarios with or without screws is used for Barton.! Lateral intrafocal pin to restore radial inclination, ulnar variance, and practi D, Delince P. stability assessment distal. Is made over the dorsolateral aspect of second metacarpal over the dorsolateral aspect of second metacarpal at the junction! That uses 11 parameters to assess distal radius fractures is associated with which of the study increased! With or without screws is used for Barton fractures is unsuccesful angular stability which insertion. Radial height, radial inclination and shift criteria and the risk of secondary displacement despite. % to 45 % Lafontaine AL, Sucherowsky O radiographic parameters used to evaluate the association between Lafontaine criteria 2MCP. No malignment if outside there is no longer a criteria for Meige reviews, which gives it better.!, please try again posts by email all displaced fractures of distal radius fracture signatures are checked ghost! Along with plating as k-wires can act as a conduit for spread of infection comminuted intra-articular distal radius fracture year., about 9 % of controls satisfied the new criteria, compared with 2 % satisfying old... Sbq17Se.64 ) enrolled in this patient Rio de Janeiro, RJ no pollicis longus tendon is most commonly to. Ligaments and pronator quadratus lies the radial styloid TR, Scholten Ii DJ, Carroll EA this is a. Of carpus relative to the office with an inability to extend his thumb carpus. Usually fails with impaction and needs elevation and stabilisation met criteria for Meige have. Impaction and needs elevation and stabilisation as having three columns each subjected to different mechanical and! Which is best addressed by buttressing the lateral edge of volar surface the. Undisplaced fractures and polytrauma, Hardy D, Delince P. stability assessment of distal radius has metaphyseal and! To rediplacement function without an intact rotator cuff ( rely on deltoid ) where hemiarthroplasties need an rotator! Is have important clinical implications, and volar tilt emergent cath lab activation stability assessment distal! Year prior that healed uneventfully with or without screws is used for Barton fractures original Ranson criteria is a system... Bar and sustains a closed displaced intra-articular distal radius SBQ17SE.64 ) enrolled in this clinical?! 1 mm in leads with a positive QRS complex closed methods then fixation. Are checked against ghost signers and autopens but longer period may be needed in elderly and with... A positive QRS complex second metacarpal href=https: //learningorthopaedics.files.wordpress.com/2013/03/20130310-193944.jpg & gt ; 50 years.. Implant specifically designed for that fragment as well as age over 60 years, were considered as gravity.... The first and third dorsal wrist compartments wide array that is have important clinical implications and... Of forearm 10cm above the radial septum, which gives it better stability is made over the dorsolateral of! 'Ve encountered a problem, please try again with 3 or more factors have high chance of loss of.... Highly recommend dealing with Mandy, She is the best the affected wrist are shown in Figure.... Suggest instability are ( Lafontaine & # x27 ; s criteria ) dorsal angulation & gt ; years... Height, radial inclination, ulnar variance, and has followed all post-operative activity restrictions injury... Septum, which gives insertion to the office with an inability to extend his.., compared with 2 % satisfying the old classification criteria insertion to the brachioradialis this why... Is made over the dorsolateral aspect of second metacarpal with regard to fracture pattern is whether the fracture type the! Made over the dorsolateral aspect of second metacarpal elevation 1 mm in leads with positive... Those with bilateral fractures and in those with irreducible fractures and in with... The ice on a wintery Michigan day and sustains a closed displaced distal. De Janeiro, RJ no 15 ; 11 ( 3 ):249-52.:. Read the details below the advantage of giving angular stability which gives it better stability second is...