EPIDEMIOLOGY, CLASSIFICATION, AND TREATMENT OF BILATERAL FRACTURES OF THE DISTAL RADIUS

To study epidemiology, fracture pattern, associated injuries, and treatment of individuals with bilateral distal radius fracture, in a tertiary hospital.

Methods:

Retrospective cross-sectional study developed based on patients with bilateral distal radius fracture from January 2012 to November 2017. Demographic data, trauma mechanism, radiological patterns, degree of deviation, associated injuries, classification of fractures according to the Association of Osteosynthesis (AO), the Salter-Harris (SH) and Frykman scales, and type of treatment used in each case.

Results:

13 cases were included in the trial, 10 adults and three children. In infants, the mean age was 9.6 years (7-11 years), and low-energy trauma was described in all these cases. In total, 66.6% of the children presented the SHII classification . In adult patients, the mean age observed was 43.5 years (27-56 years), with high-energy trauma reported in four (40%) cases. The AO 23C.3 and 23B.2 classifications were the most prevalent in adults.

Conclusion:

In adult individuals, there was a higher incidence of open fractures, wrist joint involvement, ulna fracture, and concomitant injuries, with high-energy trauma observed only in this group, corresponding to half of the cases. Level of Evidence IV, Case Series.

Keywords:
Radius Fractures; Epidemiology; Wrist Injuries; Clinical Study

#	Age	Sex	Energy of trauma	Deviation of degree		Ulna fracture		Associated injuries	Exposed fracture
#	Age	Sex	Energy of trauma	R	L	R	L	Associated injuries	R	L
1	35	M	Low	38˚	34˚	No	Yes	-	No	No
2	52	M	High	5˚	11˚	No	Yes	-	No	Yes
3	52	F	Low	21˚	20˚	No	No	Traumatic brain injury	No	No
4	11	M	Low	23˚	16˚	Yes	Yes	-	No	No
5	7	M	Low	0˚	36˚	Yes	Yes	-	No	No
6	30	M	High	19˚	9˚	No	No	Tibial fracture	No	No
7	11	M	Low	29˚	34˚	No	Yes	-	No	No
8	56	M	High	39˚	3˚	Yes	No	Pubic symphysis diastasis	Yes	No
9	56	F	High	0˚	21˚	No	Yes	-	Yes	Yes
10	41	M	High	18˚	30˚	No	No	-	No	No
11	55	F	Low	11˚	9˚	Yes	Yes	-	No	No
12	27	M	Low	21˚	23˚	No	No	Scaphoid fracture	No	No
13	31	M	Low	10˚	5˚	No	Yes	traumatic brain injury + mandible fracture	No	No

#	Articular involvement		Posterior comminution		AO/Salter-Harris Classification		Universal Classification		Frykman Classification
#	R	L	R	L	R	L	R	L	R	L
1	Yes	Yes	Yes	Yes	23C3.2	23C3.1	IV-C	IV-B	VII	VIII
2	Yes	Yes	No	No	23B3.1	23C3.1	IV-B	IV-B	III	VIII
3	No	No	Yes	No	23A2.1	23A2.1	II	II	I	I
4	No	No	No	No	SH-II	SH-II	-	-	-	-
5	No	No	No	Yes	Metaphyseal	Metaphyseal	-	-	-	-
6	Yes	Yes	Yes	Yes	23B2.1	23B2.1	IV-B	IV-B	III	III
7	No	No	Yes	Yes	SH-II	SH-II	-	-	-	-
8	Yes	Yes	No	No	23C1.3	23C1.2	IV-B	IV-C	VIII	III
9	Yes	No	No	No	23B1.1	23A2.1	III	II	III	II
10	Yes	Yes	Yes	Yes	23C3.2	23B3.1	IV-C	IV-B	III	IV
11	No	No	Yes	Yes	23A1.2	23A1.2	II	II	II	II
12	Yes	No	Yes	No	23B2.1	23B2.1	IV-B	IV-A	III	III
13	Yes	Yes	No	Yes	23C1.2	23C3.1	IV-A	IV-B	III	IV

#	AO/Salter Harris		Exposed fracture		Fracture treatment
#	R	L	R	L	R	L
1	23C3.2	23C3.1	No	No	Elective surgery	Elective surgery
2	23B3.1	23C3.1	No	Yes	Elective surgery	External fixation + Elective surgery
3	23A2.1	23A2.1	No	No	Closed reduction + cast	Closed reduction + cast
4	SH-II	SH-II	No	No	Elective surgery	Elective surgery
5	Metaphyseal bilateral		No	No	Closed reduction + cast	Closed reduction + cast
6	23B2.1	23b2.1	No	No	Closed reduction + cast	Elective surgery
7	SH-II	SH-II	No	No	Elective surgery	Elective surgery
8	23C1.3	23C1.2	Yes	No	External fixation + Elective surgery	Elective surgery
9	23B1.1	23A2.1	Yes	Yes	External fixation + Elective surgery	External fixation + Elective surgery
10	23C3.2	23B3.1	No	No	Elective surgery	Elective surgery
11	23A1.2	23A1.2	No	No	Closed reduction + cast	Closed reduction + cast
12	23B2.1	23B2.1	No	No	Elective surgery	Closed reduction + cast
13	23C1.2	23C3.1	No	No	Elective surgery	Elective surgery

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

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[1] Correspondence: Jonatas Brito de Alencar Neto. Rua Barão do Rio Branco, 1816, Fortaleza, CE, Brazil, 60025061. jonatasbrito19@hotmail.com