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KMID : 0386419990120041012
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Journal of the Korean Fracture Society
1999 Volume.12 No. 4 p.1012 ~ p.1020
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Treatment of Die - punch Fractures in Unstable Distal Radius Fractures
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Rhee Seung-Koo
Chung Yang-Guk
Lee Hwa Sung
Ryoo Seung-Joon
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Abstract
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Die-punch fracture is a comminuted intra-drticular fracture on the distal radius with depressedarticular fragments caused by impaction of carpal bones, mainly lunate or scaphoid. As in theother intra-articular fractures, the accurate rehtoration of congruent articular surface is necessaryto get good functional results. The purpose of this study is to review the results in a series of 24die-punch fracturef according to the type of fractures dnd the method of treatments. During the 5year period after July, 1993, total 24 die-punch fractures in 22 patients were treated bysurgery(22 cases) or closed method(2 cases) and were followed up for average 29 months. Onthe last follow-up examination, radiographic changes of grade 1 or 2 of post-traumatic arthritiswere seen in twelve wrists and ten of them comptained of pain at wrists. Mean range of motionof wrist joints were 62 of flexion, 64 of extension, 80 of pronation, 77 of supination, 17 ofradial deviation and 27 of ulnar deviation. According to the Demerit point system. total 22 of 24cases(91.7%) showed excellent or good result and there were no poor results. From theseresults, we concluded the die-punch fractures are so unstable comminuted intraarticular fractureon the distal radius with displaced postero-medial fracture fragments on the radiolunate joint,that if we only reduce them anatomically, mostly by open reduction, internal fixation with orwithout bone grafts, then we could obtain good results.
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KEYWORD
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Distal radius, Die-punch fracture
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