PMID- 35589086 OWN - NLM STAT- MEDLINE DCOM- 20221101 LR - 20230104 IS - 1877-0568 (Electronic) IS - 1877-0568 (Linking) VI - 108 IP - 7 DP - 2022 Nov TI - Description of unusual osteochondral laminar fragment patterns in Distal Radius fractures. PG - 103321 LID - S1877-0568(22)00148-7 [pii] LID - 10.1016/j.otsr.2022.103321 [doi] AB - BACKGROUND: Distal radius fracture (DRF) is one of the most common fractures and, frequently, surgical treatment is mandatory in the presence of an intra-articular fracture. However, there are some unusual intra-articular fracture patterns, were it remains challenging to properly recognize and anatomically reconstruct the articular surface. The objective of the present study is to describe an intra-articular fracture pattern of the distal radius characterized by the presence of osteochondral laminar fragments, which could potentially require a different treatment to standard stabilization. We aim to answer the following questions: (1) What are the radiological characteristics of intra-articular DRFs with osteochondral laminar fragments (OCLF), (2) What is the prevalence of DRFs with OCLF relative to all intra-articular surgical DRFs, (3) What are the differences in epidemiological characteristics of patients with OCLF in relation to all patients with intra-articular DRFs, (4) What is the prevalence of intra-articular DRFs with OCLF in patients belonging to a closed community. PATIENTS AND METHODS: We reviewed radiological and tomographic records of all adult patients operated on distal radius fractures at our institution. We analyzed tomographic characteristics; prevalence of osteochondral laminar fragments relative to all intra-articular surgical distal radius fractures and compared clinical and demographic characteristics of patients with osteochondral laminar fragments in relation to all patients with intra-articular fractures. RESULTS: Two main groups according to the fracture pattern were described: group I, volar rim impacted OCLF (vOCLF); and group II, central impacted OCLF (cOCLF). Prevalence of OCLF relative to surgical intra-articular DRFs: 42/989 (4.2%); group I: 23/989 (2.32%); group II: 19/989 (1.92%). Characteristics of patients with OCLF compared to all patients with intra-articular DRFs: Significant differences were found in the five variables evaluated (age, less than 65 years, female, high energy fracture, and associated fractures). The global prevalence of DRFs with OCLF in patients affiliated with the medical care insurance system of our institution was 2 per 10,000 individuals (95% CI 1.4 to 2.9). DISCUSSION: Global prevalence of these fragments relative to surgical intra-articular fractures was very low. However, despite being epidemiologically rare, it is important to identify these specific fracture patterns because their treatment can be challenging. LEVEL OF EVIDENCE: IV (Observational/Descriptive); Cross sectional study. CI - Copyright (c) 2022 Elsevier Masson SAS. All rights reserved. FAU - Donndorff, Agustin Guillermo AU - Donndorff AG AD - "Carlos E. Ottolenghi" Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Potosi 4247 C1199ABB, Buenos Aires, Argentina; Hand Surgery and Upper Extremity Center, Carlos E. Ottolenghi Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Cafruni, Virginia Maria AU - Cafruni VM AD - "Carlos E. Ottolenghi" Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Potosi 4247 C1199ABB, Buenos Aires, Argentina. FAU - Bronenberg Victorica, Pedro AU - Bronenberg Victorica P AD - "Carlos E. Ottolenghi" Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Potosi 4247 C1199ABB, Buenos Aires, Argentina. Electronic address: pedro.bronenberg@hospitalitaliano.org.ar. FAU - Gallucci, Gerardo Luis AU - Gallucci GL AD - "Carlos E. Ottolenghi" Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Potosi 4247 C1199ABB, Buenos Aires, Argentina; Hand Surgery and Upper Extremity Center, Carlos E. Ottolenghi Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Boretto, Jorge Guillermo AU - Boretto JG AD - "Carlos E. Ottolenghi" Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Potosi 4247 C1199ABB, Buenos Aires, Argentina; Hand Surgery and Upper Extremity Center, Carlos E. Ottolenghi Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - De Carli, Pablo AU - De Carli P AD - "Carlos E. Ottolenghi" Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Potosi 4247 C1199ABB, Buenos Aires, Argentina; Hand Surgery and Upper Extremity Center, Carlos E. Ottolenghi Institute, Service of Orthopedics and Traumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20220516 PL - France TA - Orthop Traumatol Surg Res JT - Orthopaedics & traumatology, surgery & research : OTSR JID - 101494830 SB - IM MH - Adult MH - Humans MH - Female MH - Aged MH - *Intra-Articular Fractures/diagnostic imaging/surgery MH - *Radius Fractures/diagnostic imaging/surgery MH - Fracture Fixation, Internal/methods MH - Cross-Sectional Studies MH - Wrist Joint MH - Bone Plates OTO - NOTNLM OT - Articular impaction OT - Distal radius fracture OT - Lunate fossa OT - Osteochondral fragments OT - Scaphoid fossa EDAT- 2022/05/20 06:00 MHDA- 2022/11/02 06:00 CRDT- 2022/05/19 20:08 PHST- 2021/03/05 00:00 [received] PHST- 2021/09/15 00:00 [revised] PHST- 2021/10/08 00:00 [accepted] PHST- 2022/05/20 06:00 [pubmed] PHST- 2022/11/02 06:00 [medline] PHST- 2022/05/19 20:08 [entrez] AID - S1877-0568(22)00148-7 [pii] AID - 10.1016/j.otsr.2022.103321 [doi] PST - ppublish SO - Orthop Traumatol Surg Res. 2022 Nov;108(7):103321. doi: 10.1016/j.otsr.2022.103321. Epub 2022 May 16.