Fracture Disatl Radius, Parial Denervation
Conditions
Keywords
parital denervation, comminuted distal radius fractures, chronic wrist pain
Brief summary
the aim of Partial Wrist Denervation in Comminuted articular Distal Radius Fractures is to decrease incidence of chronic wrist pain follwing this type of fracture
Detailed description
Distal radius fractures represent the most common fractures in adults showing an overall prevalence of 17.5 % with respect to all fractures. partial wrist denervation is an adjunctive procedure performed during initial fracture fixation to mitigate chronic pain by interrupting sensory innervation to the wrist joint. It targets the anterior interosseous nerve (AIN) and posterior interosseous nerve (PIN), which convey nociceptive signals from the radiocarpal and midcarpal joints. Comminuted intra-articular distal radius fractures (AO/OTA Type C2/C3) often lead to post-traumatic arthritis due to articular incongruity and capsular damage. Denervation at the index procedure may reduce central sensitization and chronic pain by resecting afferent pain fibers, potentially improving postoperative rehabilitation and functional outcomes. Acute comminuted intra-articular distal radius fractures (AO/OTA C2/C3) with high risk of post-traumatic arthritis (e.g., articular step-off \>2 mm, severe fragmentation). * Active individuals seeking motion preservation, those with high functional demands (e.g., athletes, laborers), or patients preferring a less invasive option than salvage procedures. * Adjunct to primary fixation: Performed concurrently with volar locking plate (VLP) or dorsal plating.
Interventions
PROCEDUREPartial Wrist Denervation in Comminuted articular Distal Radius Fractures
Partial Wrist Denervation in Comminuted articular Distal Radius Fractures through sme approach of the surgery
Sponsors
Assiut University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
observational
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Age from 18 * Fracture Pattern: Acute, comminuted intra-articular distal radius fractures (AO/OTA Type C2 or C3). * Surgical Context: Procedure performed as a primary adjunct during initial open reduction and internal fixation (ORIF).
Exclusion criteria
Active local infection over the surgical site. * Compromised soft tissue envelope that precludes safe dissection. * Vascular injury or compromise requiring repair. * Pre-existing neurological deficit (e.g., complex regional pain syndrome, major peripheral nerve injury).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The end results PAIN will be assessed according to mayo clinc wrist score | 2 weeks, 6 weeks, 3 months, 6 months..and 1 year | mayo clinc wrist score its a clincal reported outcome measure designed to assess function and pain of the wrist follwing surgery the score is bassed on 100 points divided into four equally weighted categories the final score places the wrist into outcome category total score 90/100 is excellent while below 65 is poor |
Countries
Egypt
Contacts
STUDY_DIRECTORwalyd ryad saleh, professor of orthopedics
Assiut University
Outcome results
None listed