title: Treatment strategy for distal radius fractures with ipsilateral arteriovenous shunts.
abstract: OBJECTIVE
  To describe our management of 3 patients with chronic renal failure who sustained distal radius fractures in limbs containing dialysis shunts.
  
  
  METHODS
  The 3 patients were 48-61 years old, and 2 of them were men. Because the injured limbs contained arteriovenous shunts, tourniquets were not used. Volar locking plate fixation was applied via the Henry approach. The patients' grip strength; visual analog scale scores; Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores; modified Mayo scores; and their range of wrist joint motion were assessed during the final follow-up examination. In addition, complications and the presence/absence of dysfunction of the forearm shunt were also investigated.
  
  
  RESULTS
  The mean duration of the postoperative follow-up period was 9 months (range, 7-10 mo), and the subjects' mean wrist motion values were 75°, 79°, 78°, and 87° during flexion, extension, pronation, and supination, respectively. Grip strength on the affected side as a percentage of that seen on the healthy side ranged from 71% to 90%. The patients' visual analog scale; QuickDASH; and modified Mayo scores were all excellent, and bone union was achieved in all 3 cases. No shunt dysfunction or skin soft tissue complications were noted.
  
  
  CONCLUSIONS
  Volar locking plate fixation via the Henry approach might be useful for treating distal radius fractures in cases in which an arteriovenous shunt is present in the same limb. Shunt dysfunction and hemorrhaging are of concern during open surgery, but these were not issues in our patients.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sugiyama
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Shizuoka, Japan. Electronic address: knaito@juntendo.ac.jp.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Naito
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Igeta
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Obata
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Obayashi
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D015331:Cohort Studies; D005260:Female; D005542:Forearm / Q000098:blood supply*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications / Q000601:surgery*; D006435:Renal Dialysis
keywords: Arteriovenous fistula; Henry approach; distal radius fracture; hemodialysis patients