Long-term follow-up of distal radius fractures, an evaluation of the current guideline: the relation between malunion, osteoarthritis and functional outcome

2020 ◽  
Vol 30 (8) ◽  
pp. 1357-1362
Author(s):  
D. Visser ◽  
N. M. C. Mathijssen ◽  
M. V. van Outeren ◽  
J. W. Colaris ◽  
M. R. de Vries ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Current Guideline ◽  
Radius Fractures ◽  
Long Term Follow Up

scholarly journals The importance of radiological results in distal radius fracture operations: Functional outcome after long-term (6.5 years) follow-up

2018 ◽  
Vol 6 ◽  
pp. 205031211877657 ◽  
Author(s):  
L Raudasoja ◽  
H Vastamäki ◽  
T Raatikainen
Keyword(s):  
Retrospective Study ◽  
Functional Outcome ◽  
Distal Radius ◽  
Statistical Correlation ◽  
Joint Surface ◽  
Radius Fractures ◽  
Radiological Results ◽  
Hand Evaluation

Background and Aims: Whether or not radiological results correlate with functional outcome after operative treatment of distal radius fractures still remains controversial. We carried out a retrospective study to analyse the long-term (6.5 year) outcome of radius fractures treated by means of surgery in our hospital. The aim of the study was to explore whether step-off on radius joint surface, shortening of the radius versus ulnar height and dorsal or volar tilt of the radius correlate with long-term Patient-Rated Wrist Evaluation or Quick Disability of the Arm, Shoulder and Hand scores among 100 consecutive patients after surgical treatment. Materials and Methods: Of these, 60 patients (63 wrists) participated. They were examined radiologically, clinically and by means of a questionnaire. Results: Shortening of the radius correlated significantly with both Patient-Rated Wrist Evaluation and Quick Disability of the Arm, Shoulder and Hand scores. Step-off on the radius joint surface correlated significantly with worse PRWE scores, with no difference in Quick Disability of the Arm, Shoulder and Hand evaluation. Dorsal or volar tilt showed no statistical correlation (though it was mild in this group). The age of the patients (below 60 years vs 60 years or above) did not affect the PRWE or Quick Disability of the Arm, Shoulder and Hand results. Conclusion: Our results indicate that when it comes to conserving the radial height and congruence of the joint surface, the more precise the reduction of the fracture achieved by surgical means, the better the functional outcome.

scholarly journals 333 Management of Distal Radius Fractures During The COVID-19 Crisis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J East ◽  
M Tahir ◽  
D Bose ◽  
H Quraishi
Keyword(s):  
Distal Radius ◽  
Primary Outcome Measure ◽  
Fracture Pattern ◽  
Distal Radius Fractures ◽  
Unstable Fracture ◽  
Radius Fractures ◽  
Before And After ◽  
Long Term Follow Up ◽  
Controversial Topic

Abstract Introduction Distal radius fractures are common. Treatment depends on a multitude of factors including the pattern / displacement of the fracture, patient age, pre-morbid function, and surgeon preference. We aim to investigate the effect of the pandemic on the management and short-term outcomes of patients with DRF’s. Method Retrospective review of all adult DRF’s two months before and after BOA released emergency standards on trauma management. The primary outcome measure was the proportion of patients managed non-operatively before and during COVID-19. Data extracted: demographics, comorbidities, cognitive baseline, treatment, and follow-up. Radiographs were reviewed for displacement [dorsal tilt (>10o), ulnar variance (>3mm), intra-articular step (>2mm)]. Results Pre-COVID (n = 29), COVID (n = 35). Characteristics were comparable in terms of median age (66 and 72 years, p = 0.41), %aged ≤65 (48% and 37%, p = 0.37), dominant side fracture (36% and 40%, p = 0.52), presence ≥ 2 co-morbidities (41% and 43%, p = 0.91). More patients were managed non-operatively during COVID (86% vs. 69%, p = 0.11), 2 of whom had unstable fracture pattern and developed malunion, compared to none in pre-COVID period. Conclusions Management of DRF’s remains a controversial topic, particularly in age <65 years. Long term follow up of patients with significant fracture displacement managed conservatively during COVID pandemic could help guide future practice.

Comparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures

2019 ◽  
Vol 46 (3) ◽  
pp. 591-598 ◽  
Author(s):  
Paphon Sa-ngasoongsong ◽  
Manuela Rohner-Spengler ◽  
Dimitri E. Delagrammaticas ◽  
Reto Hansjörg Babst ◽  
Frank J. P. Beeres
Keyword(s):  
Fracture Healing ◽  
Functional Outcome ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Patient Reported

scholarly journals Radiographs late in the follow up of uncomplicated distal radius fractures: are they worth it? Clinical outcome and financial implications

2012 ◽  
Vol 4 (2) ◽  
pp. 20 ◽  
Author(s):  
Nicholas Eastley ◽  
Randeep Aujla ◽  
Zeeshan Khan
Keyword(s):  
Grip Strength ◽  
Distal Radius ◽  
Financial Regulation ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Wrist Movement ◽  
Delayed Imaging ◽  
Secondary Osteoarthritis

Fractures of the distal radius are common. Displacement can quickly lead to secondary osteoarthritis. Early follow up radiographs are subsequently paramount to facilitate for early attempts at reduction. Developing callus eventually makes this impractical. In the absence of complications we propose that radiographs may become obsolete at the later stages of follow up. We investigate whether clinical deformity, range of wrist movement and grip strength are independent of radiographs taken later than 2 weeks into the follow up of uncomplicated cases. Local cases between May 2009 and December 2011 were reviewed. Devised criteria regulated case selection. Data was collected from radiological software and occupational therapy clinical notes. Fractures were placed in short or term follow up groups dependant on whether they were imaged later than 2 weeks into follow up. T-tests compared our outcomes measures between these groups. 138 cases were included; 77 short term; 61 long term. No cases reported visible clinical deformity. There were no significant differences between grip strength or range of wrist movement for the short and long term groups. No cases required intervention for late displacement. Although complications may justify delayed imaging, our results suggest radiographs late in the follow up of uncomplicated distal radius fractures have no impact on our outcome measures. Further studies are required to confirm this. Financial regulation means any potential benefits from the removal of these unnecessary radiographs should be recognised. Established radiological follow up regimes need to be devised.

Distal Radius Fracture Treatment Outcomes in Patients With Ipsilateral Hemiplegia or Hemiparesis

Hand ◽  
2021 ◽  
pp. 155894472199973
Author(s):  
Nicholas Munaretto ◽  
Adam Tagliero ◽  
Raahil Patel ◽  
Peter C. Rhee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Functional Classification ◽  
Radius Fractures ◽  
Radiographic Outcomes ◽  
Ipsilateral Hemiparesis

Background Little information exists to guide decision-making with regard to distal radius fractures in the setting of ipsilateral hemiparesis or hemiplegia. Methods Patients who sustained a distal radius fracture in the setting of ipsilateral hemiparesis or hemiplegia secondary to brain injury were evaluated. Investigated variables included perioperative pain, preinjury House functional classification score, length of immobilization, radiographic outcome measurements, and time to union. Results There were 15 patients with distal radius fractures with a mean age of 65.9 years. The mean clinical and radiographic follow-up was 2.8 and 2.9 years, respectively. Wrists were placed into the nonoperative group (NOG, n = 10) and operative group (OG, n = 5). Pain significantly decreased at final follow-up for both groups. Baseline House functional classification scores averaged 1.3 and 1.6 for the NOG and OG, respectively, and were maintained at final follow-up. Length of immobilization for the NOG was 46 days and OG was 37 days, P = .15. Radiographic outcomes at final follow-up in the NOG and OG, respectively, were a mean radial height of 9.3 versus. 11.6 mm, radial inclination of 18.3° versus 22.3°, 4.2° dorsal tilt versus 5.3° volar tilt, and tear drop angle of 45.6° versus 44.5°. There were no significant differences in these measurements. Time to radiographic union averaged 58 days for the NOG and 67 days for the OG, P = .42. There were no revision surgeries. Conclusions Based on this small case series, patients with distal radius fracture and ipsilateral hemiparesis or hemiplegia may have similar clinical, functional, and radiographic outcomes, regardless of nonoperative or operative treatment.

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