Recovery, age, and gender effects on hand dexterity after a distal radius fracture. A 1-year prospective cohort study

2018 ◽  
Vol 31 (4) ◽  
pp. 465-471 ◽  
Author(s):  
Pavlos Bobos ◽  
Emily A. Lalone ◽  
Ruby Grewal ◽  
Joy C. MacDermid
Keyword(s):  
Cohort Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Gender Effects ◽  
Radius Fracture ◽  
Age And Gender ◽  
Hand Dexterity ◽  
And Gender

Impact of Thrombophilia and Incidence of Symptomatic Thromboembolism in First Degree Family Members (FM) of Pediatric Index Cases: a Prospective Cohort Study in FM > 14 Years of Age.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2977-2977
Author(s):  
Ulrike Nowak-Gottl ◽  
Monika Stoll ◽  
Rolf Mesters ◽  
Sabine Thedieck ◽  
Susan Halimeh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Family Members ◽  
Age And Gender ◽  
Lipoprotein A ◽  
Off Label ◽  
Healthy Family ◽  
And Gender ◽  
Index Cases

Abstract Abstract 2977 Poster Board II-957 Background: Venous thrombosis is a multifactorial disease and inherited genetic traits (IT) constitute a major risk factor. The aim of the present prospective cohort study was to determine i) the relative and absolute risks of first symptomatic thromboembolism [TE] in previously healthy family members of children with venous thromboembolism, and ii) whether to screen family members in a high risk population. Methods: In 205 patients (neonate to 18 years) and 526 FM followed over a total person-time of 14157 years /1000 units [person-time] a comprehensive IT screening was performed along with recording of family histories of preexisting cardiovascular diseases. FM were followed until July 2009: study endpoint was cumulative time to first TE within FM. Survival analysis (Cox regression: hazard ratio (HR/95% Confidence intervals (CIs)] adjusted for age and gender and number of new cases divided by the total population at risk (incidence rate) were calculated (events (%) per 1000 person-years [CIs]). Results: The final study population included 526 FM with 462 subjects > 14 years. The cumulative TE –free survival in FM with IT was significantly lower compared to those without: HR/CI: 6.6/ 3.3-13.5. The overall rate of symptomatic TEs was 2.9%[2.07-3.9]. The hazard adjusted for age and gender in the group of antithrombin(AT)-/protein C[PC)-/protein S(PS)-deficient FM was 29.4%[13.3-62.5], and for carriers of factor (F) V G1691A, F II G202010A mutations or elevated lipoprotein (a) it was found to be 3.3%[1.3-8.3], 1.96% [0.4- 9.0] and 2.1%[1.04-3.8]. Corresponding annual incidence rates in FM > 14 years were 4.8% for AT-/PC- or PS-deficiency states, 0.72% in subjects carrying the FV mutation, 0.36 % in FII carriers, and 0.20% for subjects with elevated lipoprotein (a) compared with 0.19% in FM with no IT. Thus, compared to adult data from the view of adult index cases [Lijfering W et al. Blood 2009] i) the risk of TE in family members of pediatric index cases with TE depends on IT, ii) the age at TE in the index patient as well as in the family members has a strong effect on TE incidence, and iii) the first symptomatic TE in primary healthy family members > 14 years of age with respect to the IT investigated is comparable to or exceeds adult data. Conclusions: i) Adult family members of pediatric index patients with an early onset of symptomatic thrombosis should be considered for IT testing, ii) primary thromboprophylaxis in family members derived from pediatric index patients should be considered in risk situations in adult carriers of AT/PC/PS-deficiencies & FV mutation. In addition, iii) larger prospective studies are needed to investigate the effects of multiple ITs and its interactions to take into account whether events are provoked or not to investigate the effect of screening. Disclosures: Off Label Use: Enoxaparin (LMWH) is used off-label in children to prevent symptomatic thromboembolism.

scholarly journals Agreement between Initial Classification and Subsequent Reclassification of Fractures of the Distal Radius in a Prospective Cohort Study

Hand ◽  
2009 ◽  
Vol 5 (1) ◽  
pp. 68-71 ◽  
Author(s):  
Roderick H. van Leerdam ◽  
J. Sebastiaan Souer ◽  
Anneluuk L. C. Lindenhovius ◽  
David C. Ring
Keyword(s):  
Cohort Study ◽  
Distal Radius ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Initial Classification

scholarly journals Splinting after Distal Radius Fracture Fixation: A Prospective Cohort Analysis of Postoperative Plaster Splint versus Soft Dressing

2019 ◽  
Vol 08 (06) ◽  
pp. 452-455
Author(s):  
Spencer Poiset ◽  
Jack Abboudi ◽  
Gregory Gallant ◽  
Christopher Jones ◽  
William Kirkpatrick ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Prospective Cohort ◽  
Cohort Analysis ◽  
Outcome Data ◽  
Open Reduction Internal Fixation ◽  
Radius Fracture ◽  
Hardware Failure ◽  
Radiographic Outcomes ◽  
Pain Scores

Abstract Background The effect of postoperative dressing and splinting after distal radius fracture (DRF) open reduction internal fixation (ORIF) is not well understood. A prospective cohort analysis was performed to assess differences in functional and radiographic outcomes with the use of plaster splinting or soft dressing following DRF ORIF. Methods All patients undergoing DRF ORIF with locking volar plates were consecutively enrolled. Preoperative demographic and postoperative radiographic and functional outcome data were collected at 2 weeks and 3 months postoperatively. Functional data included range of motion (ROM), pain on visual analog scale (VAS), Patient-Rated Wrist Evaluation (PRWE), and quick Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiographic data included loss of fracture reduction. Results A total of 139 patients were enrolled (79 plaster splinting, 60 soft dressing). By the first postoperative visit (POV), there was one case of loss of reduction with plaster splinting and one case with soft dressing with no hardware failure or revision surgery in either group, and no difference in DASH, PRWE, or VAS pain scores. By the final POV, the soft dressing group showed greater ROM in extension by 9.6, flexion by 10.9, and supination by 4.8 degrees over plaster splinting. Additionally, the soft dressing group demonstrated statistically significant improvement in PRWE and DASH scores, as well as VAS pain scores as compared with plaster splinting. Conclusions Applying only soft dressing following DRF ORIF demonstrated improvements in ROM, VAS, and functional outcomes by final follow-up, with no significant differences in radiographic outcomes. No benefit of applying a plaster splint was identified.

scholarly journals Recovery of grip strength and hand dexterity after distal radius fracture: A two-year prospective cohort study

Hand Therapy ◽  
2017 ◽  
Vol 23 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Pavlos Bobos ◽  
Goris Nazari ◽  
Emily A Lalone ◽  
Ruby Grewal ◽  
Joy C MacDermid
Keyword(s):  
Grip Strength ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Radius Fracture ◽  
Linear Modeling ◽  
Post Injury ◽  
Uninjured Side ◽  
Hand Dexterity ◽  
Over Time

Introduction Clinicians often evaluate deficits after an injury by comparing the injured and uninjured side. It is important to understand what deficits occur in hand function after distal radius fracture, how they change over time and their clinical relevance. The purpose of this study was to evaluate the differences in grip strength and hand dexterity between the injured and uninjured hands of patients two years following distal radius fracture. Methods Patients with distal radius fracture were recruited in a specialized hand clinic. Grip strength and hand dexterity were examined bilaterally with a Jamar hand-held dynamometer and with the NK dexterity device at 3, 6, 12 and 24 months’ post-injury respectively. Generalized linear modeling was performed, with age and sex as covariates to assess changes over time, and between sides. Results Patients (n = 154) exhibited mean differences of grip strength between injured and uninjured side at 3 months’ (12.09 kg) and 6 months’ (7.47 kg) follow-up. The associated deficit standardized response means (SRM) were 1.30 and 0.73, respectively. At 2-years follow-up the mean deficit on the injured side was 2.30 kg with SRM = 0.22. One hundred and eleven patients who completed dexterity testing demonstrated small to trivial side to side differences across all time points. Conclusions There were clinically important differences in grip strength between the injured and uninjured hands in patients with a distal radius fracture at 3 and 6 months’ follow-up. However, at 12 and 24 months, grip strength differences were small and of uncertain clinical importance. Trivial to small differences in hand dexterity can be expected between the injured and uninjured hand by 2 years after distal radius fracture.

scholarly journals A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008–2013

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014854 ◽  
Author(s):  
Dhanya Nambiar ◽  
Mark Stoové ◽  
Matthew Hickman ◽  
Paul Dietze
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
General Population ◽  
Social Services ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
People Who Inject Drugs ◽  
Secondary Outcome ◽  
Public And Private ◽  
And Gender

ObjectivesInjecting drug use is a persistent behaviour that increases the risk of morbidities and mortality. We assessed the burden of hospital separations among people who inject drugs (PWID), the excess compared to the general population and characteristics of separations associated with frequent use.DesignProspective cohort study.SettingAll public and private hospitals in Victoria.Participants757 community-based PWID with hospital separations between January 2008 and June 2013 identified through record linkage, who contributed over 3729 person-years.Primary and secondary outcome measuresCounts, proportions and rates of hospital separations, descriptive administrative data including all diagnoses, comparison of separation rates to the general population, trend in separations and factors associated with frequent separations.ResultsThere were 2106 separations in the cohort. The most common principal diagnoses were related to mental and behavioural disorders (31%), but social circumstances influencing health was the most common group of diagnoses (61%) when all contributing diagnoses for each patient were considered. Separation rates were up to three times higher than in the age-matched population, and there was a 12% increase in separations every 6 months. Over a quarter (29%) of the cohort had frequent separations (defined as two or more separations in a calendar year), which were associated with mental health-related diagnoses, being discharged to locations other than a patient’s residence, having a medical as opposed to surgical intervention, seasonal patterns, relationship status and gender.ConclusionsMental health conditions and other characteristics associated with separations and frequent separations in particular, emphasise the importance of providing referrals to harm reduction, social services and mental health services at discharge in order to reduce excess hospital separations among PWID.

Sign in / Sign up

Export Citation Format

Share Document