scholarly journals Differences in patient and injury characteristics between sports- and non-sports related distal radius fractures

2020 ◽  
Vol 106 (8) ◽  
pp. 1605-1611
Author(s):  
In-Tae Hong ◽  
Jun-Ku Lee ◽  
Cheungsoo Ha ◽  
Seongmin Jo ◽  
Pei Wei Wang ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Injury Characteristics

scholarly journals Interpreting Patient-Reported Outcome Results: Is One Minimum Clinically Important Difference Really Enough?

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 360-364
Author(s):  
Dylan L. McCreary ◽  
Benjamin C. Sandberg ◽  
Debra C. Bohn ◽  
Harsh R. Parikh ◽  
Brian P. Cunningham
Keyword(s):  
Distal Radius ◽  
Treatment Modality ◽  
Emotional Health ◽  
Minimum Clinically Important Difference ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Time Points ◽  
Injury Characteristics ◽  
Clinically Important Difference ◽  
Patient Reported

Background: Patient-reported outcomes (PROs) are the gold standard for reporting clinical outcomes in research. A crucial component of interpreting PROs is the minimum clinically important difference (MCID). Patient-Rated Wrist Evaluation (PRWE) is a disease-specific PRO tool developed for use in distal radius fractures. The purpose of this study was to determine the influence of injury characteristics, treatment modality, and calculation methodology on the PRWE MCID in distal radius fractures. We hypothesize the MCID would be significantly influenced by each of these factors. Methods: From 2014 to 2016, 197 patients with a distal radius fracture were treated at a single level I trauma center. Each patient was asked to complete a PRWE survey at preoperative baseline, 6-week postoperative, and 12-week postoperative dates. The MCID was derived utilizing 2 distinct strategies, anchor and distribution. Anchor questions involved overall health anchor and mental and emotional health anchor. Patient variables regarding demographics, injury characteristics, and treatment modality were collected. Results: The MCID was unique between analytical methods at all time points. The distribution MCID presented commonality across assessed variables. However, the anchor MCID was unique by AO/OTA fracture classifications, treatment modality, and time points. Conclusions: Our study found the MCID was heavily influenced by assessment time points, analytical method, treatment modality, and fracture classification. These results suggest that to accurately interpret PRO data in clinical trials, an anchor question should be included so that the MCID can be determined for the specific patient population included in the study.

scholarly journals Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Hand ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 104-111 ◽  
Author(s):  
Ruby Grewal ◽  
Joy C. MacDermid ◽  
Janet Pope ◽  
Bert M. Chesworth
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Third Party ◽  
Radius Fractures ◽  
Injury Characteristics ◽  
Patient Reported ◽  
Injury Characteristic ◽  
Forward Stepwise ◽  
Initial Fracture ◽  
One Year

Distal radius fractures are common injuries; however, identifying which factors are responsible for predicting outcomes remains an area of controversy. The purpose of this study was to define factors predictive of patient-reported pain and disability at 1 year in a prospective cohort of extra-articular distal radius fractures ( n=222). Data were collected at the initial visit and after 3, 6, and 12 months. The primary outcome was the 1-year patient-rated wrist evaluation (PRWE) score. The effect of baseline patient and injury characteristics on the 1-year PRWE score was assessed. Univariate and forward stepwise regression analyses both agreed that the most influential predictor of pain and disability at 1 year was injury compensation. The 1-year PRWE score was significantly higher for subjects involved with third-party claims (35.48) compared to those that were not involved in any claims (14.97), p=0.006. The regression model found that three baseline factors – injury compensation, education, and other medical comorbidities – explained 16.4% of the variance in PRWE scores at 1 year. No injury characteristic, including the degree of initial fracture displacement, was found to significantly influence the 1-year PRWE score. This study has shown that baseline patient and injury characteristics play a small role in predicting 1-year patient-reported pain and disability in extra-articular distal radius fractures. Conceptual factors outside of this biomedical model should be investigated.

The Effect of Volarly Angulated Distal Radius Fractures on Forearm Rotation: In Vitro Biomechanical Study

2015 ◽  
Vol 04 (S 01) ◽  
Author(s):  
Masao Nishiwaki ◽  
Mark Welsh ◽  
Louis Ferreira ◽  
James Johnson ◽  
Graham King ◽  
...  
Keyword(s):  
Distal Radius ◽  
Biomechanical Study ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Forearm Rotation

scholarly journals Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study

2011 ◽  
Vol 93 (1) ◽  
pp. 57-60 ◽  
Author(s):  
DC Perry ◽  
DMG Machin ◽  
JA Casaletto ◽  
DJ Brown
Keyword(s):  
High Risk ◽  
Distal Radius ◽  
Plate Fixation ◽  
Tendon Injury ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Fixed Angle ◽  
Volar Plate Fixation

INTRODUCTION Rupture of extensor pollicis longus (EPL) tendon is a recognised complication following volar plate fixation of distal radius fractures, usually from attrition caused by prominent screws. We sought to identify the screw holes in some of the most commonly used plates which may precipitate tendon injury. SUBJECTS AND METHODS Three fixed-angle volar locking plates were sequentially positioned into 18 cadaveric arms. A wire was passed through each of the holes in the plates using a locking guide and the dorsal relationships noted. RESULTS Each plate had specific ‘high-risk’ holes which directed the wire towards the EPL groove. The central screw holes appeared mostly implicated in EPL injury. CONCLUSIONS Awareness of ‘high-risk’ holes and appropriate minor alterations in surgical technique may consequently decrease the incidence of EPL irritation and rupture.

A Multimodal Pain Management Regimen for Open Treatment of Distal Radius Fractures: A Randomized Blinded Study

Hand ◽  
2020 ◽  
pp. 155894472097514
Author(s):  
Julian Zangrilli ◽  
Nura Gouda ◽  
Armen Voskerijian ◽  
Mark L. Wang ◽  
Pedro K. Beredjiklian ◽  
...  
Keyword(s):  
Pain Management ◽  
Distal Radius ◽  
Bone Healing ◽  
Pain Control ◽  
Distal Radius Fractures ◽  
Study Group ◽  
Radius Fractures ◽  
Multimodal Pain Management ◽  
Regional Block ◽  
Rebound Increase

Background Adequate pain control is critical after outpatient surgery where patients are not as closely monitored. A multimodal pain management regimen was compared to a conventional pain management method in patients undergoing operative fixation for distal radius fractures. We hypothesized that there would be a decrease in the amount of narcotics used by the multimodal group compared to the conventional pain management group, and that there would be no difference in bone healing postoperatively. Methods Forty-two patients were randomized into 2 groups based on pain protocols. Group 1, the control, received a regional block, acetaminophen, and oxycodone. Group 2 received a multimodal pain regimen consisting of daily doses of pregabalin, celecoxib, and acetaminophen up until postoperative day (POD) #3. They also received a regional block with oxycodone for breakthrough pain. Results From POD#3 to week 1, there was a significant increase in oxycodone use in the study group correlating with the point in time when the multimodal regimen was discontinued. The shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) scores taken at 2 weeks postoperation showed a significantly lower average score in the study group compared to the control. There was no difference in bone healing. Conclusions The 2 regimens yielded similar pain control after surgery. The rebound increase in narcotic use after the multimodal regimen was discontinued, and significant difference in QuickDASH scores seen at 2 weeks postoperatively supported that multimodal regimens may not necessarily lead to decreased narcotic use in outpatient upper extremity surgery, but in the short term are shown to improve functional status.

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