scholarly journals Long-term subjective results and radiologic prognosis of a distal radius fracture in working-aged patients – a prognostic cohort study of 201 patients

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110609
Author(s):  
Teemu P Hevonkorpi ◽  
Lauri Raittio ◽  
Susanna Vähä-Tuisku ◽  
Antti P Launonen ◽  
Ville M. Mattila
Keyword(s):  
Cohort Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Pain Catastrophizing ◽  
Radius Fracture ◽  
Secondary Outcome ◽  
Aged Patients ◽  
The Mean

Objective To investigate long-term outcomes associated with distal radius fracture (DRF) in working-aged patients. The authors hypothesized that the majority of patients experience no permanent loss of function when measured with patient-rated wrist evaluation (PRWE). Methods This was a retrospective cohort study of patients with a DRF aged between 18 and 65 years. The primary outcome measure was PRWE score at a minimum of 4 years after DRF. Secondary outcome measures were pain catastrophizing scale (PCS) and radiographic measurements. Results Of 201 patients included, 179 were primarily treated non-operatively with a 5-week cast treatment and 22 were primarily operated. The mean follow-up duration was 5 years. The mean PRWE score was 10.9 (95% confidence interval 8.4, 13.4) and median PRWE was 3.5 (interquartile range, 0.0–13.0). There was minor correlation between PCS and PRWE score (correlation coefficient [CC] 0.3), and between PRWE score and dorsal angulation of the fracture measured after closed reduction (CC 0.2) and in one-week follow-up radiographs (CC 0.2). Conclusions Working-aged patients seem to gain nearly normal wrist function after DRF in longer follow-up. Pain catastrophizing appears to correlate with long-term treatment outcome.

scholarly journals Radius distraction could contribute to long-term stability for treating distal radioulnar joint instability during volar plating of distal radius fracture: a retrospective case series study

2021 ◽  
Author(s):  
Cheng-Yu Yin ◽  
Hui-Kuang Huang ◽  
Duretti Fufa ◽  
Jung-Pan Wang
Keyword(s):  
Surgical Technique ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Druj Instability

Abstract BackgroundThe surgical technique of radius distraction for stabilization of distal radioulnar joint (DRUJ) if intraoperative DRUJ instability was found after the fixation of distal radius fracture has been previously described, but this surgical technique lacks clinical and radiographic effect in minimal 3 years follow-up. We therefore evaluated the clinical outcome and radiographic results of radius distraction in minimal 3 years follow-up.MethodsWe reviewed the case series of distal radius fracture with concomitant DRUJ instability receiving radius distraction from the senior author over a 5-year period (January 1st, 2013 to June 30th, 2017) retrospectively, and the evaluation of clinical and radiographic outcomes was performed at clinic as long-term follow-up; a total 34 patients had been evaluated.ResultsAt minimal post-operative 36 months follow-up, all cases demonstrated acceptable wrist range of motion with stable DRUJs and low NRS of wrist pain (0.6, SD 0.7) and DASH score (mean 9.1, SD 6.2), and there were no cases suffering from nonunion of distal radius. The mean ulnar variance of injured wrist and uninjured wrist were − 1.2 mm and 0.2mm, respectively (SD 1.0 and 0.6) with significant statistical difference.ConclusionsRadius distraction during volar fixation of distal radius fracture should be consider if DRUJ instability was found by the radioulnar stress test intraoperatively, and the long-term DRUJ stability could be achieved by maintenance of normal-to-negative ulnar variance, with decreased wrist pain and satisfactory function outcome.Level of EvidenceTherapeutic Level IV

scholarly journals Patient Reported Pain and Disability Following a Distal Radius Fracture: A Prospective Study

2017 ◽  
Vol 11 (1) ◽  
pp. 589-599 ◽  
Author(s):  
Emily Lalone ◽  
Joy MacDermid ◽  
Ruby Grewal ◽  
Graham King
Keyword(s):  
Prospective Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Radius Fracture ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
One Year ◽  
A Prospective Study

Background: Fractures of the distal radius are common. Few studies investigating the extended long term outcomes of participants following a distal radius fracture (especially beyond 2 years) and they have relied on subjective measures or single objective tests to measure participant’s final outcome. Objectives: The objective of this study was to describe the pain and disability in long-term follow-up of participants after a distal radius fracture. Participants who had previously participated in a prospective study, where baseline and standardized one-year follow-up were performed, were contacted to volunteer to participate in this follow-up (FU) study. Sixty-five participants (17 males, 48 females) with an average age of 57 (SD 13) years at the time of injury and 67 (SD 13 years) at follow-up were evaluated at an average of 11(SD 6) years (range 2-20 years). Results: The majority of patients (85%) participants reported no change or had less pain and disability (PRWE) (<5 point difference) at their long-term follow-up compared to their one year PRWE scores. One year PRWE scores were found to be predictive (19.1%) of the variability in long term PRWE score (p=0.02). Age, gender, and mechanism of fall were not significant predictors of worsened outcome. Conclusion: The majority of people that are experiencing no or low patient reported pain and disability one year following a DRF can expect to retain their positive outcome 10-20 years later. This study did not identify how to predict worsened outcome.

scholarly journals Relationship between distal radius fracture malunion and arm-related disability: A prospective population-based cohort study with 1-year follow-up

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Elisabeth Brogren ◽  
Manfred Hofer ◽  
Michael Petranek ◽  
Philippe Wagner ◽  
Lars B Dahlin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Population Based ◽  
Radius Fracture

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.

scholarly journals The Relationship between Hand Therapy and Long-Term Outcomes after Distal Radius Fracture in Older Adults

2019 ◽  
Vol 144 (2) ◽  
pp. 230e-237e ◽  
Author(s):  
Kevin C. Chung ◽  
Sunitha Malay ◽  
Melissa J. Shauver ◽  
Kevin C. Chung ◽  
H. Myra Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Radius Fracture ◽  
Hand Therapy ◽  
Long Term Outcomes ◽  
The Relationship

scholarly journals Responsiveness of EQ-5D in Patients With a Distal Radius Fracture

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 572-580 ◽  
Author(s):  
Johanna Rundgren ◽  
Anders Enocson ◽  
Cecilia Mellstrand Navarro ◽  
Gunnar Bergström
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Controlled Trial ◽  
Roc Curves ◽  
Change Score ◽  
Radius Fracture ◽  
External Criterion ◽  
Patient Reported ◽  
External Responsiveness

Background: The EuroQol Group 5-Dimension (EQ-5D) questionnaire is frequently used as an outcome measure of general patient-reported health-related quality of life (HRQoL). We evaluated the internal and external responsiveness of EQ-5D (specifically EQ-5Dindex score) in patients with a surgically treated distal radius fracture. Methods: Within the context of a randomized controlled trial (RCT), 132 patients with a surgically treated distal radius fracture filled out EQ-5D and Patient-Rated Wrist Evaluation (PRWE-Swe) at baseline (preinjury state), and at 3 and 12 months. Internal responsiveness was evaluated by calculating mean change score and standardized response mean (SRM) of the EQ-5Dindex scores. External responsiveness was evaluated with PRWE-Swe as the external criterion. PRWE-Swe was used to define 4 subgroups of patients with different clinical outcomes. The ability of EQ-5Dindex change score to discriminate between these subgroups was analyzed with logistic regression, receiver operating characteristic (ROC) curves, and area under the ROC curves (AUROCs). Correlation analysis was made with Spearman’s ρ test. Results: The mean change in EQ-5Dindex score from baseline to the 3-month follow-up was −16.1 and from the 3- to the 12-month follow-up was 7.6. The corresponding SRMs were large (0.93) and small to moderate (0.47). Analysis of external responsiveness displayed odds ratios >1 and AUROCs between 0.70 and 0.76 in all 4 subgroups. The proportion of patients correctly classified into the 4 subgroups by the EQ-5Dindex change scores was 78% to 94%. Spearman’s ρ was 0.35. Conclusion: EQ-5D displayed an overall acceptable to good responsiveness in patients with a distal radius fracture. It may thus be used as a measure of HRQoL in this patient group.

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.

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