Outcome Metrics in the Treatment of Distal Radius Fractures in Patients Aged Above 50 Years: A Systematic Review

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Nathaniel Fogel ◽  
Kevin Mertz ◽  
Lauren M. Shapiro ◽  
Allison Roe ◽  
Sahitya Denduluri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Examination ◽  
Outcome Measures ◽  
Distal Radius ◽  
Meta Analysis ◽  
Final Analysis ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Patient Reported ◽  
Level I

Background The inclusion of patient-reported outcome measures (PROMs) serves to better quantify aspects of patient outcomes missed with objective measures, including radiographic indices and physical examination findings. We hypothesize that PROMs are inconsistently and heterogeneously captured in the treatment of distal radius fractures. Methods We performed a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines of all level I and II randomized controlled trials (RCTs) of distal radius fracture treatment of any modality for those older than 50 years of age from January 2008 to January 2018. A total of 23 studies were included in the final analysis. The metrics used by each study to assess outcomes were collected, compared, and described. Results Physical examination findings and radiographic measures were reported in 70% and 74% of studies, respectively. Patient-reported outcomes measures were used to assess outcomes in 74% of studies. Only the Disabilities of the Arm, Shoulder, and Hand was used in greater than half of the studies (57%). Pain scores were assessed in 39% of studies and complications in only 26%. Conclusions There is substantial heterogeneity and lack of standardization in the collection of both objective outcome measures and PROMs in level I and II RCTs for the treatment of distal radius fractures. The ability to compare between studies or aggregate data among studies is therefore limited. Radiographic and physical examination findings remain frequently reported despite known limitations of these metrics. The routine collection of PROMs after the treatment of distal radius fractures can ensure care is directed toward improving what is most important to patients.

scholarly journals The role of concomitant ligament injury in the development of post-traumatic osteoarthritis after distal radius fractures: a protocol for a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039591
Author(s):  
Malou E Slichter ◽  
Gerald A Kraan ◽  
Wichor M Bramer ◽  
Joost W Colaris ◽  
Nina M C Mathijssen
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ligament Injury ◽  
Original Research ◽  
Cochrane Central Register ◽  
Radius Fractures ◽  
Patient Reported ◽  
Post Traumatic

IntroductionTreatment of distal radius fractures (DRFs) aims to restore anatomic position of the fracture fragments and congruity of the articular surface to optimise functional outcomes and prevent osteoarthritis in the long term. While ligament injury of the wrist is often associated with DRFs and sole ligament injuries of the wrist lead to osteoarthritis, it is plausible that concomitant ligament injury in DRFs may aggravate degenerative changes of the wrist. The relationship between concomitant ligament injury and post-traumatic osteoarthritis in patients with DRFs is unclear. This study aims to identify the types of associated ligament injury in patients with a DRF and to elucidate the association of ligament injury on the development of post-traumatic osteoarthritis.Methods and analysisThis protocol is written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) guidelines. An electronic search in MEDLINE, Embase, Web of Science, Cochrane Central Register of Trials and Google Scholar has been created and performed by a Health Sciences librarian with expertise in systematic review searching. Original research articles in English literature, which report on concomitant ligament injury of the wrist in relation to post-traumatic osteoarthritis, patient-reported outcome measures or clinician-reported outcome measures in patients (aged ≥18 years) with DRFs will be included. Two reviewers will independently screen and appraise articles and perform data extraction. In case of any disagreements, a third reviewer will be consulted. A systematic qualitative synthesis will be performed using text and tables.Ethics and disseminationNo ethical approval is required, since this is a protocol for a systematic review. The systematic review will be submitted for publication in a peer-reviewed scientific journal and for presentation at relevant conferences.PROSPERO registration numberCRD42020165007.

scholarly journals Complications of Distal Radius Fractures in the Elderly: A Systematic Review and Meta-analysis

2017 ◽  
Vol 42 (9) ◽  
pp. S8 ◽  
Author(s):  
Paul Kooner ◽  
Rajeshwar S. Sidhu ◽  
Joy MacDermid ◽  
Ruby Grewal
Keyword(s):  
Systematic Review ◽  
Distal Radius ◽  
Meta Analysis ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals Objective Outcome Measures Continue to Improve from 6 to 12 Months after Conservatively Treated Distal Radius Fractures in the Elderly—A Prospective Evaluation of 50 Patients

2021 ◽  
Vol 10 (9) ◽  
pp. 1831
Author(s):  
Rikke Thorninger ◽  
Daniel Wæver ◽  
Jonas Pedersen ◽  
Jens Tvedegaard-Christensen ◽  
Michael Tjørnild ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Distal Radius ◽  
Case Series ◽  
The Elderly ◽  
Patient Reported Outcome Measures ◽  
Distal Radius Fractures ◽  
Fracture Dislocation ◽  
Radius Fractures ◽  
Patient Reported ◽  
Prospective Case Series

Distal radius fractures (DRF) in the elderly population above 65 years represent 18% of all fractures and are thereby the second most frequent fracture in the elderly. Fracture dislocation and comminution are often used to determine whether non-operative or operative treatment is indicated. The purpose of this prospective case series of minimally displaced DRF treated with a dorsal cast was to assess the complication rate and patient-reported outcome measures. This single-centre, single-blinded, prospective case series followed 50 conservatively treated DRF patients for one year. Primary outcomes were complications and Quick Disability of Arm Shoulder and Hand (qDASH) score. Secondary outcomes were range of motion (ROM), grip strength and pain, and Patient-Rated Wrist/Hand Evaluation (PRWHE). Results showed only minor complications with a return to prior ROM, qDASH, and pain after 12 months and improvement in outcomes after 6–12 months. In conclusion, the majority of DRF patients who were treated non-operatively with five-week dorsal casting recover fully after minimally displaced DRF. This standard approach is thus considered safe, and the present results provide a reference for other studies.

Predictors of unstable distal radius fractures: a systematic review and meta-analysis

2015 ◽  
Vol 41 (5) ◽  
pp. 501-515 ◽  
Author(s):  
M. M. J. Walenkamp ◽  
S. Aydin ◽  
M. A. M. Mulders ◽  
J. C. Goslings ◽  
N. W. L. Schep
Keyword(s):  
Systematic Review ◽  
Distal Radius ◽  
Meta Analysis ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Closed Treatment ◽  
Secondary Displacement ◽  
Type 3

The aim of this study was to perform a systematic review in order to identify predictors of secondary displacement in distal radius fractures. We performed a systematic review and identified all studies that reported secondary displacement following distal radius fractures. Where possible, we pooled the odds ratios of predictors. The initial search yielded 3178 studies of which 27 were included. Multiple studies found that age, shortening, volar comminution, loss of radial inclination, the presence of a volar hook, AO type 3 fractures (A3, B3, C3) and the Older classification were significant predictors of secondary displacement. Pooling revealed a significantly increased risk of secondary displacement in fractures with dorsal comminution, in women and in patients aged >60 years. An associated ulna fracture or intra-articular involvement does not result in an increased risk of secondary displacement. The overview provided in this study can help surgeons to inform patients of the chances of success of closed treatment regarding the radiological outcome and facilitate shared decision making. Level of evidence: II

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