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Jo YH, Lee MK, Lee YS, Choi WS, Kim JH, Kim J, Lee CH. Radiographic and clinical outcomes of muenster and sugar tong splints for distal radius fractures: a comparative study. BMC Musculoskelet Disord 2024; 25:261. [PMID: 38570756 PMCID: PMC10988914 DOI: 10.1186/s12891-024-07362-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Non-operative management is typically indicated for extra-articular distal radius fractures. Conservative treatments such as Sugar tong splints (STs) and Muenster splints (MUs) are commonly used. However, there is limited research and outcome data comparing the two splint types. Therefore, this study aimed to investigate and compare the radiographic and clinical outcomes of treatment using STs and MUs. METHODS In this retrospective comparative study, we aimed to evaluate and compare the radiographic and clinical outcomes of STs and MUs for the treatment of distal radius fractures. The study included 64 patients who underwent closed reduction (CR) in the emergency room and were treated with either STs or MUs splints (STs group: n = 38, MUs group: n = 26). Initial X-rays, post-CR X-rays, and last outpatient follow-up X-rays were evaluated. Radial height (RH), ulnar variance (UV), radial inclination (RI), and volar tilt (VT) were measured by a blinded investigator. The Quick DASH form was applied to measure patients' satisfaction after treatments. RESULTS There were no significant differences in baseline characteristics, initial radiographic measurements, or radiographic measurements immediately after CR between the two groups. However, the overall radiological values deteriorated to some degree in both groups compared to the post-CR images. Furthermore, using a paired test, the STs group showed significant differences in RH and RI, and the MUs group showed significant differences in RH and UV between the last follow-up and post-CR images. CONCLUSIONS The study concluded that there was no difference in clinical outcomes between the two splint types. However, both STs and MUs groups showed reduced radiographic parameters, and the MUs group showed a significant reduction of RH and UV in the treatment of distal radius fractures. LEVEL OF EVIDENCE Level IV; Retrospective Comparison; Treatment Study.
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Affiliation(s)
- Young-Hoon Jo
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Myoung Keun Lee
- Department of Orthopaedic Surgery, College of Medicine, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Young Seok Lee
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Wan-Sun Choi
- Department of Orthopaedic Surgery, College of Medicine, Ajou University, Suwon, Republic of Korea
| | - Joo-Hak Kim
- Department of Orthopaedic Surgery, Myongji Hospital, Goyang, Republic of Korea
| | - Jiwhan Kim
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Chang-Hun Lee
- Department of Orthopaedic Surgery, College of Medicine, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
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Kong L, Li C, Bai J, Lu J. Surgical treatment of distal radius fractures: impact on forearm rotation in non-elderly patients. Sci Rep 2024; 14:2876. [PMID: 38311631 PMCID: PMC10838908 DOI: 10.1038/s41598-024-53520-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/01/2024] [Indexed: 02/06/2024] Open
Abstract
Forearm rotation restriction (FRR) is common after surgery for distal radius fractures (DRFs). The aim of the current study was to investigate the effect of DRFs on forearm rotation. This retrospective study reviewed patients with DRFs who underwent surgical treatment from January 2019 to December 2021. The patients' basic data and radiographic parameters were analyzed. Forearm rotation, including pronation and supination, was assessed using a standard goniometer. The Patient-Rated Wrist Evaluation (PRWE) score was evaluated, and the incidence of FRR at the 6-month follow-up was recorded. Univariate and multivariate logistic regression analyses were performed to identify risk factors correlated with FRR. A total of 127 patients with DRFs were included in this study. After surgery, 46 cases were considered to have FRR, with a rate of 36.2%, while the remaining 81 cases (63.8%) did not have FRR. The PRWE scores were 22.8 ± 5.2 and 17.9 ± 4.2 in the FRR group and non-FRR group, respectively, and the difference was statistically significant (P < 0.05). Multivariate analysis showed that the involvement of the sigmoid notch (OR, 2.88; 95% CI 1.49-5.56), post-operative volar tilt < 0° (OR, 2.16; 95% CI 1.34-3.50), and post-operative ulnar variance > 0 mm (OR, 1.37; 95% CI 1.06-1.78) were independently associated with the incidence of FRR. The FRR is associated with an increased PRWE score and may have had some impact on the patient's daily life. Fractures involving the sigmoid notch, dorsal angulation, and radial shortening deformity were found to be correlated with the incidence of FRR. Preoperative risk notification and intraoperative preventive measures are necessary for these patients.
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Affiliation(s)
- Lingde Kong
- Department of Orthopedics, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, 050051, Hebei, China
| | - Chenfei Li
- Department of Orthopedics, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, 050051, Hebei, China
| | - Jiangbo Bai
- Department of Orthopedics, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, 050051, Hebei, China
| | - Jian Lu
- Department of Orthopedics, Third Hospital of Hebei Medical University, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, Shijiazhuang, 050051, Hebei, China.
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Bry K, Kortesniemi M, Koivikko M, Kerttula L. Comparison of cone beam computed tomography and plane radiographs of radial fractures as a basis for radiographical measurements. BMC Med Imaging 2023; 23:125. [PMID: 37710172 PMCID: PMC10500865 DOI: 10.1186/s12880-023-01093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine whether radiological measurements of radial fracture position made in cone beam computed tomography (CBCT) projection images are comparable to those made on traditional radiographs and could potentially substitute them. METHODS Sixteen patients with fractures of the distal radius referred for radiographs were recruited for an additional CBCT scan which was performed immediately afterwards. Projection images and volumetric data were saved from the CBCT scans. Measurements of ulnar variance, radial inclination and volar tilt were made from all three sets of images. RESULTS Agreement of projection image based measurements with radiographs was nearly as good as as the agreement of cross sectional image measurements with radiographs. The average difference between the results for projection images and radiographs were -1.2 mm (SD 1.9 mm), for radial inclination 0.7° (SD 2.9°) and for volar tilt 1.9° (SD 5.6°). CONCLUSION Differences between radiological measurements between the modalities studied are small and projection images could be used for the assessment of distal radial fractures.
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Affiliation(s)
- Kristian Bry
- Bridge Hospital, HUS, Haartmaninkatu 4, 00029 Helsinki, Finland
- Department of Radiology, Helsinki Medical Imaging Center, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland
| | - Mika Kortesniemi
- Department of Radiology, Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O.Box 263, HUS, 00029 Helsinki, Finland
| | - Mika Koivikko
- Bridge Hospital, HUS, Haartmaninkatu 4, 00029 Helsinki, Finland
- Department of Radiology, Helsinki Medical Imaging Center, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland
| | - Liisa Kerttula
- Bridge Hospital, HUS, Haartmaninkatu 4, 00029 Helsinki, Finland
- Department of Radiology, Helsinki Medical Imaging Center, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland
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Grinčuk A, Petryla G, Masionis P, Sveikata T, Uvarovas V, Makulavičius A. Short-term results and complications of the operative treatment of the distal radius fracture AO2R3 C type, planned by using 3D-printed models. Prospective randomized control study. J Orthop Surg (Hong Kong) 2023; 31:10225536231195127. [PMID: 37620284 DOI: 10.1177/10225536231195127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
PURPOSE 3D-printed models rapidly evolving in orthopaedic. Studies show that 3D-printed models used for preoperative planning improve a better understanding of fracture morphology and reduce operative time, blood loss and frequency of fluoroscopy, but there are no studies that investigated possible advantages in the outcomes and complications for the treatment of distal radius fracture (DRF). Our study aims to evaluate short-term functional results and complications between two groups treated DRF using 3D-printed models for preoperative planning and without. We hypothesize that the addition of 3D-printed models would improve functional outcomes and reduce complication rates. METHODS 66 randomized cases of DRF AO/OTA C type were enrolled and divided into "Control group" (n = 33) and "3D-printed model group" (n = 33). Personalized 3D-printed models were created. The primary outcomes were: Patient-Rated Wrist Evaluation questionnaire, Quick Disabilities of the Arm, Shoulder and Hand Score questionnaire, and complications. The secondary outcomes were: measurement of the range of motions, grip strength, radiological evaluation, and the visual analogue scale. Assessments were measured at 6 weeks, 3 months, and 6 months intervals. RESULTS We found that the integration of the 3D-printed model in preoperative planning decreased complication incidence significantly - from 30.3% in the "Control group" to 6.1% in the "3D-printed model group", p = .022. But we did not find a difference in functional and radiological outcomes. CONCLUSION The 3D-printed models for preoperative planning surgically treating DRF AO/OTA C type can help minimize the complication rate, however, they can't improve functional outcomes in the short-term results. LEVEL OF EVIDENCE Level I randomized controlled study.
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Affiliation(s)
- Aleksandr Grinčuk
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Giedrius Petryla
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Povilas Masionis
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tomas Sveikata
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Valentinas Uvarovas
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Aleksas Makulavičius
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Falk SSI, Mittlmeier T, Gradl G. Residual dorsal displacement following surgery in distal radial fractures: A cause for trouble? Eur J Trauma Emerg Surg 2022; 49:843-850. [PMID: 35881150 PMCID: PMC10175380 DOI: 10.1007/s00068-022-02061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Distal radius fractures have great impact on activities of daily living of affected patients. Repeatedly, a non-anatomic restoration of the volar tilt can be observed in a minimum of 20% in postoperative X-ray control examinations. Hence, the question arises whether the achieved reduction is functionally acceptable, or whether a further attempt should be made to improve the surgical outcome. METHODS The data presented here originate from a prospective analysis including three therapy studies on surgical treatment options for fractures of the distal radius between 2004 and 2011. For this study, the participants were divided into two groups: The first group represents the cases with non-anatomical restoration of the volar tilt with - 5° to 5°. The second group contains patients with an anatomical volar tilt between 6° and 15°. RESULTS A total of 624 patients were screened according to the inclusion criteria. Radiological evaluation showed consolidation of all fractures. The mean volar tilt as measured in standard x-rays of the wrist was 0° and 8°, respectively. The range of wrist motion in relation of the healthy opposite side was comparable in all directions (for example comparison group 1: Ext/Flex 94/94%; group 2: Ext/Flex 93/93%). Functional assessment of postoperative midterm results employing the Castaing and Gartland & Werley scores 2.3 years after surgery did not reveal significant differences between both groups. CONCLUSION According to the available data, a volar tilt in the range of - 5° to 5° can be tolerated intraoperatively without any risk of loss of function regarding the patient's manual abilities.
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Affiliation(s)
- Steffi S I Falk
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany.
| | - Thomas Mittlmeier
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany
| | - Georg Gradl
- Munich Municipal Hospital Group, Clinic of Trauma, Orthopaedic, Hand and Reconstructive Surgery, Clinic Harlaching, Sanatoriumsplatz 2, 81545, Munich, Germany
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AGAR A, GÜNEŞ O, ŞAHİN A, KILIÇ B, ERTÜRK C, GÜLABİ D. Evaluation of Radiological Parameters in Elderly Patients Treated Conservatively for Distal Radius Fracture. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.1003090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Egund L, McGuigan FE, Egund N, Besjakov J, Åkesson KE. Patient-related outcome, fracture displacement and bone mineral density following distal radius fracture in young and older men. BMC Musculoskelet Disord 2020; 21:816. [PMID: 33287782 PMCID: PMC7722451 DOI: 10.1186/s12891-020-03843-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/26/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Distal radius fractures can adversely affect wrist function; for men with this fracture, the role played by fracture severity, age and osteoporosis on fracture outcome has not been sufficiently studied. OBJECTIVE To describe patient-reported outcome and the association with bone integrity, fracture severity and future fracture risk among young and older men with distal radius fracture. METHODS This prospective study includes 133 men with acute distal radius fracture, mean age 54 (range 21-88), who were followed for 12 months. They were categorized as younger (< 65) and older (65+). Main outcome was DASH (Disability of the Arm, Shoulder and Hand) at 12 months; DASH > 15 was defined as poor outcome. Fractures were classified and radiographic displacement identified at initial presentation and follow-up. BMD was measured and FRAX 10-year probability of fracture calculated. RESULTS Disability was higher in older men (DASHmedian 10 vs 2; p = 0.002); a clinically meaningful difference (ΔDASH = 10, p = 0.017) remained after adjustment for displacement, fracture classification and treatment method. Almost 50% of older men vs 14% in younger had poor outcome, p < 0.001. Bone mineral density did not independently predict outcome. Older men with a displaced fracture at initial presentation had greater disability (DASHmedian, IQR 45, 14;73) and risk of fracture (FRAXmajor osteoporotic 14, 8;21). CONCLUSION Men over the age of 65 with a distal radius fracture are more likely to have post-fracture disability regardless of radiographic appearance. Fracture displacement, indicating impaired bone strength, is also more common and associated with an increased risk of fracture within 10-years. Secondary fracture prevention should therefore be considered in men presenting with distal radius fracture.
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Affiliation(s)
- Lisa Egund
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, 205 02, Malmö, Sweden
- Department of Orthopedics, Skåne University Hospital, 205 02, Malmö, Sweden
| | - Fiona E McGuigan
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, 205 02, Malmö, Sweden
| | - Niels Egund
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jack Besjakov
- Department of Radiology, Skåne University Hospital, Malmö, Sweden
| | - Kristina E Åkesson
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, 205 02, Malmö, Sweden.
- Department of Orthopedics, Skåne University Hospital, 205 02, Malmö, Sweden.
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Corrective Osteotomy of Distal Radius Malunion Using a Rectangular-shaped Iliac Bone Graft and Volar Plating. Tech Hand Up Extrem Surg 2020; 25:130-135. [PMID: 33122494 DOI: 10.1097/bth.0000000000000321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Distal radius fractures are one of the most common injuries seen by orthopedists at the emergency room and clinics. Severity and configuration may vary, and therapeutic options are broad, but regardless of the course of treatment, all cases can potentially lead to malunion. When malunion requires surgical correction, the surgery can be technically demanding. Here, we demonstrate an alternative technique to perform corrective osteotomies for extra-articular or minimally displaced articular distal radius malunion. We provide simplification of the procedure by eliminating one of the planes taken into consideration when performing an osteotomy. This technique includes the use of a tricortical iliac bone graft, which we feel, provides dependable structural support, preventing collapse. The technique allows the surgeon an easy means to access the osteotomy gap and apply the graft. Finally, we supplement this surgical technique by providing our outcomes. Our data suggest that the technique effectively restores radiographic wrist parameters and provides good union rates.
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Reyes-Aldasoro CC, Ngan KH, Ananda A, d’Avila Garcez A, Appelboam A, Knapp KM. Geometric semi-automatic analysis of radiographs of Colles' fractures. PLoS One 2020; 15:e0238926. [PMID: 32925940 PMCID: PMC7489566 DOI: 10.1371/journal.pone.0238926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/26/2020] [Indexed: 11/19/2022] Open
Abstract
Fractures of the wrist are common in Emergency Departments, where some patients are treated with a procedure called Manipulation under Anaesthesia. In some cases, this procedure is unsuccessful and patients need to revisit the hospital where they undergo surgery to treat the fracture. This work describes a geometric semi-automatic image analysis algorithm to analyse and compare the x-rays of healthy controls and patients with dorsally displaced wrist fractures (Colles' fractures) who were treated with Manipulation under Anaesthesia. A series of 161 posterior-anterior radiographs from healthy controls and patients with Colles' fractures were acquired and analysed. The patients' group was further subdivided according to the outcome of the procedure (successful/unsuccessful) and pre- or post-intervention creating five groups in total (healthy, pre-successful, pre-unsuccessful, post-successful, post-unsuccessful). The semi-automatic analysis consisted of manual location of three landmarks (finger, lunate and radial styloid) and automatic processing to generate 32 geometric and texture measurements, which may be related to conditions such as osteoporosis and swelling of the wrist. Statistical differences were found between patients and controls, as well as between pre- and post-intervention, but not between the procedures. The most distinct measurements were those of texture. Although the study includes a relatively low number of cases and measurements, the statistical differences are encouraging.
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Affiliation(s)
| | - Kwun Ho Ngan
- School of Mathematics, Computer Science and Engineering, City, University of London, London, United Kingdom
| | - Ananda Ananda
- School of Mathematics, Computer Science and Engineering, City, University of London, London, United Kingdom
| | - Artur d’Avila Garcez
- School of Mathematics, Computer Science and Engineering, City, University of London, London, United Kingdom
| | | | - Karen M. Knapp
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
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Volar plate for intra-articular distal radius fracture. A prospective comparative study between elderly and young patients. Orthop Traumatol Surg Res 2020; 106:319-323. [PMID: 32044260 DOI: 10.1016/j.otsr.2019.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/18/2019] [Accepted: 12/29/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Treatment of the distal radius fracture in elderly remains controversial. The objective was to assess the outcomes of volar locking plate for displaced complete intra-articular distal radius fractures in elderly as compared to younger patients. HYPOTHESIS The outcomes in elderly patients would be comparable with those in younger patients with a low rate of complications. MATERIAL AND METHODS Non-randomised prospective comparative study between 70 patients older than 65 years and 46 younger patients with AO type-C fractures. The main outcome was Disabilities Arm, Shoulder and Hand (DASH) score. Secondary variables were Patient-Rated Wrist Evaluation (PRWE) score, range of motion, Visual Analogue Scale (VAS) for pain, and grip strength. Radiological measurements were also performed. RESULTS The mean follow-up was 30.9 (range, 24-53) months. There were no significant differences in mean DASH, PRWE, VAS-pain, wrist motion or radiological parameters at final follow-up. Multivariate analysis showed that the functional outcomes were significantly influenced by baseline ulnar positivity greater than 3mm at baseline but not by age. DISCUSSION The study hypothesis was confirmed. Surgical treatment with volar locking plate for displaced complete intra-articular fractures of the distal radius in elderly patients represents a safe and effective treatment alternative with similar early complication rate than in younger. LEVEL OF EVIDENCE III, cohort study.
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Nguyen A, Vather M, Bal G, Meaney D, White M, Kwa M, Sungaran J. Does a Hand Strength-Focused Exercise Program Improve Grip Strength in Older Patients With Wrist Fractures Managed Nonoperatively?: A Randomized Controlled Trial. Am J Phys Med Rehabil 2020; 99:285-290. [PMID: 32195715 DOI: 10.1097/phm.0000000000001317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Distal radius fractures in the older population significantly impair grip strength. The aim of the study was to investigate whether a hand strength focused exercise program during the period of immobilization for nonoperatively managed distal radius fractures in this population improved grip strength and quality of life. DESIGN This is a single-center randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Fifty-two patients older than 60 yrs who experienced distal radius fractures managed nonoperatively with cast immobilization. The intervention group (n = 26) received a home hand strength-focused exercise program from 2 and 6 wks after injury while immobilized in a full short arm cast. The control group (n = 26) performed finger range of motion exercises as per protocol. Primary outcome was grip strength ratio of injured arm compared with uninjured arm. Secondary outcome included functional scores of the 11-item shortened version of the Disabilities of the Arm, Shoulder and Hand. Outcomes were measured at 2, 6, and 12 wks after injury. RESULTS The intervention group significantly improved grip strength ratio at both 6 and 12 wks (6 wks: 40% vs 25%, P = 0.0044, and 12 wks: 81% vs 51%, P = 0.0035). The intervention group improved the 11-item Disabilities of the Arm, Shoulder and Hand score at 12 wks; however, this was not statistically significant (25 vs 40, P = 0.066). CONCLUSIONS A hand strength-focused exercise program for elderly patients with distal radius fractures while immobilized significantly improved grip strength.
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Affiliation(s)
- Antony Nguyen
- From the Liverpool Hospital, Liverpool, New South Wales, Australia (AN); Concord Hospital, Sydney, New South Wales, Australia (AN, MV, GB, DM, MW, MK, JS); and Royal North Shore Hospital, Sydney, New South Wales, Australia (GB, MK)
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Jensen J, Rasmussen BSB, Duus LA, Torfing T, Precht H, Tromborg H, Graumann O. Distal radius fractures and radiographic assessment: a systematic review of measurement accuracy. Acta Radiol 2019; 60:1482-1489. [PMID: 30845815 DOI: 10.1177/0284185119834687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Janni Jensen
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Benjamin SB Rasmussen
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Louise A Duus
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Trine Torfing
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Helle Precht
- CONRAD Research Program, University College Lillebelt, Odense, Denmark
- Cardiology Research department, Odense University hospital, Svendborg
| | - Hans Tromborg
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopedic Surgery, Odense University Hospital, Odense, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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First Place Award: A radiographic analysis of closed reduction and casting of distal radial fractures with consideration of candidacy. CURRENT ORTHOPAEDIC PRACTICE 2019. [DOI: 10.1097/bco.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Radiographic Thresholds With Increased Odds of a Poor Outcome Following Distal Radius Fractures in Patients Over 65 Years Old. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2019. [DOI: 10.1016/j.jhsg.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Watanabe K. Carpal Alignment in Distal Radius Fractures Following Volar Locking Plate Fixation. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2019. [DOI: 10.1016/j.jhsg.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Lalone E, MacDermid J, Grewal R, King G. Patient Reported Pain and Disability Following a Distal Radius Fracture: A Prospective Study. Open Orthop J 2017; 11:589-599. [PMID: 28979578 PMCID: PMC5620403 DOI: 10.2174/1874325001711010589] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/11/2017] [Accepted: 05/14/2017] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- Emily Lalone
- Western Univeristy - Mechanical and Materials Engineering, 1151 Richmond Street, London, Ontario N6A 5B9, Canada
| | - Joy MacDermid
- McMaster University - School of Rehabilitation Science, Rm 429, IAHS Victoria, Hamilton, Ontario L8S 1C7, Canada
| | - Ruby Grewal
- The University of Western Ontario - Roth
- McFarlane Hand and Upper Limb Center, St Joseph's Health Center 268 Grosvenor Street, London, Ontario N6A 4L6, Canada
| | - Graham King
- Roth
- McFarlane Hand and Upper Limb Centre - Orthopedic Surgery, London, Ontario, Canada
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