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Article
A cohort study of one-year functional and radiographic outcomes following intra-articular distal radius fractures
Hand
  • Emily A. Lalone, Hand and Upper Limb Centre
  • Vaishnav Rajgopal, Western University
  • James Roth, Western University
  • Ruby Grewal, Western University
  • Joy C. MacDermid, Hand and Upper Limb Centre
Document Type
Article
Publication Date
1-1-2014
URL with Digital Object Identifier
10.1007/s11552-013-9586-6
Abstract

Background: The purpose of this study was to describe the outcomes of a series of patients followed prospectively after intra-articular distal radius fractures. Methods: One hundred forty-eight patients with intra-articular fractures (mean age, 47 years; age range, 44-54 years; gender distribution, 60 males and 88 females) were treated with cast only, arthroscopy/closed reduction plus pins, arthroscopy/closed reduction with external fixation, open reduction and internal fixation (ORIF) alone, and ORIF with external fixation according to surgeon preference and fracture characteristics. The 1-year outcomes across the groups were measured radiographically (n = 148) and functionally (n = 113; 1-year Wrist Outcome Measure score, Grip Strength, SF-36, and PRWE scores). Results: Radiographically, the groups had statistically significant differences in radial inclination, volar tilt, intra-articular step-off, and radial shortening in the pre-treatment X-rays. However, following treatment, treatment groups demonstrated no difference statistically in their follow-up radiographic measures. One-year PRWE scores were found to be statistically different across groups. Across groups, the ORIF-alone treatment group had the highest PRWE score reflecting greatest amount of pain and disability. One-year wrist outcome measure scores and grip strength scores were also found to be significantly different across treatment groups. The general health status as measured by the SF-36 was not found to be different across treatment groups. Conclusions: These findings are consistent with treatment by indication; suboptimal ORIF outcomes may reflect older practice patterns with dorsal plating. A randomized control trial that compares treatments controlling for fracture severity and studies that develop formal clinical prediction rules for treatment assignment are needed. © 2014 American Association for Hand Surgery.

Citation Information
Emily A. Lalone, Vaishnav Rajgopal, James Roth, Ruby Grewal, et al.. "A cohort study of one-year functional and radiographic outcomes following intra-articular distal radius fractures" Hand Vol. 9 Iss. 2 (2014) p. 237 - 243
Available at: http://works.bepress.com/joy-macdermid/3/