Association Between Radiological and Patient-Reported Outcome in Adults With a Displaced Distal Radius Fracture: A Systematic Review and Meta-Analysis

Mulders, Marjolein A. M.; Detering, Robin; Rikli, Daniel; Rosenwasser, Melvin P.; Goslings, J. Carel; Schep, N.W.L.

doi:10.1016/j.jhsa.2018.05.003

Cited by 42 publications

(32 citation statements)

References 40 publications

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“…39 – 43 However, multiple studies have also suggested that clinically important differences in the outcomes are not associated with anatomic radiographic reduction parameters and that other factors may play a more important role. 27 , 44 – 52 This study supports that near-anatomic reduction, especially at the time of long-term follow up, may provide no clinically important additional benefit. More studies are needed to evaluate whether a poor anatomic reduction leads to long-term issues due to potential changes in carpal stability and radiocarpal degenerative changes.…”

Section: Discussionsupporting

confidence: 57%

“…25 Radial height outside of the AAOS criteria was defined as less than 8.6 mm, based on the average population’s radial height. 26 The methods of measurement were based on those described by Mulders et al 27 Patients who met the inclusion criteria were notified via email that they would be receiving a request to complete a QuickDASH questionnaire via email or phone call, and if they did not want to be contacted, they could notify the study investigators or decline the request. For responders, REDCap was used to collect QuickDASH scores at the time of final follow up.…”

Section: Methodsmentioning

confidence: 99%

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Evaluating the Impact of Social Deprivation on Mid-Term Outcomes Following Distal Radius Open Reduction Internal Fixation

Zeidan

Stephens

Zhang

et al. 2021

Journal of Hand Surgery Global Online

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Although baseline biopsychosocial factors are associated with short-term patient-reported outcomes following distal radius fracture open reduction internal fixation (ORIF), their effect on midterm outcomes is unclear. We aimed to evaluate the effect of social deprivation, previously established as a surrogate for depression, pain interference, and anxiety, on quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores >1 year following distal radius ORIF. Methods: Adult patients (!18 years) with an isolated distal radius fracture treated with ORIF by orthopedic trauma and hand surgeons at a single tertiary academic center over a 3-year period were included. Outcomes at !1 year postoperatively were evaluated using QuickDASH. Age, follow-up duration, area deprivation index (ADI; a measure of social deprivation), subspecialty (hand vs trauma), and postoperative alignment were assessed using linear regression with 95% confidence intervals after bootstrapping and a permutation test for P values to test for their association with the final QuickDASH score. Results: Follow-up data were obtained for 98 of 220 (44.5%) patients at a mean of 3.1 ± 1.0 years after surgery. Mean age and ADI were 53.2 ± 15.4 years and 26.8 ± 18.7, respectively. Most fractures were intra-articular (67.3%), and 72.4% had acceptable postoperative alignment parameters, as defined by the American Academy of Orthopaedic Surgeons clinical practice guidelines. The mean QuickDASH score was 13.0 ± 16.5. There were no significant associations between the final QuickDASH score and any studied factor, including ADI, as determined using univariable analysis. Multivariable analysis showed no association between ADI and the final QuickDASH score, independent of age, sex, treating service, follow-up duration, and fracture alignment or pattern. Conclusions: At mid-term follow up after distal radius ORIF, ADI did not correlate with QuickDASH scores, and the QuickDASH scores of the patients did not differ from those of the general population. However, our cohort mostly comprised patients with levels of deprivation below the national median. Although studies have shown that the short-term outcomes of distal radius ORIF are influenced by biopsychosocial factors, outcomes at the time of final recovery may not be associated with social deprivation. Type of study/level of evidence: Prognostic IV.

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Section: Discussionsupporting

confidence: 57%

Section: Methodsmentioning

confidence: 99%

Evaluating the Impact of Social Deprivation on Mid-Term Outcomes Following Distal Radius Open Reduction Internal Fixation

Zeidan

Stephens

Zhang

et al. 2021

Journal of Hand Surgery Global Online

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“…Today, companies offer a wide range of specifically designed plates and screws to provide ideal stabilization for each fracture type. Arthroscopically assisted techniques broadened the technique spectrum especially when reducing intraarticular fractures [28][29][30][31][32][33][34][35]. Selecting the optimal choice from the different options available becomes difficult, especially for young surgeons with minor experience.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Hintringer¹,

Rosenauer

Pezzei

et al. 2020

Arch Orthop Trauma Surg

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A wide range of different classifications exist for distal radius fractures (DRF). Most of them are based on plane X-rays and do not give us any information on how to treat these fractures. A biomechanical understanding of the mechanical forces underlying each fracture type is important to treat each injury specifically and ensure the optimal choice for stabilization. The main cause of DRFs are forces acting on the carpus and the radius as well as the position of the wrist in relation to the radius. Reconstructing the mechanism of the injury gives insight into which structures are involved, such as ruptured ligaments, bone fragments as well as the dislocated osteoligamentous units. This article attempts to define certain key fragments, which seem crucial to reduce and stabilize each type of DRF. Once the definition is established, an ideal implant can be selected to sufficiently maintain reduction of these key fragments. Additionally, the perfect approach is selected. By applying the following principles, the surgeon may be assisted in choosing the ideal form of treatment approach and implant selection.

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“…It makes sense to hypothesize that flattening a wet circumferential applied cast at the level of the wrist before it has hardened is essential to prevent redisplacement. Noteworthy to mention is that radial shortening seems to have the most significant negative impact on patient-reported outcomes during follow-up, making this parameter a potentially important factor in predicting outcome [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Does circumferential casting prevent fracture redisplacement in reduced distal radius fractures? A retrospective multicentre study

et al. 2021

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Background This study evaluates whether a circumferential cast compared to a plaster splint leads to less fracture redisplacement in reduced extra-articular distal radius fractures (DRFs). Methods This retrospective multicentre study was performed in four hospitals (two teaching hospitals and two academic hospitals). Adult patients with a displaced extra-articular DRF, treated with closed reduction, were included. Patients were included from a 5-year period (January 2012–January 2017). According to the hospital protocol, fractures were immobilized with a below elbow circumferential cast (CC) or a plaster splint (PS). The primary outcome concerned the difference in the occurrence of fracture redisplacement at one-week follow-up. Results A total of 500 patients were included in this study (PS n = 184, CC n = 316). At one-week follow-up, fracture redisplacement occurred in 52 patients (17%) treated with a CC compared to 53 patients (29%) treated with a PS. This difference was statistically significant (p = 0.001). Conclusion This study suggests that treatment of reduced DRFs with a circumferential cast might cause less fracture redisplacement at 1-week follow-up compared to treatment with a plaster splint. Level of Evidence Level III, Retrospective study.

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Association Between Radiological and Patient-Reported Outcome in Adults With a Displaced Distal Radius Fracture: A Systematic Review and Meta-Analysis

Abstract: Prognostic IV.

Cited by 42 publications

References 40 publications

Evaluating the Impact of Social Deprivation on Mid-Term Outcomes Following Distal Radius Open Reduction Internal Fixation

Evaluating the Impact of Social Deprivation on Mid-Term Outcomes Following Distal Radius Open Reduction Internal Fixation

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Does circumferential casting prevent fracture redisplacement in reduced distal radius fractures? A retrospective multicentre study

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