Critical Analysis of Causality between Negative Ulnar Variance and Kienböck Disease

Stahl, Stéphane; Stahl, Adelana Santos; Meisner, Christoph; Hentschel, P.; Valina, Stephan; Luz, Oliver; Schaller, Hans-Eberhard; Lotter, Oliver

doi:10.1097/prs.0b013e31829f4a2c

Cited by 46 publications

(23 citation statements)

References 48 publications

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“…We applied these criteria to determine the relationship between vitamin C and CRPS similar to health research in other medical specialties. (14–16) Strength of association, consistency, specificity, temporality, biological gradient (dose response relationship), biological plausibility, coherence, experimental evidence, and analogy constitute the 9 Hill criteria. (17) We determined a criterion to be met when a definition and explanation of it provided by Hill were valid with vitamin C and CRPS based on the available evidence.…”

Section: Methodsmentioning

confidence: 99%

“…We did not find any information about the number of criterion to be met for an association to be considered causal, but we observed that if majority of criteria were met, the authors considered the association to be causal. (14–16) In addition, there was a lack of information about the weightage of individual criterion. In the preparation of this manuscript, the authors adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.…”

Section: Methodsmentioning

confidence: 99%

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Testing the Validity of Preventing Complex Regional Pain Syndrome With Vitamin C After Distal Radius Fracture

Malay¹,

Chung²

2014

The Journal of Hand Surgery

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Purpose The American Academy of Orthopaedic Surgeons (AAOS) recommends the use of vitamin C to prevent complex regional pain syndrome (CRPS) for patients with distal radius fractures (DRF). We hypothesized that the evidence for supporting this recommendation is weak, based on epidemiological principles of association and causality. The specific aim of this project was to test the validity of this recommendation. Methods We conducted a literature review to retrieve articles reporting on the use of vitamin C to prevent CRPS. Data collected included sample size, study design type, dose of vitamin C used, and outcome measures of association expressed as relative risk and odds ratio. We then applied Hill criteria to evaluate the relationship between vitamin C and CRPS. Results We obtained 225 articles from the database search. After the exclusion of duplicates, unrelated articles, editorial letters, and commentaries, we found 4 articles and one systematic review relevant to our topic. Six of the nine Hill criteria were met, and an earlier meta-analysis showed a quantified reduction in CRPS risk. However, criteria like biological plausibility, specificity, and coherence were not met. Conclusions The number of causal/association criteria met was adequate to support the scientific premise of the effect of vitamin C in preventing CRPS after distal radius fracture. Furthermore, vitamin C administration is of relatively low cost and has few complications unless administered in large doses. Owing to sufficient epidemiological evidence availability, the AAOS recommendation of vitamin C to prevent CRPS has practical merit. Level of evidence Therapeutic, Level II.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Testing the Validity of Preventing Complex Regional Pain Syndrome With Vitamin C After Distal Radius Fracture

Malay¹,

Chung²

2014

The Journal of Hand Surgery

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“…Although there is no published research to indicate that PLFD does not alter the UV individually in the absence of distal radius fracture, numerous studies implicated possible role of UV in the pathogenesis of Kienbock’s disease, or instability in the wrist and carpal ligamentous disruption (3, 12-14). …”

Section: Discussionmentioning

confidence: 99%

Distal Radius Radiographic Indices and Perilunate Fracture Dislocation

et al. 2016

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BackgroundDistal radius radiographic indices may play a role as risk factors in pathogenesis of Kienbock’s disease, scaphoid fracture and nonunion. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature.ObjectivesThe aim of this study was to evaluate the possible role of distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt as risk factors in the perilunate fracture dislocation injury of the wrist.Patients and MethodsWe studied distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt in 43 patients with perilunate fracture dislocations and compared them with 44 wrists in the control group.ResultsThe mean values of the radial height, radial inclination, ulnar variance and volar tilt were 12.74 (5 - 18), 24.20 (7 - 35), -0.73 (-5 - 4) and 12.28 (2 - 20) in the patient group. These values were 12.68 (9 - 22), 23.22 (17 - 30), -0.11 (-4 - 3) and 11.05 (-3 - 20), respectively in the control group. There was no statistically significant difference between the two groups.ConclusionsThis study did not show that distal radius anatomical indices including the radial height, radial inclination, ulnar variance and volar tilt influence perilunate fracture dislocation as risk factors.

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“…It is characterized by lunate sclerosis, cystic changes, fragmentation and articular surface collapse on plain radiograph [3,4]. It occurs most commonly in men aged 20 to 40 years of age.…”

Section: Introductionmentioning

confidence: 99%