Fractures of the distal forearm in young adults: An epidemiologic description of 341 patients

Lindau, Tommy; Aspenberg, Per; Arner, Marianne; Redlundh-Johnell, Inga; Hagberg, Lars

doi:10.3109/17453679909011248

Cited by 66 publications

(49 citation statements)

References 24 publications

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“…Lindau et al [15] found that distal radial fractures in men younger than 60 and women younger than 50 represent a special group and were intraarticular in more than two thirds of the cases, displaced in 50%, and were mostly caused by severe trauma. Furthermore, they were often combined with intraarticular pathology as intercarpal ligament ruptures, triangular fibro cartilaginous complex pathology, and cartilage damage.…”

Section: Discussionmentioning

confidence: 99%

The Buttazzoni Classification of Distal Radial Fractures in Adults: Interobserver and Intraobserver Reliability

Wadsten

Sayed-Noor

Sjödén

et al. 2009

Hand (New York, N,Y.)

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Despite the fact that distal radial fracture is the commonest fracture, there is a little evidence-based knowledge about the value of its classification to guide management and predict prognosis. The available classification systems are either complicated or weakly applicable in clinical practice. Older's classification is the most reliable, but does not cover all radial fracture types. We evaluated the interobserver and intraobserver reliability of a new classification system which is a modification of Older's classification covering all radial fracture types. Two hundred and thirty-two consecutive adult patients with acute distal radial fractures were blindly evaluated according to the new classification by three orthopedic surgeons twice with 1-year interval. The interobserver reliability was measured using the Fleiss kappa coefficient, and the intraobserver reliability was measured using the Cohen's kappa coefficient. The new classification showed fair to substantial interobserver and intraobserver reliability, i.e., results comparable to the reliability of commonly used classification systems. The reliability was better for younger patients and when evaluation was carried out by handsurgery-interested orthopedic surgeons. The new classification system is simple, covers all radial fracture types, and has an acceptable reliability. Further studies are needed to judge its ability to direct management and predict prognosis.

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Section: Discussionmentioning

confidence: 99%

The Buttazzoni Classification of Distal Radial Fractures in Adults: Interobserver and Intraobserver Reliability

Wadsten

Sayed-Noor

Sjödén

et al. 2009

Hand (New York, N,Y.)

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“…The operations performed in these 133 patients were divided into 4 groups: external fixation (63 patients), internal fixation with the TriMed system (51 patients), internal fixation with volar plating (16 patients), and other procedures (3 patients: 1 screw fixation, and 2 with combined internal and external fixation) ( Figure 5). As in previous studies, we arbitrarily defined men less than 60 years of age and women below the age of 50 to constitute a non-osteoporotic age group, as opposed to the older osteoporotic age group (Kopylov et al 1993, Lindau et al 1999 DASH questionnaire DASH is a self-administered questionnaire that was developed by the AAOS and the Institute for Work and Health in Canada (Hudak et al 1996). A Swedish version has been validated for use in upper extremity disorders but not specifically for distal radius fractures (Atroshi et al 2000).…”

Section: Patient Groupsmentioning

confidence: 99%

Evaluation of a treatment protocol in distal radius fractures

2008

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Background and purpose Distal radius fractures are most often treated nonoperatively, but sometimes they are treated surgically when deemed unstable. Based on the literature, a consensus protocol for treatment has been developed in southern Sweden to aid clinicians in their decision making. We evaluated the results of this protocol prospectively using a validated outcome instrument (DASH) in a large consecutive and populationbased series of unselected patients.Methods 581 patients were treated according the protocol. Age, sex, fracture side, and type of treatment were registered. The subjective outcome was measured by DASH. 133 patients were operated.Results 75% of the patients returned the questionnaire. The median DASH score at 3 months was 18.3 and at 12 months it was 7.5. All treatment groups had low DASH scores at the final follow-up. Reduced, nonoperated fractures had a worse score (11.6) than undisplaced (4.2) or operated fractures (6.0). Age was the only other predictor, with older patients having a worse score. A correlation was found between the short-version 11-item QuickDASH questionnaire and the full 30-item DASH, both at 3 months (r = 0.98) and at 1 year (r = 0.97) (p < 0.001 for both).Interpretation Most patients have residual symptoms at 3 months after the fracture but are normalized at 1 year. Good final subjective result was achieved with the proposed protocol regardless of initial severity and treatment of the fracture, as indicated by a low median DASH score in all groups. There was correlation between QuickDASH and the full DASH, and the former could be used in future studies.

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“…The mean VAS was 1.3 (0-5.9), the mean DASH score was 6.6 (0-22.5) and the mean G&W score was 4.7 (1)(2)(3)(4)(5)(6)(7)(8)(9). There were five patients with a positive Tolat test.…”

Section: Clinical Analysismentioning

confidence: 95%

“…2,3,5,9,17,19 While the relationship between the distal radius and ulna has received much attention in Galeazzi fractures, in reducing an isolated distal radius fracture the DRUJ is largely ignored. Traditional criteria for a successful reposition depend on the angulation, inclination and length of the distal radius, as well as intraarticular radio-carpal step-off.…”

Section: Introductionmentioning

confidence: 99%

The distal radio-ulnar joint: Persisting deformity in well reduced distal radius fractures in an active population

et al. 2007

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Introduction: Ulnar pain is reported in 20-37% after a distal radius fracture, related to incongruence and osteoarthritis of the distal radio-ulnar joint (DRUJ). Our hypothesis is that even well reduced conservative treated distal radius fractures (according to traditional criteria) result in a deformity of the DRUJ. Patients and methods: Eighteen non-osteoporotic patients with a distal radius fracture treated conservatively between 1998 and 2001 were reviewed. Of both wrists, a CT scan was performed in pronation, neutral position and supination. Deformities and congruence were evaluated and measured. Pain-and disability scores, special DRU tests, range of motion and grip strength were measured. Results: Out of 18 patients, 17 had arthritic changes in the DRUJ versus 1 in the contra lateral wrist ( p < 0.001).In neutral position significant DRUJ incongruence was found in the fractured wrist compared to the contra lateral side ( p = 0.047). There were few complaints but in 28% there was a positive Tolat test, related to higher pain scores. Ulnar deviation and supination even as grip strength were worse in the fractured wrist. Conclusions: Well reduced distal radius fractures according to traditional criteria, do lead to serious radiographic pathologies shown on CT scans. #

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Fractures of the distal forearm in young adults: An epidemiologic description of 341 patients

Cited by 66 publications

References 24 publications

The Buttazzoni Classification of Distal Radial Fractures in Adults: Interobserver and Intraobserver Reliability

The Buttazzoni Classification of Distal Radial Fractures in Adults: Interobserver and Intraobserver Reliability

Evaluation of a treatment protocol in distal radius fractures

The distal radio-ulnar joint: Persisting deformity in well reduced distal radius fractures in an active population

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