Distal Radius Malunion Increases Risk of Persistent Disability 2 Years After Fracture: A Prospective Cohort Study.
(2013) In Clinical Orthopaedics and Related Research 471(5). p.1691-1697- Abstract
- BACKGROUND: Studies concerning the relationship between distal radius fracture malunion and a persistent arm-related disability have produced conflicting results. QUESTIONS/PURPOSES: We investigated (1) how arm-related disability changes during the first 2 years after a fracture and (2) whether fracture malunion causes persistent disability. METHODS: One hundred twenty-three patients with distal radius fractures, treated with closed reduction and casts or external or percutaneous pin fixations, completed the DASH questionnaire at baseline, 3 months, 6 months, 1 year, and 2 years after fracture. Radiographic measurements were made at 1 year. Using a definition of malunion as ulnar variance of 1 mm or more and dorsal tilt greater than 10°,... (More)
- BACKGROUND: Studies concerning the relationship between distal radius fracture malunion and a persistent arm-related disability have produced conflicting results. QUESTIONS/PURPOSES: We investigated (1) how arm-related disability changes during the first 2 years after a fracture and (2) whether fracture malunion causes persistent disability. METHODS: One hundred twenty-three patients with distal radius fractures, treated with closed reduction and casts or external or percutaneous pin fixations, completed the DASH questionnaire at baseline, 3 months, 6 months, 1 year, and 2 years after fracture. Radiographic measurements were made at 1 year. Using a definition of malunion as ulnar variance of 1 mm or more and dorsal tilt greater than 10°, the patients were classified into three groups: no malunion (n = 35), malunion involving either ulnar variance or dorsal tilt (n = 65), and malunion involving ulnar variance and dorsal tilt (n = 23). The changes in the DASH scores with time (baseline to 2 years), in relation to malunion, were analyzed using generalized estimating equations adjusted for age, sex, fracture type (extraarticular or intraarticular), and treatment method. RESULTS: The mean change in DASH scores from baseline to 2 years was worse for patients with malunions involving ulnar variance and dorsal tilt than for patients with no malunions (mean difference, 13; 95% CI, 1.4-25) and for patients with malunions involving either ulnar variance or dorsal tilt (mean difference, 13; 95% CI, 2.2-24). CONCLUSION: After distal radius fracture, arm-related disabilities are more likely to persist at least 2 years in patients with fractures that healed with shortening and dorsal angulation than in patients with only shortening or dorsal angulation or without malunion. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3438169
- author
- Brogren, Elisabeth LU ; Wagner, Philippe LU ; Petranek, Michael and Atroshi, Isam LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Clinical Orthopaedics and Related Research
- volume
- 471
- issue
- 5
- pages
- 1691 - 1697
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000316959100042
- pmid:23361928
- scopus:84876670560
- pmid:23361928
- ISSN
- 0009-921X
- DOI
- 10.1007/s11999-012-2767-8
- language
- English
- LU publication?
- yes
- id
- 116713c2-ad14-4182-9853-ba5096f8011f (old id 3438169)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23361928?dopt=Abstract
- date added to LUP
- 2016-04-01 10:26:49
- date last changed
- 2022-04-20 02:11:42
@article{116713c2-ad14-4182-9853-ba5096f8011f,
abstract = {{BACKGROUND: Studies concerning the relationship between distal radius fracture malunion and a persistent arm-related disability have produced conflicting results. QUESTIONS/PURPOSES: We investigated (1) how arm-related disability changes during the first 2 years after a fracture and (2) whether fracture malunion causes persistent disability. METHODS: One hundred twenty-three patients with distal radius fractures, treated with closed reduction and casts or external or percutaneous pin fixations, completed the DASH questionnaire at baseline, 3 months, 6 months, 1 year, and 2 years after fracture. Radiographic measurements were made at 1 year. Using a definition of malunion as ulnar variance of 1 mm or more and dorsal tilt greater than 10°, the patients were classified into three groups: no malunion (n = 35), malunion involving either ulnar variance or dorsal tilt (n = 65), and malunion involving ulnar variance and dorsal tilt (n = 23). The changes in the DASH scores with time (baseline to 2 years), in relation to malunion, were analyzed using generalized estimating equations adjusted for age, sex, fracture type (extraarticular or intraarticular), and treatment method. RESULTS: The mean change in DASH scores from baseline to 2 years was worse for patients with malunions involving ulnar variance and dorsal tilt than for patients with no malunions (mean difference, 13; 95% CI, 1.4-25) and for patients with malunions involving either ulnar variance or dorsal tilt (mean difference, 13; 95% CI, 2.2-24). CONCLUSION: After distal radius fracture, arm-related disabilities are more likely to persist at least 2 years in patients with fractures that healed with shortening and dorsal angulation than in patients with only shortening or dorsal angulation or without malunion. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.}},
author = {{Brogren, Elisabeth and Wagner, Philippe and Petranek, Michael and Atroshi, Isam}},
issn = {{0009-921X}},
language = {{eng}},
number = {{5}},
pages = {{1691--1697}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Clinical Orthopaedics and Related Research}},
title = {{Distal Radius Malunion Increases Risk of Persistent Disability 2 Years After Fracture: A Prospective Cohort Study.}},
url = {{http://dx.doi.org/10.1007/s11999-012-2767-8}},
doi = {{10.1007/s11999-012-2767-8}},
volume = {{471}},
year = {{2013}},
}