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Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.

Abramo, Antonio LU ; Kopylov, Philippe LU and Tägil, Magnus LU (2008) In Acta Orthopaedica 79(3). p.376-385
Abstract
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 population based 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... (More)
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 population based 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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Fractures, Malunited: surgery, Fracture Fixation: methods, Malunited: therapy, Ununited: surgery, Ununited: therapy, Radius Fractures: therapy, Radius Fractures: surgery
in
Acta Orthopaedica
volume
79
issue
3
pages
376 - 385
publisher
Taylor & Francis
external identifiers
  • wos:000257593200011
  • pmid:18622842
  • scopus:47249108583
ISSN
1745-3682
DOI
10.1080/17453670710015283
language
English
LU publication?
yes
id
73ff52e2-60c5-447e-ad13-362758e05009 (old id 1181219)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18622842?dopt=Abstract
date added to LUP
2008-08-08 16:08:02
date last changed
2017-09-24 04:07:55
@article{73ff52e2-60c5-447e-ad13-362758e05009,
  abstract     = {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 population based 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&lt; 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.},
  author       = {Abramo, Antonio and Kopylov, Philippe and Tägil, Magnus},
  issn         = {1745-3682},
  keyword      = {Fractures,Malunited: surgery,Fracture Fixation: methods,Malunited: therapy,Ununited: surgery,Ununited: therapy,Radius Fractures: therapy,Radius Fractures: surgery},
  language     = {eng},
  number       = {3},
  pages        = {376--385},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.},
  url          = {http://dx.doi.org/10.1080/17453670710015283},
  volume       = {79},
  year         = {2008},
}