Abstract
Background: Distal radius fractures are the most common fractures at the ER and constitute about 1/6 of all fractures. We report the patient related outcome scores as measured prospectively and consecutively with the DASH- score (Disabilities of the Arm Shoulder and Hand) in an unselected cohort of distal radius fractures. It is often stated that fractures in a non-osteoporotic age group were more severe than in an elderly group.
Materials and Methods: 542 patients, at the age of 18 and above with a distal radius fracture were registered between September 2001 and June 2003,. Age, gender and treatment were registered and DASH-forms sent to the patients at 3 and 12 months post fracture. 50 patients were excluded because of physical or mental inability to fill out the form. 352 of the remaining 493 patients completed the 3 months form and 355 the 12 months form. 127 patients were operated with external fixation or internal fixation due to unstable fractures and the rest were treated conservatively in a cast for four weeks. The patients were subdivided in a non-osteoporotic group, defined as men under the age of 60 and women under the age of 50 and an osteoporotic group above that age. The DASH-form was sent to an age- and gender-matched control group for comparison
Results: The response rate was 72% at both 3 months and 12 months. For the whole group the DASH score decreased from 24 at 3 months to 17 at 12 months (p< 0,001; scale range 0–100). The DASH-score in the younger, non-osteoporotic group was 17 and 12 and for the osteoporotic group 27 and 18 at 3 and 12 months respectively. At one year there was no difference in DASH score between the operated patients and the patients treated conservatively. In the age and gender matched control-group DASH score was 8; in the older group 10 and in the younger 3.
Conclusion: A distal radius fracture has a great impact on the patients function the first year as measured with the validated DASH-score. Three months after fracture patients have markedly increased DASH-score, which decreases slowly for the next nine months but do not normalize as compared to a non-injured matched population. The worst scores are seen in the older population. In our experience operative treatment in the unstable fractures manages to restore function to a level equal to patients with stabile, conservatively treated fractures.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
