Objectives. The patient-rated wrist evaluation (PRWE) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are patient-reported outcome measures (PROMs) used for clinical and research purposes. Methodological high-quality clinimetric studies that determine the measurement properties of these PROMs when used in patients with a
Objectives. Patient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with
Introduction. The distal radius is the most frequently fractured bone in the forearm with an annual fracture incidence in the UK of about 9–37 in 10,000. Restoration of normal anatomy is an important factor that dictates the final functional outcome. A number of operative options are available, including Kirschner wiring, bridging or non-bridging external fixation and open reduction and internal fixation by means of dorsal, radial or volar plates. We designed this study to analyse the clinical and radiological outcome of
Older fracture patients frequently ask whether their osteoporosis will affect fracture healing. There is only limited previous data about this. We investigated recovery after
Purpose.
Aims: To detect discriminant features in the cyclic kinematic patterns generated during selected upper limb activities of daily living by a normative and a
To ascertain the optimum number, thickness and configuration of K-wires needed to prevent displacement of
Advancements in treating complications of operatively treated distal radius fractures. We will review tips and tricks to avoid complications associated with operative fixation of these complicated injuries. We will cover treatment of the distal radioulnar joint, associated distal ulna fracture, complications of malreduction and implant prominence. During this session, we will review the latest techniques for treating these complex distal radius fractures and how to avoid associated complications.
The aim of this study was to identify psychosocial factors associated with pain intensity and disability following distal radius fracture (DRF). We prospectively followed up 216 adult patients with DRF for 9 months. Demographics, injury and treatment details and psychological measures (Hospital Anxiety and Depression Score (HADS), Pain Catastrophising Scale (PCS), Post Traumatic Stress Disorder Checklist – Civilian (PCL-C), Tampa Scale for Kinesiophobia (TSK), Illness Perception Questionnaire Brief (IPQB), General Self-efficacy Scale (GSES) and Recovery Locus of Control (RLOC)) were collected at enrolment. Multivariable linear regression was used to identify factors associated with DASH and Likert pain score. Ten week DASH was associated with age (β-coefficient (β)= 0.3, p < 0.001), deprivation score (β=0.2, p = 0.014), nerve injury (β=0.1, p = 0.014), HADS depression (β=0.2, p = 0.008), IPQB (β=0.2, p = 0.001) and RLOC (β= −0.1, p = 0.031). Nine month DASH was associated with age (β=0.1, p = 0.04), deprivation score (β=0.4, p = 0.014), number of medical comorbidities (β=0.1, p = 0.034), radial shortening (β=0.1, p = 0.035), HADS depression (β=0.2, p = 0.015) and RLOC (β= −0.1, p = 0.027). Ten week pain score was associated with deprivation score (β=0.1, p = 0.049) and IPQB (β=0.3, p < 0.001). Pain score at 9 months was associated with number of medical comorbidities (β=0.1, p = 0.047). Psychosocial factors are more strongly associated with pain and disability than injury or treatment characteristics after DRF. Identifying and treating these factors could enhance recovery.
Long term outcomes of distal radius fractures have rarely been studied prospectively and do not traditionally extend past 1–2 years following treatment. The purpose of this study was to describe the long term patient-rated pain and disability of patients after a distal radius fracture and to also determine the differences in patient reported pain and disability after one year following injury and at the long term follow-up. Patients who had previously participated in a prospective study, where baseline and standardised one year follow-up were performed following a distal radius fracture were contact to participate in this long term follow-up (LTFU) study. Eligible cases that consented agreed to evaluation which included being sent a package in the mail contain a letter of information and questionnaire. Baseline demographic data including age and sex, as well as date of fracture, mechanism of fall and attending physician information was obtained for all participating subjects. Patient rated pain and disability was measured at baseline, one year and at long-term follow-up using the Patient Rated Wrist Evaluation (PRWE). Patients were categorised as having had a worse outcome (compared to one year follow-up PRWE scores) if their LTFU PRWE score increased by 5 points, having no change in status (if their score changed by four or less points) or improved if their LTFU PRWE score decreased by 5 or more points. Sixty-five patients (17 male, 48 female) with an average age of 57 years at the time of injury and 67 years at follow-up were included in the study. The mean length of follow-up was 10.7 (± 5.8) years (range: 3–19 years). Overall, 85% of patients reported having no change or had less patient-reported pain and disability (PRWE) at their long-term follow-up compared to their one year PRWE scores. As well, one year PRWE scores were found to be predictive (20.2%) of the variability in long term PRWE score (p=0.001). This study provided data on a cohort of prospectively followed patients with a distal radius fracture, approximately 10 years after injury. This data may be useful to clinicians and therapists who are interested in determining the long term effects of this frequently occurring upper extremity fracture. The results of this study indicate that after 10 years following a distal radius fracture, 85% of patients will have good outcomes. The results of this study also indicate that majority of cases, if patients have a low amount of pain and disability at one year, then these outcomes will also be true approximately 10 years later.
Aims. The primary aim of this study is to quantify and compare outcomes following a dorsally displaced fracture of the distal radius in elderly patients (aged ≥ 65 years) who are managed conservatively versus with surgical fixation (open reduction and internal fixation). Secondary aims are to assess and compare upper limb-specific function, health-related quality of life, wrist pain, complications, grip strength, range of motion, radiological parameters, healthcare resource use, and cost-effectiveness between the groups. Methods. A prospectively registered (ISRCTN95922938) randomized parallel group trial will be conducted. Elderly patients meeting the inclusion criteria with a dorsally displaced distal radius facture will be randomized (1:1 ratio) to either conservative management (cast without further manipulation) or surgery. Patients will be assessed at six, 12, 26 weeks, and 52 weeks post intervention. The primary outcome measure and endpoint will be the Patient-Rated Wrist Evaluation (PRWE) at 52 weeks. In addition, the abbreviated version of the Disabilities of Arm, Shoulder and Hand questionnaire (QuickDASH), EuroQol five-dimension questionnaire, pain score (visual analogue scale 1 to 10), complications, grip strength (dynamometer), range of motion (goniometer), and radiological assessments will be undertaken. A cost-utility analysis will be performed to assess the cost-effectiveness of surgery. We aim to recruit 89 subjects per arm (total sample size 178). Discussion. The results of this study will help guide treatment of dorsally displaced
Aims. It is not clear which type of casting provides the best initial treatment in adults with a
The relationship between advancing patient age, decreasing bone mineral density and increasing
Displaced
The aim of this study was to investigate surgeons’ reported change of treatment preference in response to the results and conclusion from a randomized controlled trial (RCT) and to study patterns of change between subspecialties and nationalities. Two questionnaires were developed through the Delphi process for this cross-sectional survey of surgical preference. The first questionnaire was sent out before the publication of a RCT and the second questionnaire was sent out after publication. The RCT investigated repair or non-repair of the pronator quadratus (PQ) muscle during volar locked plating of
Aims. The aim of this study was to investigate surgeons’ reported change of treatment preference in response to the results and conclusion from a randomized contolled trial (RCT) and to study patterns of change between subspecialties and nationalities. Methods. Two questionnaires were developed through the Delphi process for this cross-sectional survey of surgical preference. The first questionnaire was sent out before the publication of a RCT and the second questionnaire was sent out after publication. The RCT investigated repair or non-repair of the pronator quadratus (PQ) muscle during volar locked plating of
Despite the variety of implants or techniques that exist to treat displaced
Aim: To investigate factors that influence outcomes one year after