The aims of this study in relation to distal radius fractures were to determine (1) the floor and ceiling effects for the QuickDASH and PRWE, (2) the floor and ceiling effects when defined to be within the minimal clinically important difference (MCID) of the minimal or maximal scores, (3) the degree to which patients with a floor or ceiling effect felt that their wrist was ‘normal’, and (4) patent factors associated with a floor or ceiling effect. A retrospective cohort study of patients sustaining a distal radius fracture during a single year was undertaken. Outcome measures included the QuickDASH, PRWE, EQ-5D-3L and normal wrist score. There were 526 patients with a mean age of 65yrs and 77% were female. Most patients were managed non-operatively (73%, n=385). The mean follow-up was 4.8yrs. A ceiling effect was observed for both the QuickDASH (22.3%) and PRWE (28.5%). When defined to be within the MCID of the best score, the effect increased to 62.8% for the QuickDASH and 60% for PRWE. Patients that achieved the best functional outcome according to the QuickDASH and PRWE felt their wrist was only 91% and 92% normal, respectively. Sex (p=0.000), age (p=0.000), dominant
Fractures of the distal radius are common, and form a considerable proportion of the trauma workload. We conducted a study to examine the patterns of injury and treatment for adult patients presenting with distal radius fractures to a major trauma centre serving an urban population. We undertook a retrospective cohort study to identify all patients treated at our major trauma centre for a distal radius fracture between 1 June 2018 and 1 May 2021. We reviewed the medical records and imaging for each patient to examine patterns of injury and treatment. We undertook a binomial logistic regression to produce a predictive model for operative fixation or inpatient admission.Aims
Methods
There is a lack of published evidence relating to the rate of nonunion seen in occult scaphoid fractures, diagnosed only after MRI. This study reports the rate of delayed union and nonunion in a cohort of patients with MRI-detected acute scaphoid fractures. This multicentre cohort study at eight centres in the UK included all patients with an acute scaphoid fracture diagnosed on MRI having presented acutely following wrist trauma with normal radiographs. Data were gathered retrospectively for a minimum of 12 months at each centre. The primary outcome measures were the rate of acute surgery, delayed union, and nonunion.Aims
Methods
To compare operative and nonoperative treatment for displaced distal radius fractures in patients aged over 65 years. A total of 100 patients were randomized in this non-inferiority trial, comparing cast immobilization with operation with a volar locking plate. Patients with displaced AO/OTA A and C fractures were eligible if one of the following were found after initial closed reduction: 1) dorsal angulation > 10°; 2) ulnar variance > 3 mm; or 3) intra-articular step-off > 2 mm. Primary outcome measure was the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) after 12 months. Secondary outcome measures were the Patient-Rated Wrist and Hand Evaluation (PRWHE), EuroQol-5 dimensions 5-level questionnaire (EQ-5D-5L), range of motion (ROM), grip strength, “satisfaction with wrist function” (score 0 to 10), and complications.Aims
Methods
Distal radial fractures are the most common fracture sustained by the adult population. Most can be treated using cast immobilization without the need for surgery. The aim of this study was to assess the feasibility of a definitive trial comparing the commonly used fibreglass cast immobilization with an alternative product called Woodcast. Woodcast is a biodegradable casting material with theoretical benefits in terms of patient comfort as well as benefits to the environment. This was a multicentre, two-arm, open-label, parallel-group randomized controlled feasibility trial. Patients with a fracture of the distal radius aged 16 years and over were recruited from four centres in the UK and randomized (1:1) to receive a Woodcast or fibreglass cast. Data were collected on participant recruitment and retention, clinical efficacy, safety, and patient acceptability.Aims
Methods
To synthesise the literature and perform a meta-analysis detailing
the longitudinal recovery in the first two years following a distal
radius fracture (DRF) managed with volar plate fixation. Three databases were searched to identify relevant articles.
Following eligibility screening and quality assessment, data were
extracted and outcomes were assimilated at the post-operative time
points of interest. A state-of-the-art longitudinal mixed-effects
meta-analysis model was employed to analyse the data.Aims
Materials and Methods
Patient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with distal radial fractures. Which PROM to select is often based on assessment of measurement properties, such as validity and reliability. Measurement properties are assessed in clinimetric studies, and results are often reviewed without considering the methodological quality of these studies. Our aim was to systematically review the methodological quality of clinimetric studies that evaluated measurement properties of PROMs used in patients with distal radial fractures, and to make recommendations for the selection of PROMs based on the level of evidence of each individual measurement property. A systematic literature search was performed in PubMed, EMbase, CINAHL and PsycINFO databases to identify relevant clinimetric studies. Two reviewers independently assessed the methodological quality of the studies on measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Level of evidence (strong / moderate / limited / lacking) for each measurement property per PROM was determined by combining the methodological quality and the results of the different clinimetric studies.Objectives
Methods
