Journal Article10.1097/BOT.0000000000000566
Determinants of Functional Outcome in Distal Radius Fractures in High-Functioning Patients Older Than 55 Years.
Jeremie Larouche,Jeffrey Pike,Gerard P. Slobogean,Pierre Guy,Henry M Broekhuyse,Peter J OʼBrien,Kelly A Lefaivre +6 more
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TL;DR: Even in high-functioning patients older than 55 years, there was no difference in patient-reported outcomes at 1 year in the open reduction group as compared with the closed reduction group, and physicians should pay particular attention to radial shortening and persistent articular gaps following their chosen treatment plan for distal radial fractures.
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Abstract: Objectives To determine the influence of treatment and radiographic parameters on patient-reported functional outcomes on a population of non-frail elderly with distal radius fractures. Design Prospective cohort study. Setting Level 1 trauma center. Patients/participants Patients older than 55 years presenting with a distal radius fracture and a Canadian Study of Health and Aging Clinical Frailty Scale score of 1 or 2. Intervention Closed reduction and casting or open reduction and internal fixation as per the treating surgeons' decision. Main outcome measures Radiographic scores at baseline, 6 weeks, and 12 weeks, as well as Disabilities of the Arm, Shoulder and Hand, Short Form 36, and Patient-Reported Wrist Evaluation scores up to 1 year after injury. Univariate analysis and linear regression analysis were performed on outcome measures. Results No difference exists in outcomes based on treatment choice. Patients with ulnar positivity greater than 2 mm at baseline, after treatment, and at final follow-up had worse patient-reported scores at 1 year. Persistent articular gaps and/or steps greater than 2 mm after treatment were also associated with worse patient-reported outcomes. Conclusion Even in high-functioning patients older than 55 years, there was no difference in patient-reported outcomes at 1 year in the open reduction group as compared with the closed reduction group. Instead, physicians should pay particular attention to radial shortening and persistent articular gaps following their chosen treatment plan for distal radial fractures. Level of evidence Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Citations
Association between distal radius fracture malunion and patient-reported disability: a systematic review and meta-analysis
Muhanned Ali,Roberto S. Rosales,Elisabeth Brogren,Markus Waldén,Jesper Nordenskjöld,Isam Atroshi +5 more
TL;DR: This systematic review and meta-analysis investigates the association between distal radius fracture malunion and patient-reported disability, examining whether malunion leads to increased disability in patients with DRF.
International Survey: Factors Associated With Operative Treatment of Distal Radius Fractures and Implications for the American Academy of Orthopaedic Surgeons' Appropriate Use Criteria.
TL;DR: Surgeons use patient age and fracture displacement to make treatment recommendations for intraarticular DRF and the AUC should be updated to include these clinical factors as essential components in its algorithm.
Does Radiographic Alignment Correlate With Patient-Reported Functional Outcomes and Posttreatment Complications in Older Patients Treated for Wrist Fractures?
TL;DR: In this paper , the authors reported the radiographic outcomes from the Combined Randomized and Observational Study of Surgery for Fractures In the distal Radius in the Elderly trial, investigate the association between radiographic outcome and patient-reported function, and explore whether this association was affected by post-treatment complications and direction of malalignment.
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