Background: Disability of the upper limb is one of the consequences of distal radius fracture (DRF). The outcome of DRF treatment is based on objective clinical variables, as strength or range of movement (ROM); sometimes these variables do not correlate with the functional level of the patient. The principal objective of our study was to assess the repercussion of conservative treatment of DRF on upper limb disability. Methods: This is a retrospective review of prospectively collected data. We collected data of 61 nonconsecutive DRFs treated conservatively from July 2007 to August 2008. Results: Average Disabilities of the Arm, Shoulder and Hand (DASH) score before fracture was 20.8 points; average DASH score after the fracture was 42.6. There was a significant increase in the upper limb disability after 1 year of follow-up in the patients treated conservatively (P < .001; size effect, 1.06). Average radial inclination, radial tilt, and radial length were 18.18°, 3.35°, and 5.76 mm, respectively. Average ROM for flexion-extension was 100.6° and for pronation-supination 144.0°. ROM for flexion-extension of the unaffected wrist was 128.2° and for pronation-supination 172.4°. We did not find any significant statistical correlation between the increase in disability and the decrease in the ROM (P > .05). We did not find any significant statistical correlation between the increase in the disability and the worsening in the radiological parameters (P > .05). Our results confirm the hypothesis that the conservative treatment of DRF produced an increase in the upper limb disability after 1 year of follow-up. Conclusions: Our study does not show a correlation between the increase in upper limb disability and the decrease in wrist ROM. Our study did not find a correlation between radiological measures and DASH scores.
AnzarutAJohnsonJARoweBHet al. Radiologic and patient-reported functional outcomes in an elderly cohort with conservatively treated distal radius fractures. J Hand Surg Am. 2004;29(6):1121-1127. doi:10.1016/j.jhsa.2004.07.002
2.
AroHTKoivunenT.Minor axial shortening of the radius affects outcome of Colles’ fracture treatment. J Hand Surg Am. 1991;16(3):392-398. doi:10.1016/0363-5023(91)90003-t.
3.
AroraRGablMGschwentnerMet al. A comparative study of clinical and radiologic outcomes of unstable Colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma. 2009;23(4):237-242. doi:10.1097/BOT.0b013e31819b24e9.
4.
BartonTChambersCBannisterG.A comparison between subjective outcome score and moderate radial shortening following a fractured distal radius in patients of mean age 69 years. J Hand Surg Eur Vol. 2007;32(2):165-169. doi:10.1016/j.jhsb.2006.11.010.
5.
BrogrenEHoferMPetranekMet al. Relationship between distal radius fracture malunion and arm-related disability: a prospective population-based cohort study with 1-year follow-up. BMC Musculoskelet Disord. 2011;12(1):9. doi:10.1186/1471-2474-12-9.
6.
CardosoRSzaboRM.Wrist anatomy and surgical approaches. Orthop Clin North Am. 2007;38(2):127-148. doi:10.1016/j.ocl.2007.02.010.
7.
ChangulaniMOkonkwoUKeswaniTet al. Outcome evaluation measures for wrist and hand: which one to choose?Int Orthop. 2008;32(1):1-6. doi:10.1007/s00264-007-0368-z.
8.
ChungKCShauverMJBirkmeyerJD.Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am. 2009;91(8):1868-1873. doi:10.2106/JBJS.H.01297.
9.
CollesA.Historical paper on the fracture of the carpal extremity of the radius (1814). Injury. 1970;2(1):48-50.
10.
FujiiKHenmiTKanematsuY.Fractures of the distal end of radius in elderly patients: a comparative study of anatomical and functional results. J Orthop Surg. 2002;10(1):9-15.
11.
GehrmannSVWindolfJKaufmannRA.Distal radius fracture management in elderly patients: a literature review. J Hand Surg Am. 2008;33(3):421-429. doi:10.1016/j.jhsa.2007.12.016.
12.
GliatisJDPlessasSJDavisTR.Outcome of distal radial fractures in young adults. J Hand Surg Br. 2000;25(6):535-543. doi:10.1054/jhsb.2000.0373.
13.
GoldhahnJAngstFSimmenBR.What counts: outcome assessment after distal radius fractures in aged patients. J Orthop Trauma. 2008;22(8)(suppl):S126-S130. doi:10.1097/BOT.0b013e31817614a1.
14.
GrewalRMacDermidJCPopeJet al. Baseline predictors of pain and disability one year following extra-articular distal radius fractures. Hand. 2007;2(3):104-111. doi:10.1007/s11552-007-9030-x.
15.
JaremkoJLLambertRGWRoweBHet al. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?Clin Radiol. 2007;62(1):65-72. doi:10.1016/j.crad.2006.08.013.
16.
JungH-WHongHJungHJet al. Redisplacement of distal radius fracture after initial closed reduction: analysis of prognostic factors. Clin Orthop Surg. 2015;7(3):377-382. doi:10.4055/cios.2015.7.3.377.
17.
KarnezisIAFragkiadakisEG.Association between objective clinical variables and patient-rated disability of the wrist. J Bone Joint Surg Br. 2002;84(7):967-970. doi:10.1302/0301-620x.84b7.12673.
18.
KumarSPenematsaSSadriMet al. Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?Int Orthop. 2008;32(4):505-509. doi:10.1007/s00264-007-0355-4.
19.
LainoDKTejwaniN.Indications for operative fixation of distal radius fractures: a review of the evidence. Bull NYU Hosp Jt Dis. 2012;70(1):35-40.
20.
LichtmanDBindraRBoyerMet al. The treatment of distal radius fractures. J Am Acad Orthop Surg. 2009;93(8):1-191.
21.
LichtmanDMBindraRRBoyerMIet al. American Academy of Orthopaedic Surgeons clinical practice guideline on: the treatment of distal radius fractures. J Bone Joint Surg Am. 2011;93(8):775-778. doi:10.2106/JBJS.938ebo.
22.
MacIntyreNJDewanN.Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther. 2015;29(2):136-145. doi:10.1016/j.jht.2016.03.003.
23.
Mellstrand-NavarroCPetterssonHJ.The operative treatment of fractures of the distal radius is increasing. Bone Joint J. 2014;96(7):963-969. doi:10.1302/0301-620X.96B7.
24.
NellansKKowalskiE.The epidemiology of distal radius fractures. Hand Clin. 2012;28(2):113-125. doi:10.1016/j.hcl.2012.02.001.
25.
RosalesRSDelgadoEB.Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability. J Hand Surg Am. 2002;27(2):334-343. doi:10.1053/jhsu.2002.30059.
26.
SouerJ-SLozano-CalderonSARingD.Predictors of wrist function and health status after operative treatment of fractures of the distal radius. J Hand Surg Am. 2008;33(2):157-163. doi:10.1016/j.jhsa.2007.10.003.
27.
WarwickDAlamM.(i) Anatomy of the carpus and surgical approaches. Orthop Trauma. 2011;25(5):317-323. doi:10.1016/j.mporth.2011.07.010.
28.
WilckeMKTAbbaszadeganHAdolphsonPY. Patient-perceived outcome after displaced distal radius fractures. A comparison between radiological parameters, objective physical variables, and the DASH score. J Hand Ther. 2007;20(4): 290-298; quiz 299. doi:10.1197/j.jht.2007.06.001.
29.
YoungBTRayanGM.Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. J Hand Surg Am. 2000;25(1):19-28. doi:10.1053/jhsu.2000.jhsu025a0019.
