In the Journals

Anatomic distal radius fracture restoration not linked with improved subjective outcomes

Kevin Chung

Twelve months after treatment, there was no correlation between precise restoration of the wrist anatomy and better patient-reported outcomes in older patients who had distal radius fractures, according to study results.

Researchers identified 166 patients aged 60 years or older from the Wrist and Radius Injury Surgical Trial who had distal radius fractures. Patients were randomized to receive volar locking plate, percutaneous pinning, external fixation or casts if they chose nonoperative treatment. Two-phase multivariable regression models were developed based on the biomechanical principle of alignment to evaluate the correlation between radiographic measures of reduction and function and patient-reported outcomes 12 months after treatment. Twelve months after treatment, investigators measured hand grip strength, wrist arc of motion, radial deviation, ulnar deviation, the Michigan Hand Outcomes Questionnaire (MHQ) total score, MHQ function score, and MHQ activities of daily living score.

Results showed that of the 84 correlation coefficients calculated, only two correlation coefficients were statistically significant. Investigators noted in patients who were aged 70 years or older, every degree increase in radial inclination away from the normal hand grip strength in the injured hand was 1.1 kg weaker compared with the uninjured hand. Also, each millimeter increase toward normal in ulnar variance correlated with a 10.4-point improvement in MHQ activity of daily living score. However, these radiographic measures did not correlate with the MHQ total scores or function scores. – by Monica Jaramillo

 

Disclosures: Chung reports he receives funding from the NIH and book royalties from Wolters Kluwer and Elsevier. Please see the study for all other authors’ relevant financial disclosures.

 

Kevin Chung

Twelve months after treatment, there was no correlation between precise restoration of the wrist anatomy and better patient-reported outcomes in older patients who had distal radius fractures, according to study results.

Researchers identified 166 patients aged 60 years or older from the Wrist and Radius Injury Surgical Trial who had distal radius fractures. Patients were randomized to receive volar locking plate, percutaneous pinning, external fixation or casts if they chose nonoperative treatment. Two-phase multivariable regression models were developed based on the biomechanical principle of alignment to evaluate the correlation between radiographic measures of reduction and function and patient-reported outcomes 12 months after treatment. Twelve months after treatment, investigators measured hand grip strength, wrist arc of motion, radial deviation, ulnar deviation, the Michigan Hand Outcomes Questionnaire (MHQ) total score, MHQ function score, and MHQ activities of daily living score.

Results showed that of the 84 correlation coefficients calculated, only two correlation coefficients were statistically significant. Investigators noted in patients who were aged 70 years or older, every degree increase in radial inclination away from the normal hand grip strength in the injured hand was 1.1 kg weaker compared with the uninjured hand. Also, each millimeter increase toward normal in ulnar variance correlated with a 10.4-point improvement in MHQ activity of daily living score. However, these radiographic measures did not correlate with the MHQ total scores or function scores. – by Monica Jaramillo

 

Disclosures: Chung reports he receives funding from the NIH and book royalties from Wolters Kluwer and Elsevier. Please see the study for all other authors’ relevant financial disclosures.