Relationship between distal radius fracture malunion and arm-related disability: A prospective population-based cohort study with 1-year follow-up

BMC Musculoskeletal Disorders

Research Article

Lars B Dahlin¹  Elisabeth Brogren¹  Isam Atroshi²  Manfred Hofer³  Michael Petranek⁴  Philippe Wagner⁵ 

[1] Department of Clinical Sciences, Malmö-Hand Surgery, Department of Hand Surgery, Lund University, Malmö University Hospital, Lund,Malmö, Sweden;Department of Clinical Sciences,, Lund, Lund University, Hässleholm Hospital, Lund,Hässleholm, Sweden;Department of Physical and Occupational Therapy, Kristianstad Hospital, Kristianstad, Sweden;Department of Radiology, Hässleholm Hospital, Hässleholm, Sweden;Swedish National Competence Center for Musculoskeletal Disorders, Department of Orthopedics, Lund University Hospital, Lund, Sweden;

关键词: External Fixation;    Closed Reduction;    Distal Radius Fracture;    Ulnar Variance;    Cast Group;   

DOI  :  10.1186/1471-2474-12-9

 received in 2010-05-26, accepted in 2011-01-13,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundDistal radius fracture is a common injury and may result in substantial dysfunction and pain. The purpose was to investigate the relationship between distal radius fracture malunion and arm-related disability.MethodsThe prospective population-based cohort study included 143 consecutive patients above 18 years with an acute distal radius fracture treated with closed reduction and either cast (55 patients) or external and/or percutaneous pin fixation (88 patients). The patients were evaluated with the disabilities of the arm, shoulder and hand (DASH) questionnaire at baseline (concerning disabilities before fracture) and one year after fracture. The 1-year follow-up included the SF-12 health status questionnaire and clinical and radiographic examinations. Patients were classified into three hypothesized severity categories based on fracture malunion; no malunion, malunion involving either dorsal tilt (>10 degrees) or ulnar variance (≥1 mm), and combined malunion involving both dorsal tilt and ulnar variance. Multivariate regression analyses were performed to determine the relationship between the 1-year DASH score and malunion and the relative risk (RR) of obtaining DASH score ≥15 and the number needed to harm (NNH) were calculated.ResultsThe mean DASH score at one year after fracture was significantly higher by a minimum of 10 points with each malunion severity category. The RR for persistent disability was 2.5 if the fracture healed with malunion involving either dorsal tilt or ulnar variance and 3.7 if the fracture healed with combined malunion. The NNH was 2.5 (95% CI 1.8-5.4). Malunion had a statistically significant relationship with worse SF-12 score (physical health) and grip strength.ConclusionMalunion after distal radius fracture was associated with higher arm-related disability regardless of age.

【 授权许可】

CC BY   
© Brogren et al; licensee BioMed Central Ltd. 2011