Predictors of functional outcomes after surgical treatment of distal radius fractures.
OBJECTIVE
Identifying predictors of outcomes is important in anticipating and treating patients with underlying factors that may affect recovery. The predictors of functional outcomes after distal radius fracture (DRF) treatment have not been well defined in the past.


METHODS
This was a prospective cohort study designed to identify predictors of hand outcomes after DRF treatment. The study included consecutive patients with inadequately reduced DRFs who had open reduction and internal fixation with volar plating. Demographic and socioeconomic data were collected at the time of the initial treatment. Outcome data were collected 3, 6, and 12 months after surgery. Outcome evaluation consisted of radiographic measurements and the Michigan Hand Outcomes Questionnaire (MHQ). We hypothesized that the following factors are important predictors of functional outcomes: (1) age, (2) socioeconomic status, (3) severity of fracture pattern, and (4) postsurgical radiographic measurements. Regression models were developed using the overall MHQ score as the outcome variable at 3 months and 1 year after surgery.


RESULTS
Sixty-six patients had data available at 3 months and 49 patients had data available at 1 year. At 3 months after surgery, radiographic incongruity (step + gap) was a significant predictor after controlling for age, fracture type, dorsal-volar tilt angulation, and income. Patients with increased incongruity reported lower MHQ scores (worse functional outcomes). At 1 year after surgery, however, only age and income were significant predictors after controlling for fracture type. Increased age and decreased income were associated with lower MHQ scores.


CONCLUSIONS
After successful surgery and hand therapy, only age and income were significantly associated with long-term outcomes 1 year after surgery. Precise anatomic reduction enhances short-term functional outcomes in DRF treatment.


METHODS
Prognostic, Level I.
Chung
Kevin C
KC
Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109-0340, USA. kecchung@med.umich.edu
Kotsis
Sandra V
SV
Kim
H Myra
HM
D000367:Age Factors; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D020127:Recovery of Function; D012044:Regression Analysis; D012720:Severity of Illness Index; D012923:Social Class; D011795:Surveys and Questionnaires; D016896:Treatment Outcome