Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.
OBJECTIVE
Distal radius fractures are most often treated nonoperatively, but sometimes they are treated surgically when deemed unstable. Based on the literature, a consensus protocol for treatment has been developed in southern Sweden to aid clinicians in their decision making. We evaluated the results of this protocol prospectively using a validated outcome instrument (DASH) in a large consecutive and population based series of unselected patients.


METHODS
581 patients were treated according the protocol. Age, sex, fracture side, and type of treatment were registered. The subjective outcome was measured by DASH. 133 patients were operated.


RESULTS
75% of the patients returned the questionnaire. The median DASH score at 3 months was 18.3 and at 12 months it was 7.5. All treatment groups had low DASH scores at the final follow-up. Reduced, nonoperated fractures had a worse score (11.6) than undisplaced (4.2) or operated fractures (6.0). Age was the only other predictor, with older patients having a worse score. A correlation was found between the short-version 11-item QuickDASH questionnaire and the full 30-item DASH, both at 3 months (r = 0.98) and at 1 year (r = 0.97) (p< 0.001 for both).


CONCLUSIONS
Most patients have residual symptoms at 3 months after the fracture but are normalized at 1 year. Good final subjective result was achieved with the proposed protocol regardless of initial severity and treatment of the fracture, as indicated by a low median DASH score in all groups. There was correlation between QuickDASH and the full DASH, and the former could be used in future studies.
Abramo
Antonio
A
Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden. tony.abramo@med.lu.se
Kopylov
Philippe
P
Tagil
Magnus
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000601:surgery / Q000628:therapy; D005599:Fractures, Ununited / Q000601:surgery / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011379:Prognosis; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome