Quality of life after volar plate fixation of articular fractures of the distal part of the radius.
BACKGROUND
Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked plate fixation of unstable intra-articular distal radial fractures with functional and radiographic results as well as with quality-of-life data from population norms.


METHODS
Fifty-four consecutive patients with intra-articular distal radial fractures and a mean age of sixty-three years were managed with a volar locked plate system. Range of motion, grip strength, and radiographs were assessed at a mean of six years postoperatively. The wrist-scoring systems of Gartland and Werley and Castaing were adopted for the assessment of objective outcomes. The Disabilities of the Arm, Shoulder and Hand and Short Form-36 questionnaires were completed as subjective outcome measures, and the results were compared with United States and Austrian population norms.


RESULTS
Functional improvement continued for two years postoperatively. At the time of the latest follow-up, >90% of all patients had achieved good or excellent results according to the scoring systems of Gartland and Werley and Castaing. The results of the Short Form-36 questionnaire were similar to the United States and Austrian population norms. The mean Disabilities of the Arm, Shoulder and Hand score was 5 points at two years, and it increased to 13 points at six years. The twenty patients with radiocarpal arthritis had significantly poorer results in the physical component summary measure of the Short Form-36 questionnaire (p = 0.012).


CONCLUSIONS
The results of the present single-center study show that, following distal radial fracture fixation, wrist arthritis may affect the patient's subjective well-being, as documented with the Short Form-36, without influencing the functional outcome. Well-designed longitudinal clinical trials are needed to confirm the findings of the present investigation in terms of quality of life after surgical treatment of intra-articular distal radial fractures.
Gruber
Gerald
G
Department of Orthopedic Surgery, Medical University of Graz, Graz, Austria. gerald_gruber@klinikum-graz.at
Zacherl
Max
M
Giessauf
Christian
C
Glehr
Mathias
M
Fuerst
Florentine
F
Liebmann
Walter
W
Gruber
Karl
K
Bernhardt
Gerwin Alexander
GA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D018737:Hand Strength; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery