Factors associated with one-year outcome after distal radial fracture treatment.
OBJECTIVE
To identify factors that affect functional outcome one year after distal radial fracture treatment.


METHODS
521 women and 121 men aged 16 to 92 (mean, 59) years with distal radial fractures underwent external fixation (n=123), open reduction and internal fixation (n=63), a combination of both (n=10), distal radial osteotomy for symptomatic malunion (n=90), or casting with (n=194) or without (n=162) prior closed manipulation under regional anaesthesia. The indication for surgery (rather than casting) was metaphyseal instability. Radiographic evaluation (dorsal angulation, radial shortening, carpal malalignment, and malunion) was made before and after treatment and after fracture healing. Functional evaluation (range of movement, grip strength, and activities of daily living) was made at a mean of 16 (range, 6-54) months after injury.


RESULTS
After multiple regression analysis, poorer functional score was associated with increasing age (p<0.001), dorsal angulation after healing (p<0.016), presence of volar comminution (p=0.005), and pain (p<0.001). Poorer grip strength was associated with non-dominant side injury, increasing age, dorsal angulation after healing, positive ulnar variance, comminution, and pain (all p<0.001). Predicted malunion showed colinearity with age (r=0.657), dorsal comminution (r=0.694), and dorsal angulation (r=0.626).


CONCLUSIONS
Understanding factors associated with outcome helps surgeons to make the treatment decision for distal radial fracture to achieve optimum outcome.
Victoria Hospital Kirkcaldy, Kirkcaldy, United Kingdom.
Jonathan
J
Cowie
St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
Raymond
R
Anakwe
Edinburgh Orthopaedic Trauma Unit, Edinburgh, United Kingdom.
Margaret
M
McQueen
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000628:therapy*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
radius fractures; treatment outcome