title: Fracture severity of distal radius fractures treated with locking plating correlates with limitations in ulnar abduction and inferior health-related quality of life.
abstract: BACKGROUND
  The operative treatment of distal radius fractures has significantly increased after the introduction of locking plates. The aim of the present study was the evaluation of health-related quality of life, functional and radiological outcome of patients with distal radius fractures treated with the locking compression plate (LCP).
  
  
  METHODS
  In the present study 128 patients (130 fractures) that were operatively treated with the LCP (2.4 mm/3.5 mm, Synthes(®)) were retrospectively evaluated. Mean follow-up was 22.7 months (SD 10.6). The fractures were radiographically evaluated (radial inclination, palmar tilt, ulnar variance) pre-, postoperatively and at the last follow-up visit. Range of motion (ROM) was documented. Grip strength was assessed with the use of a JAMAR dynamometer. The score for disabilities of the arm, shoulder and hand (DASH) and the Gartland-Werley score (GWS) were evaluated. Health-associated quality of life was assessed with use of SF-36 Health Survey.
  
  
  RESULTS
  Postoperative reduction was excellent; at the last follow-up visit only minimal reduction loss was observed. Except for pronation, a statistically significant decrease of ROM was present; in most cases that was not disturbing for the patients. The injured side achieved 83.9% of grip strength of the intact side. Mean DASH was 18.9 and mean GWS was 3.5. Health-associated quality of life was generally not compromised. However, limitations in ulnar abduction correlated with inferior quality of life. Fracture severity correlated with inferior quality of life, despite the absence of correlation with the functional and radiological outcome. Complication rate was low.
  
  
  CONCLUSIONS
  Fracture severity seems to affect ulnar abduction and therefore patient quality of life, despite almost anatomical reduction; the objective and subjective scores were in most cases excellent. Modern everyday activities, such as keyboard typing, could be associated with the present results.
authors.affiliation: Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.
authors.forename: Serafim
authors.initials: S
authors.lastname: Tsitsilonis
authors.affiliation: Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Machó
authors.affiliation: Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Manegold
authors.affiliation: Department for Plastic Surgery and Hand Surgery, St. Marien Hospital, Berlin, Germany.
authors.forename: Björn Dirk
authors.initials: BD
authors.lastname: Krapohl
authors.affiliation: Charité - University Medicine Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Wichlas
keywords: distal radius fracture; functional outcome; locking plate; loss of reduction; quality of life