TY - JOUR
T1 - Early prognostic factors in distal radius fractures in a younger than osteoporotic age group
T2 - A multivariate analysis of trauma radiographs
AU - Beumer, Annechien
AU - Lindau, Tommy R.
AU - Adlercreutz, Catharina
N1 - Funding Information:
inclination less than 19° or exceeding 29° as well as ulnar variance exceeding plus 2 mm (Ulna+) were considered pathological. Furthermore, assessment was done whether comminution [8], or fractures through the ulnar styloid or the distal radio-ulnar or radiocarpal joint surfaces were present. Those fracture criteria that could not be quantified in degrees of dislocation but merely as present/absent or more or less severe were considered ‘subjective radiologic criteria’. A logistic regression analysis of the above mentioned parameters on the initial trauma radiographs was performed to assess which parameters would have the greatest impact on clinical outcome as assessed with the subjective part of the modified Gartland and Werley score as well as the complete modified Gartland and Werley score ([9,10], Appendix 1). This study was conducted in accordance with the guidelines published by the Swedish Research Council and the International Committee of Medical Journal Editors and supported by the institutional review board of Lund University Hospital. Written informed consent was obtained from the patient for publication of this report and any accompanying images.
PY - 2013
Y1 - 2013
N2 - Background: Treatment of distal radius fractures in patients of a younger than osteoporotic age is complex, because they often are the result of a high-energy trauma and have intra-articular fractures and associated injuries. As yet no fracture classification exists that predicts outcome. Our aim was to find the earliest possible prognostic factor by testing which radiological parameter on the trauma radiograph would have the greatest impact on clinical outcome in a younger than osteoporotic age group. Methods. We assessed 66 patients (34 F) with unilateral fractures of the distal radius from a non-Osteoporotic age group. The median age was 42 years, (10§ssup§ th§esup§ -90§ssup§th§esup§ percentile 20-54). Pre-reduction antero-posterior and lateral wrist radiographs were obtained and fracture pattern, radiocarpal joint surface tilt, radial length, radial inclination and ulnar variance were measured. Clinical outcome was assessed with the subjective part as well as the complete modified Gartland and Werley score. Multivariate analysis of those parameters was performed to assess which radiological parameter would best predict outcome. Results: It was found that post-traumatic ulna + (>2 mm) was the single factor that significantly correlated with a bad outcome. An intra-articular fracture pattern may also be a strong marker; however this was not statistically significant (RR 95% conf interval 0.94 - 20.59). Conclusions: The present study showed that post-traumatic ulna + is the most important factor in predicting bad outcome in non-osteoporotic patients, but that especially intra-articular fractures and to a lesser extent dorsal tilt may be of importance too.
AB - Background: Treatment of distal radius fractures in patients of a younger than osteoporotic age is complex, because they often are the result of a high-energy trauma and have intra-articular fractures and associated injuries. As yet no fracture classification exists that predicts outcome. Our aim was to find the earliest possible prognostic factor by testing which radiological parameter on the trauma radiograph would have the greatest impact on clinical outcome in a younger than osteoporotic age group. Methods. We assessed 66 patients (34 F) with unilateral fractures of the distal radius from a non-Osteoporotic age group. The median age was 42 years, (10§ssup§ th§esup§ -90§ssup§th§esup§ percentile 20-54). Pre-reduction antero-posterior and lateral wrist radiographs were obtained and fracture pattern, radiocarpal joint surface tilt, radial length, radial inclination and ulnar variance were measured. Clinical outcome was assessed with the subjective part as well as the complete modified Gartland and Werley score. Multivariate analysis of those parameters was performed to assess which radiological parameter would best predict outcome. Results: It was found that post-traumatic ulna + (>2 mm) was the single factor that significantly correlated with a bad outcome. An intra-articular fracture pattern may also be a strong marker; however this was not statistically significant (RR 95% conf interval 0.94 - 20.59). Conclusions: The present study showed that post-traumatic ulna + is the most important factor in predicting bad outcome in non-osteoporotic patients, but that especially intra-articular fractures and to a lesser extent dorsal tilt may be of importance too.
KW - Ddistal radius fracture
KW - Outcome
KW - Prognostic factor
KW - Radiology
UR - https://www.scopus.com/pages/publications/84878005168
U2 - 10.1186/1471-2474-14-170
DO - 10.1186/1471-2474-14-170
M3 - Article
C2 - 23697785
VL - 14
JO - BMC musculoskeletal disorders
JF - BMC musculoskeletal disorders
M1 - 170
ER -