Behandling av håndleddsbrudd 2009 – 14

Kvernmo, Hebe Désirée; Otterdal, Petter; Balteskard, Lise

doi:10.4045/tidsskr.17.0065

Cited by 7 publications

(9 citation statements)

References 13 publications

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“…[3] Volar locking plate (VLP) and external fixation (EF) are 2 of the most commonly used methods for treating DRF. [4][5][6][7][8] The goal of the operation is to restore the normal anatomy and a mobile, pain-free wrist without functional limitations. The correlation between the degree of radiographic deformity and functional outcome of the fracture however is controversial.…”

Section: Introductionmentioning

confidence: 99%

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Is there a correlation between functional results and radiographic findings in patients with distal radius fracture A0 type A3 treated with volar locking plate or external fixator?

Ludvigsen

Matre

Vetti

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

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The aim of this study was to test the hypothesis that precise restoration of distal radius fractures is correlated to better patient-reported outcome.Methods: The correlation between radiographic results and functional outcome was explored in 156 patients with extra-articular distal radius fractures included in a multicenter, randomized controlled trial comparing 2 surgical interventions, Volar Locking Plate or External Fixator. The primary functional outcome was the Patient Rated Wrist and Hand Evaluation score (PRWHE). Radiographically we assessed volar tilt, radial inclination, radial height, ulnar variance, and the presence of ulnar styloid fracture. The Pearson correlation analysis was used to estimate correlations between parameters.Results: At 1-year follow-up the mean difference in radiographic findings compared with the uninjured side (min, max) was: reduced volar tilt 5.3°(À15°, 25°), reduced radial inclination 2.3°(À6°, 12°), radial height 1.3 mm (À4 mm, 7 mm), and ulnar variance À0.5 mm (À6 mm, 3 mm). Overall, we found no correlation between radiographic parameters and the PRWHE at 1-year follow-up within the whole group, regardless of which treatment was chosen. At the time of injury 53% (N = 80) had sustained an additional ulnar styloid fracture. After 1 year this fracture was still radiographically present in 31% (N = 43) of the patients. No correlation between PRWHE score and the presence of an ulnar styloid fracture at 1-year follow-up was found.Conclusions: We found no correlation between functional outcome (PRWHE) and radiographic findings after 1 year in patients operated on with a Volar Locking Plate or External Fixator. Patient-specific factors were more important than radiographic measurements in this study group.

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Section: Introductionmentioning

confidence: 99%

“…Surgical fixation is recommended in severely displaced fractures [3] . Volar locking plate (VLP) and external fixation (EF) are 2 of the most commonly used methods for treating DRF [4–8] . The goal of the operation is to restore the normal anatomy and a mobile, pain-free wrist without functional limitations.…”

Section: Introductionmentioning

confidence: 99%

Is there a correlation between functional results and radiographic findings in patients with distal radius fracture A0 type A3 treated with volar locking plate or external fixator?

Ludvigsen

Matre

Vetti

et al. 2021

OTA International: The Open Access Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

show abstract

“…Whereas the incidence of wrist fracture has been documented slightly lower in Finnmark compared with Troms and Nordland [21], the minor difference cannot explain this finding. In Norway, the age and gender adjusted rate during the period 2009–2014 was 244 wrist fractures per 100,000 inhabitants [21]. This is in accordance with Swedish and Finish figures [22,23].…”

Section: Discussionmentioning

confidence: 93%

“…Possible causes could be surgery that is more proper. However, differences in surgical techniques were minor between Finnmark, Troms and Nordland [21] and complex patients from Finnmark were referred to the regional centre at UNN Tromsø. Consequently, surgery that is more proper cannot explain the difference.…”

Section: Discussionmentioning

confidence: 99%

Wrist malpractice claims in Northern Norway 2005–2014. Lessons to be learned

Norum

Balteskard

Thomsen³

et al. 2018

International Journal of Circumpolar Health

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Rough weather conditions in the subarctic areas of Norway may influence on the risk of wrist fracture. We implemented data from the Norwegian System of Patient Injury Compensation (NPE). All claims due to wrist surgery, performed at the public hospitals in Northern Norway, during 2005-2014 were analyzed. We employed the ICD-10 classification codes S52.5 (fracture of distal end of radius) and S52.6 (fracture of distal end of radius and ulna). Treatment was defined by NCSP codes. 84 patients (0.3%) complained. Females complained four times more often than males did (P = 0.005) and received five times more frequently a compensation (P < 0.001). NPE accepted 34 claims (40%) for injury compensation (0.1% of patients). The percentage of claims accepted for compensation decreased from 48% to 30% during study period, probably due to delay in filling claims. The main causes of complains were pain, reduced range of motion, malfunction and weakness (35/84). The main causes of compensation were “operative treatment should have been performed” (14/34) and “wrong operative method applied” (13/34). The mean amount per compensation was €14,927 (€0–€52,995). Stonger focus on quality of care, updated guidelines and shared decission-making may reduce the number og complains and compensations.

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“…However, we present data from two centers close to the national average regarding operative treatment for DRFs according to the Swedish Fracture Registry (Sundsvall: 31.7%, Umeå 28.8%, national average 32.3%). The rates of surgical intervention in Sweden are comparable to those of other countries with a similar standard of living (USA 34% [42], Norway 28% [43]. Based on the Swedish Fracture Registry, the implementation of the guidelines could be further studied on a national level by the Swedish Fracture Registry.…”

Section: Plos Onementioning

confidence: 89%

Forecasting effects of “fast-tracks” for surgery in the Swedish national guidelines for distal radius fractures

et al. 2022

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Background and purpose National guidelines for treatment of distal radius fractures (DRFs) were presented in Sweden in 2021. In the guidelines, a fast-track is recommended for 4 subgroups of highly unstable DRFs. Regardless of the results of the closed reduction these are recommended for surgery within 1 week of injury. This study aims to evaluate the potential consequences of the newly presented national guidelines on incidence of surgical interventions. Patients and methods In all, 1,609 patients (1,635 DRFs) with primary radiographs after a DRF between 2014 and 2017 at two Swedish hospitals were included in a retrospective cohort study. An estimation was made of the percentage of patients in the historical pre-guidelines cohort, that would have been recommended early primary surgery according to the new national guidelines compared to treatment implemented without the support of these guidelines. Results On a strict radiological basis, 32% (516 out of 1635) of DRFs were classified into one of the 4 defined subgroups. At 9–13 days follow-up, cast treatment was converted into delayed primary surgery in 201 cases. Out of these, 56% (112 out of 201) fulfilled the fast-track criteria and would with the new guidelines have been subject to early primary surgery. Interpretation The fast-track regimen in the new guidelines, has a high likelihood of identifying the unstable fractures benefitting from early primary surgery. If the proposed Swedish national guidelines for DRF treatment are implemented, a greater proportion of fractures would be treated with early primary surgery, and a delayed surgery avoided in the majority of cases. The potential benefits in relation to possible costs when using the fast-track criteria in every day practice are still unknown.

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Behandling av håndleddsbrudd 2009 – 14

Cited by 7 publications

References 13 publications

Is there a correlation between functional results and radiographic findings in patients with distal radius fracture A0 type A3 treated with volar locking plate or external fixator?

Is there a correlation between functional results and radiographic findings in patients with distal radius fracture A0 type A3 treated with volar locking plate or external fixator?

Wrist malpractice claims in Northern Norway 2005–2014. Lessons to be learned

Forecasting effects of “fast-tracks” for surgery in the Swedish national guidelines for distal radius fractures

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