Early postoperative improvements in the QuickDASH score after distal radius fracture are related to the type of surgical treatment

Abstract

The goal of this prospective study was to evaluate the real-life experience of 52 patients and their recovery kinetics in the first 6 weeks after surgical treatment of distal radius fractures. The fractures were treated with either a fourth-generation volar locking plate (34 patients, mean age 67 years, range 54-82) or by percutaneous pinning (18 patients, mean age 56 years, range 43-69). These patients were evaluated every week for 6 weeks with the QuickDASH (QD) questionnaire. A lower QD score indicated that the patient's physical function and symptoms had improved. At postoperative week 1, all the patients who had undergone percutaneous pinning had a QD of 80 (out of 100). One-third of patients who had undergone plate fixation had a QD of 80, while the remainder had a QD of 65. Out of all the patients who had a QD of 80 at postoperative week 1, the patients who had undergone plate fixation improved more quickly. After 6 weeks, the patients who had undergone plate fixation had a greater reduction in the QD (50 points) than the ones who had undergone pinning (30 points). Although the direct costs of locking plate fixation are 10 times higher than those of K-wire pinning, evidence suggests that these plates reduce the indirect costs. This study has shown that a patient's recovery rate, day-to-day life and physical function are better over the first 6 weeks postsurgery when the distal radius fracture is fixed with a locking plate.

Outcomes in Patients with Bilateral Distal Radius Fractures

“…However, in patients over the age of 65 years, QuickDASH scores at 12 months have been shown to be equivalent between patients treated with cast immobilization versus volar locking plate. 17 18 19 We found that QuickDASH scores did not significantly differ between the adult groups regardless of treatment and were similar to previously reported postoperative DASH (22.3) and QuickDASH scores (20.9–21.0) in unilateral DRF. 20 21 22…”

Percutaneous pinning versus volar locking plate internal fixation for unstable distal radius fractures: a meta-analysis

“…The full texts of the remaining 34 articles were reviewed, and 14 were excluded, the reasons for which are shown in Figure 1. Thus, 20 articles were included in the meta-analysis (Aita et al., 2014; Bahari-Kashani et al., 2013; Costa et al., 2014; Dzaja et al., 2013; Egol et al., 2008; Goehre et al., 2014; Gradl et al., 2013; Grewal et al., 2011; Hollevoet et al., 2011; Jeudy et al., 2012; Karantana et al., 2013; Kumbaraci et al., 2014; Lee et al., 2012; Loisel et al., 2015; Maire et al., 2013; Marcheix et al., 2010; McFadyen et al., 2011; Rozental et al., 2009; Tronci et al., 2013; Williksen et al., 2013).

Figure 1.Flow diagram of study selection.

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“…There was heterogeneity with respect to the fracture types studied. Most included studies focused on patients with AO type A and C fractures, but several studies (Costa et al., 2014; Egol et al., 2008; Loisel et al., 2015; Maire et al., 2013) also included patients with type B fractures, and we did not perform a subgroup analysis based on fracture type. There was also heterogeneity in the procedures and materials used as well as the methods of external fixation.…”

Longitudinal recovery following distal radial fractures managed with volar plate fixation

“…Study characteristics. The reports included were of mixed study designs and quality; 18 were observational study designs [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] and 28 were randomised controlled trials. The study characteristics are detailed in Table III.…”