Factors affecting the outcome of Colles' fracture: an anatomical and functional study

Stewart, Hugh D.; Innes, A.; Burke, F. D.

doi:10.1016/0020-1383(85)90126-3

Cited by 183 publications

(98 citation statements)

References 10 publications

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“…This suggests that the energy of the injury (assuming increased energy causes increased comminution) is related to functional outcome; however, this cohort consisted primarily of intra-articular (77%) distal radius fractures. Similar to our results, Stewart et al also report that the presence of an ulnar styloid fracture has no bearing on the expected final outcome [12].…”

Section: Discussionsupporting

confidence: 90%

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Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Grewal

MacDermid

Pope

et al. 2007

Hand (New York, N,Y.)

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Distal radius fractures are common injuries; however, identifying which factors are responsible for predicting outcomes remains an area of controversy. The purpose of this study was to define factors predictive of patient-reported pain and disability at 1 year in a prospective cohort of extra-articular distal radius fractures (n=222). Data were collected at the initial visit and after 3, 6, and 12 months. The primary outcome was the 1-year patientrated wrist evaluation (PRWE) score. The effect of baseline patient and injury characteristics on the 1-year PRWE score was assessed. Univariate and forward stepwise regression analyses both agreed that the most influential predictor of pain and disability at 1 year was injury compensation. The 1-year PRWE score was significantly higher for subjects involved with third-party claims (35.48) compared to those that were not involved in any claims (14.97), p=0.006. The regression model found that three baseline factors -injury compensation, education, and other medical comorbiditiesexplained 16.4% of the variance in PRWE scores at 1 year. No injury characteristic, including the degree of initial fracture displacement, was found to significantly influence the 1-year PRWE score. This study has shown that baseline patient and injury characteristics play a small role in predicting 1-year patient-reported pain and disability in extra-articular distal radius fractures. Conceptual factors outside of this biomedical model should be investigated.

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Section: Discussionsupporting

confidence: 90%

“…In a study of intra-and extraarticular distal radius fractures, Stewart et al showed that age and gender were found to have some effect, as males under the age of 65 had both better reductions and better final results [12].…”

Section: Discussionmentioning

confidence: 99%

Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Grewal

MacDermid

Pope

et al. 2007

Hand (New York, N,Y.)

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“…Radiographs were scored according to the Lidstrom system as modified by Sarmiento et al [42]. They reported no statistical correlation between the radiographic outcomes and functional outcomes (measured by the Gartland and Werley system as modified by Stewart et al [45,46]). Our study had similar patient demographics (with a larger patient cohort) and similar outcomes measured.…”

Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

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The relationship between radiographic and functional outcomes in older patients with distal radius fractures is controversial. We explored this relationship by assessing the influence of radiographic displacement and fracture comminution on the functional outcomes of these fractures. We also asked whether operative intervention and demographic factors (age, gender, duration of followup) influenced outcome. We examined 53 patients older than 55 years with distal radius fractures with various functional assessments: range of motion (ROM) and strength measurements, three subjective surveys (Disabilities of the Arm, Shoulder, and Hand; Patient-rated Wrist Evaluation; Modernized Activity Subjective Survey of 2007), a Gartland and Werley score, and an objective, standardized hand performance test (Jebsen-Taylor). We measured angulation, articular gap/stepoff, and radial shortening on final radiographs and fracture comminution of preoperative radiographs. We observed no effect of radiographic displacement on subjective or objective outcome assessments, including standardized hand performance timed testing. Surgically treated fractures were less likely to display residual dorsal angulation and radial shortening, but surgical intervention did not independently predict functional outcome. Fracture comminution, patient gender, and months of followup similarly had no effect on outcome. We found no relationship between anatomic reduction as evidenced by radiographic outcomes and subjective or objective functional outcomes in this older patient cohort.

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“…The importance of ulnar styloid fractures, which have been associated with a worse outcome (Lidström 1959, Frykman 1967, Stewart et al 1985, Stoffelen et al 1998, is also disputed. This is partly why Frykman's classi cation (1967) used each fracture type (extraarticular = I, radiocarpal = III, radioulnar = V, radiocarpal and radioulnar = VII) with a worse counterpart when the ulnar styloid was fractured (types II, IV, VI and VIII).…”

Section: Impairment Of Dru-joint Function Has a Worse Outcomementioning

confidence: 99%

“…Many authors report good long-term results (Lidström 1959, Stewart et al 1985, Altissimi et al 1986, Kopylov et al 1993, Warwick et al 1993), but overall complications occur in one third of the patients (Cooney et al 1980). The commonest complaint after distal radial fractures is ulnar-sided wrist pain (Frykman 1967, Cooney et al 1980, Altissimi et al 1986, Solgaard 1988, found in every fth patient (Frykman 1967), which affects the end-result adversely (Frykman 1967, Hollingsworth and Morris 1976, Jupiter et al 1992, Stoffelen et al 1998.…”

mentioning

confidence: 99%

The radioulnar joint in distal radial fractures: A review

Lindau

Aspenberg

2002

Acta Orthopaedica Scandinavica

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-We searched The Cochrane Library andMedline regarding the radioulnar joint in distal radial fractures and found no randomized or controlled studies. This review presents the descriptive literature by summarizing accepted views and controversies. There is only weak support for the commonly accepted treatments. Current research has shown that distal radial fractures are often associated with ligament injuries not seen on radiographs. These injuries can lead to laxity of the DRU-joint and subsequent worse outcome, which indicates that we must have a complete diagnosis including ligament injuries if we want to understand better the fracture and its sequelae. Randomized studies should be done before advocating surgical treatment of these unforeseen injuries. n What's the problem?

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Factors affecting the outcome of Colles' fracture: an anatomical and functional study

Cited by 183 publications

References 10 publications

Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Baseline Predictors of Pain and Disability One Year following Extra-Articular Distal Radius Fractures

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

The radioulnar joint in distal radial fractures: A review

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