Longitudinal recovery following distal radial fractures managed with volar plate fixation

Stinton, Susan B; Moloney, Niamh; Maclachlan, Liam; Edgar, Dale W.; Pappas, Evangelos

doi:10.1302/0301-620x.99b12.bjj-2017-0348.r1

Cited by 13 publications

(14 citation statements)

References 75 publications

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“…11 Similarly, in a meta-analysis of DRFs stabilized with volar plate fixation, significant improvements in PRWE scores were seen within the first 6 months before scores plateaued. 12 Ninety-five percent of patients (83/87) treated by either operative or nonoperative means reported some disability and 16% (14/87) reported significant disability, which interfered with daily activities at a minimum follow-up time of 1 year despite 67% undergoing physical or occupational therapy. 26 In patients with DRFs treated both operatively and nonoperatively, PRWE scores at 1 year are predictive of long-term functional outcomes up to 20 years following injury.…”

Section: Discussionmentioning

confidence: 99%

“…10 After operative treatment of DRFs most functional improvement is achieved within the first 6 months following injury. 11,12 Therefore, developing a rehabilitation program aimed at optimizing outcomes within this time frame, remains critical. However, there is a dearth of advanced rehabilitative programs that have been reported in the literature following operative fixation of DRFs and no standardized protocol has been developed to optimize patient outcomes.…”

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confidence: 99%

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Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

2020

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Background Blood flow restriction (BFR) therapy is an emerging addition to rehabilitative programs that allows patients to increase strength at lower loads over shorter time periods. Therefore, we conducted a study to evaluate the safety and efficacy of a rehabilitation program using BFR to a traditional rehabilitation protocol following operative fixation of distal radius fractures. Methods A randomized controlled study was conducted comparing a standardized rehabilitation protocol alone to a combined protocol with the use of BFR therapy in patients treated with volar plate fixation following a displaced distal radius fracture. The same exercises done in the control group were performed by the BFR group with a restrictive tourniquet in place. Patients were followed with serial radiographs to ensure fracture stability. Outcome measures included wrist range of motion, grip strength, pinch strength, visual analog scale (VAS) pain scores at rest and during activity, patient rated wrist evaluation scores (PRWE), and disabilities of the arm, shoulder, and hand scores. Results Nine patients were randomized and enrolled within the BFR group (n = 5) and control (n = 4) groups. Patients within the BFR group had a significantly greater reduction in pain with activity over the course of the rehabilitation program. Additionally, the BFR group had a significant improvement in PRWE scores during the 8-week rehabilitation program. There was no difference in radiographic measures after initiation of BFR, and all patients tolerated therapy without noted complications. Conclusion BFR therapy is safe and well tolerated after operatively treated distal radius fractures. The addition of BFR therapy can result in quicker reduction in pain with activity and improvement in patient disability when used early following operative management of a distal radius fracture. Level of Evidence This is a Level 1, prognostic study.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

2020

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“…Stinton et al 22 realizaram uma metanálise longitudinal de última geração para avaliar a recuperação durante os 2 primeiros anos pós-operatórios após uma fratura de rádio distal tratada com placa de bloqueio volar. Os autores concluíram que a melhora clínica significativa pode ser atingida em até 12 meses, atingindo após esse período um "platô estável" e níveis de normalidade prévia após a cirurgia.…”

Section: Discussionunclassified

“…Stinton et al 22 performed a state-of-the-art longitudinal meta-analysis to assess recovery during the first 2 postoperative years following a distal radius fracture treated with a volar locking plate. These authors concluded that significant clinical improvement can be achieved within 12 months; next, there is a “stable plateau”, with levels normalization.…”

Section: Discussionmentioning

confidence: 99%

Avaliação radiográfica dos pacientes submetidos a fixação percutânea com parafuso maciço para tratamento de fraturas da extremidade distal do radio

Gaibor

Thomaz

Borges

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Apresentar o resultado das avaliações radiográficas dos pacientes com fraturas extra-articulares do rádio distal submetidos a fixação percutânea com parafuso maciço de 3.5mm. Métodos Série de casos, analítica, descritiva e retrospectiva de 16 pacientes com avaliação dos parâmetros radiográficos da técnica utilizada. Resultados A média de idade da população estudada foi de 46,5 anos (25–60 anos), sendo 81,25% do sexo feminino. O tempo de espera até a cirurgia foi de 8,8 dias (4–14 dias). O tilt volar médio pré-procedimento foi - 7,41° (−23,48°–5,29°, desvio padrão [DP] ± 6,59°). O tilt volar imediatamente após o procedimento cirúrgico foi de 5,93° (DP ± 6,23°, p < 0,001). Sem diferença estatística nos valores de tilt volar ao final de 6 meses de evolução. A altura radial pré-procedimento foi de 4,13 mm (−7,8°–9,5°, DP ± 5,06°). Aumento estatisticamente significativo no pós-operatório imediato para 10,04 mm (p = 0,002). Redução significativa ao final de 6 meses para 9,55 mm (p = 0,012). Atingimos 100% de consolidação com a técnica utilizada, com índice mínimo de complicações. Nenhum paciente apresentou infecção ou precisou ser reoperado. Conclusão A técnica mostrou-se eficaz para o tratamento de fraturas extra-articulares da extremidade distal do rádio ao final de 6 meses, com baixo índice de complicações e parâmetros radiográficos aceitáveis e próximos dos valores anatômicos.

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“…As the most common form of internal fixation, volar locking plate is widely used in the treatment of unstable DRFs. Patients could have an earlier return to normal activities with the reliable fixation of volar locking plate [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors

et al. 2020

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Background: Postoperative radiocarpal joint stiffness (RJS) is common in patients with distal radius fractures (DRFs). The purpose of this study was to record the incidence of RJS and to determine potential risk factors that may be associated with it. Methods: We retrospectively included a series of patients who suffered from DRFs and underwent volar plate fixation. Patients' basic data, radiographic data, and postoperative data were collected. The incidence of RJS during follow-up was recorded, and both univariate analyses and multivariate logistic regression were used to determine factors associated with it. Results: A total of 119 patients were included in this study. After surgical procedures, there were 42 (35.3%) patients with RJS and 77 (64.7%) patients without. The incidence of RJS after surgical treatment is 35.3%. Multivariate analysis showed that intra-articular fracture (OR, 1.43; 95% CI, 1.13-1.81), pre-operative severe swelling (OR, 1.35; 95% CI, 1.05-1.74), post-operative unsatisfied volar tile (OR, 1.38; 95% CI, 1.01-1.89), and improper rehabilitation exercise (OR, 1.72; 95% CI, 1.18-2.51) were correlated with the incidence of RJS during follow-up. Conclusions: Patients with intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile, and improper rehabilitation exercise were factors associated with the incidence of wrist stiffness. Preoperative risk notification and postoperative precautions are necessary for relevant patients.

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Longitudinal recovery following distal radial fractures managed with volar plate fixation

Cited by 13 publications

References 75 publications

Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

Avaliação radiográfica dos pacientes submetidos a fixação percutânea com parafuso maciço para tratamento de fraturas da extremidade distal do radio

Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors

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