Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?
Aim To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods Consecutive patients over 50 years of age ( n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort...
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description | Aim To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods Consecutive patients over 50 years of age ( n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal (∼6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results Of the cohort studied ( n = 74, mean age 68.5 years, primarily white women), 71% had at least one “unacceptable” radiographic deformity by traditional criteria. Acceptable reduction varied from 60–99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 ± 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the "acceptability" of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary. |
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Materials and methods Consecutive patients over 50 years of age ( n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal (∼6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results Of the cohort studied ( n = 74, mean age 68.5 years, primarily white women), 71% had at least one “unacceptable” radiographic deformity by traditional criteria. Acceptable reduction varied from 60–99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 ± 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the "acceptability" of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2006.08.013</identifier><identifier>PMID: 17145266</identifier><identifier>CODEN: CLRAAG</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ltd</publisher><subject>Aged ; Biological and medical sciences ; Casts, Surgical ; Female ; Follow-Up Studies ; Fracture Fixation ; Fracture Healing ; Humans ; Injuries of the limb. Injuries of the spine ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Radiography ; Radiology ; Radius - diagnostic imaging ; Radius Fractures - diagnostic imaging ; Radius Fractures - physiopathology ; Radius Fractures - therapy ; Range of Motion, Articular ; Traumas. Diseases due to physical agents ; Treatment Outcome ; Wrist Injuries - diagnostic imaging ; Wrist Injuries - physiopathology ; Wrist Injuries - therapy ; Wrist Joint - physiopathology</subject><ispartof>Clinical radiology, 2007-01, Vol.62 (1), p.65-72</ispartof><rights>The Royal College of Radiologists</rights><rights>2006 The Royal College of Radiologists</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-b9862a05c24572f4e4e1da66256bbdb4c112697c654650581d88266e29a406653</citedby><cites>FETCH-LOGICAL-c439t-b9862a05c24572f4e4e1da66256bbdb4c112697c654650581d88266e29a406653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.crad.2006.08.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18403696$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17145266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jaremko, J.L</creatorcontrib><creatorcontrib>Lambert, R.G.W</creatorcontrib><creatorcontrib>Rowe, B.H</creatorcontrib><creatorcontrib>Johnson, J.A</creatorcontrib><creatorcontrib>Majumdar, S.R</creatorcontrib><title>Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>Aim To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods Consecutive patients over 50 years of age ( n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal (∼6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results Of the cohort studied ( n = 74, mean age 68.5 years, primarily white women), 71% had at least one “unacceptable” radiographic deformity by traditional criteria. Acceptable reduction varied from 60–99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 ± 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the "acceptability" of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Casts, Surgical</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fracture Fixation</subject><subject>Fracture Healing</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Radiography</subject><subject>Radiology</subject><subject>Radius - diagnostic imaging</subject><subject>Radius Fractures - diagnostic imaging</subject><subject>Radius Fractures - physiopathology</subject><subject>Radius Fractures - therapy</subject><subject>Range of Motion, Articular</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><subject>Wrist Injuries - diagnostic imaging</subject><subject>Wrist Injuries - physiopathology</subject><subject>Wrist Injuries - therapy</subject><subject>Wrist Joint - physiopathology</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk-L1DAYh4Mo7uzqF_AgueitNUnTTAuiyK7_YMGDCt5C-ubtmrFNZpN0YC9-dlNnYMGDEEhCnt_7Jg8h5BlnNWdcvdrVEI2tBWOqZl3NePOAbHij2kqI_sdDsmGM9VUvFDsj5ynt1q0U8jE541suW6HUhvy-CrQUceEmmv1PB9R56wATDSO1LmUz_T1eEh2jgbxEpBHtAtkFT_dl6SDTsGQIcwk5T8NkMVJjlymnggK6g_M3FIJPGA8muwPSHNHkGX1--4Q8Gs2U8OlpviDfP7z_dvmpuv7y8fPlu-sKZNPnaug7JQxrQch2K0aJErk1SolWDYMdJHAuVL8F1UrVsrbjtuvK81D0RjKl2uaCvDzW3cdwu2DKenYJcJqMx7AkrbpG9axvCiiOIMSQUsRR76ObTbzTnOnVut7p1bperWvW6WK9hJ6fqi_DjPY-ctJcgBcnwCQwU1HpwaV7rpOs9F-510cOi4uDw6gTOPRQNBeVWdvg_n-PN__EYXLelY6_8A7TLizRF8ua6yQ001_XD7F-D1ZGw-S2-QPLX7ap</recordid><startdate>20070101</startdate><enddate>20070101</enddate><creator>Jaremko, J.L</creator><creator>Lambert, R.G.W</creator><creator>Rowe, B.H</creator><creator>Johnson, J.A</creator><creator>Majumdar, S.R</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070101</creationdate><title>Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?</title><author>Jaremko, J.L ; Lambert, R.G.W ; Rowe, B.H ; Johnson, J.A ; Majumdar, S.R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-b9862a05c24572f4e4e1da66256bbdb4c112697c654650581d88266e29a406653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Casts, Surgical</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fracture Fixation</topic><topic>Fracture Healing</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Radiography</topic><topic>Radiology</topic><topic>Radius - diagnostic imaging</topic><topic>Radius Fractures - diagnostic imaging</topic><topic>Radius Fractures - physiopathology</topic><topic>Radius Fractures - therapy</topic><topic>Range of Motion, Articular</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><topic>Wrist Injuries - diagnostic imaging</topic><topic>Wrist Injuries - physiopathology</topic><topic>Wrist Injuries - therapy</topic><topic>Wrist Joint - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jaremko, J.L</creatorcontrib><creatorcontrib>Lambert, R.G.W</creatorcontrib><creatorcontrib>Rowe, B.H</creatorcontrib><creatorcontrib>Johnson, J.A</creatorcontrib><creatorcontrib>Majumdar, S.R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jaremko, J.L</au><au>Lambert, R.G.W</au><au>Rowe, B.H</au><au>Johnson, J.A</au><au>Majumdar, S.R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2007-01-01</date><risdate>2007</risdate><volume>62</volume><issue>1</issue><spage>65</spage><epage>72</epage><pages>65-72</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><coden>CLRAAG</coden><abstract>Aim To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods Consecutive patients over 50 years of age ( n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal (∼6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results Of the cohort studied ( n = 74, mean age 68.5 years, primarily white women), 71% had at least one “unacceptable” radiographic deformity by traditional criteria. Acceptable reduction varied from 60–99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 ± 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the "acceptability" of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary.</abstract><cop>Amsterdam</cop><pub>Elsevier Ltd</pub><pmid>17145266</pmid><doi>10.1016/j.crad.2006.08.013</doi><tpages>8</tpages></addata></record> |
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subjects | Aged Biological and medical sciences Casts, Surgical Female Follow-Up Studies Fracture Fixation Fracture Healing Humans Injuries of the limb. Injuries of the spine Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Prospective Studies Radiography Radiology Radius - diagnostic imaging Radius Fractures - diagnostic imaging Radius Fractures - physiopathology Radius Fractures - therapy Range of Motion, Articular Traumas. Diseases due to physical agents Treatment Outcome Wrist Injuries - diagnostic imaging Wrist Injuries - physiopathology Wrist Injuries - therapy Wrist Joint - physiopathology |
title | Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment? |
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