Comparison of Intra-Articular Simple Compression and Extra-Articular Distal Radial Fractures
BACKGROUND:The impact of a single well-reduced or stable intra-articular fracture oriented in the sagittal plane on the outcome of internal fixation of a distal radial fracture is uncertain. We tested the hypothesis that wrist motion and function scores would not differ between patients with an extr...
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| Veröffentlicht in: | Journal of bone and joint surgery. American volume 2011-11, Vol.93 (22), p.2093-2099 |
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| creator | Souer, J Sebastiaan Ring, David Jupiter, Jesse Matschke, Stefan Audigé, Laurent Marent-Huber, Marta |
| description | BACKGROUND:The impact of a single well-reduced or stable intra-articular fracture oriented in the sagittal plane on the outcome of internal fixation of a distal radial fracture is uncertain. We tested the hypothesis that wrist motion and function scores would not differ between patients with an extra-articular fracture and those with a single sagittal intra-articular fracture following open fracture reduction and internal fixation with use of a volar locking plate.
METHODS:Thirty-seven patients with a single sagittal intra-articular fracture of the distal aspect of the radius and seventy-four age and sex-matched patients with an extra-articular distal radial fracture were retrospectively analyzed with use of data gathered in a cohort study of plate and screw fixation of distal radial fractures. A volar locking plate was used in all patients. The two cohorts were analyzed for differences in motion, grip strength, pain, and Gartland and Werley, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores six, twelve, and twenty-four months after surgery. Differences between the cohorts and differences within each cohort over time were determined with use of regression analysis and the likelihood ratio test.
RESULTS:Patients with a single sagittal intra-articular fracture and those an extra-articular fracture did not differ significantly with respect to motion, grip strength, Gartland and Werley score, or DASH score at any time point. However, there was a trend toward less pronation (95% compared with 98% of that in the contralateral arm) and less grip strength (76% compared with 81% of that in the contralateral arm) at six months and toward a smaller flexion-extension arc (118° compared with 128°) at one year after surgery in patients with a single sagittal intra-articular fracture.
CONCLUSIONS:Open reduction and volar locking plate and screw fixation of extra-articular fractures and of simple intra-articular fractures of the distal aspect of the radius are associated with comparable impairment and disability within two years of surgery.
LEVEL OF EVIDENCE:Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence. |
| doi_str_mv | 10.2106/JBJS.J.01069 |
| format | Article |
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METHODS:Thirty-seven patients with a single sagittal intra-articular fracture of the distal aspect of the radius and seventy-four age and sex-matched patients with an extra-articular distal radial fracture were retrospectively analyzed with use of data gathered in a cohort study of plate and screw fixation of distal radial fractures. A volar locking plate was used in all patients. The two cohorts were analyzed for differences in motion, grip strength, pain, and Gartland and Werley, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores six, twelve, and twenty-four months after surgery. Differences between the cohorts and differences within each cohort over time were determined with use of regression analysis and the likelihood ratio test.
RESULTS:Patients with a single sagittal intra-articular fracture and those an extra-articular fracture did not differ significantly with respect to motion, grip strength, Gartland and Werley score, or DASH score at any time point. However, there was a trend toward less pronation (95% compared with 98% of that in the contralateral arm) and less grip strength (76% compared with 81% of that in the contralateral arm) at six months and toward a smaller flexion-extension arc (118° compared with 128°) at one year after surgery in patients with a single sagittal intra-articular fracture.
CONCLUSIONS:Open reduction and volar locking plate and screw fixation of extra-articular fractures and of simple intra-articular fractures of the distal aspect of the radius are associated with comparable impairment and disability within two years of surgery.
LEVEL OF EVIDENCE:Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.</description><identifier>ISSN: 0021-9355</identifier><identifier>EISSN: 1535-1386</identifier><identifier>DOI: 10.2106/JBJS.J.01069</identifier><identifier>PMID: 22262381</identifier><identifier>CODEN: JBJSA3</identifier><language>eng</language><publisher>Boston, MA: Copyright by The Journal of Bone and Joint Surgery, Incorporated</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Bone Plates ; Bone Screws ; Cohort Studies ; Diseases of the osteoarticular system ; Female ; Follow-Up Studies ; Fracture Fixation, Internal - instrumentation ; Fracture Fixation, Internal - methods ; Fracture Healing - physiology ; Fractures, Compression - diagnostic imaging ; Fractures, Compression - surgery ; Humans ; Injuries of the limb. Injuries of the spine ; Intra-Articular Fractures - diagnostic imaging ; Intra-Articular Fractures - surgery ; Male ; Medical sciences ; Middle Aged ; Orthopedic surgery ; Radiography ; Radius Fractures - diagnostic imaging ; Radius Fractures - surgery ; Range of Motion, Articular - physiology ; Recovery of Function ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Time Factors ; Traumas. Diseases due to physical agents ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of bone and joint surgery. American volume, 2011-11, Vol.93 (22), p.2093-2099</ispartof><rights>Copyright 2011 by The Journal of Bone and Joint Surgery, Incorporated</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3657-8cc37c74562aa3b386c7f56832a18942f88c1f1a21fe0174bcb9431cd956f8293</citedby><cites>FETCH-LOGICAL-c3657-8cc37c74562aa3b386c7f56832a18942f88c1f1a21fe0174bcb9431cd956f8293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25331451$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22262381$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Souer, J Sebastiaan</creatorcontrib><creatorcontrib>Ring, David</creatorcontrib><creatorcontrib>Jupiter, Jesse</creatorcontrib><creatorcontrib>Matschke, Stefan</creatorcontrib><creatorcontrib>Audigé, Laurent</creatorcontrib><creatorcontrib>Marent-Huber, Marta</creatorcontrib><creatorcontrib>LCP Distal Radius Study Group</creatorcontrib><title>Comparison of Intra-Articular Simple Compression and Extra-Articular Distal Radial Fractures</title><title>Journal of bone and joint surgery. American volume</title><addtitle>J Bone Joint Surg Am</addtitle><description>BACKGROUND:The impact of a single well-reduced or stable intra-articular fracture oriented in the sagittal plane on the outcome of internal fixation of a distal radial fracture is uncertain. We tested the hypothesis that wrist motion and function scores would not differ between patients with an extra-articular fracture and those with a single sagittal intra-articular fracture following open fracture reduction and internal fixation with use of a volar locking plate.
METHODS:Thirty-seven patients with a single sagittal intra-articular fracture of the distal aspect of the radius and seventy-four age and sex-matched patients with an extra-articular distal radial fracture were retrospectively analyzed with use of data gathered in a cohort study of plate and screw fixation of distal radial fractures. A volar locking plate was used in all patients. The two cohorts were analyzed for differences in motion, grip strength, pain, and Gartland and Werley, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores six, twelve, and twenty-four months after surgery. Differences between the cohorts and differences within each cohort over time were determined with use of regression analysis and the likelihood ratio test.
RESULTS:Patients with a single sagittal intra-articular fracture and those an extra-articular fracture did not differ significantly with respect to motion, grip strength, Gartland and Werley score, or DASH score at any time point. However, there was a trend toward less pronation (95% compared with 98% of that in the contralateral arm) and less grip strength (76% compared with 81% of that in the contralateral arm) at six months and toward a smaller flexion-extension arc (118° compared with 128°) at one year after surgery in patients with a single sagittal intra-articular fracture.
CONCLUSIONS:Open reduction and volar locking plate and screw fixation of extra-articular fractures and of simple intra-articular fractures of the distal aspect of the radius are associated with comparable impairment and disability within two years of surgery.
LEVEL OF EVIDENCE:Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Bone Plates</subject><subject>Bone Screws</subject><subject>Cohort Studies</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fracture Fixation, Internal - instrumentation</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Fracture Healing - physiology</subject><subject>Fractures, Compression - diagnostic imaging</subject><subject>Fractures, Compression - surgery</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Intra-Articular Fractures - diagnostic imaging</subject><subject>Intra-Articular Fractures - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Orthopedic surgery</subject><subject>Radiography</subject><subject>Radius Fractures - diagnostic imaging</subject><subject>Radius Fractures - surgery</subject><subject>Range of Motion, Articular - physiology</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Time Factors</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0021-9355</issn><issn>1535-1386</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpV0cFP2zAUBnBrGhql7LYzymXahRQ_O3aSIyswqCpNGnBDsl5dW5g5SbETdfz3c9bChC_Psn76ZH2PkC9AZwyoPFt8X9zOFjOa7vUHMgHBRQ68kh_JhFIGec2FOCRHMT5RSouClp_IIWNMMl7BhDzMu2aDwcWuzTqb3bR9wPw89E4PHkN265qNN9mIgonRJYXtOrv8855duNijz37h2qVxFVD3Q_LH5MCij-bzfk7J_dXl3fw6X_78cTM_X-aaS1Hmlda81GUhJEPkq_R3XVohK84Qqrpgtqo0WEAG1lAoi5Ve1QUHva6FtBWr-ZR82-VuQvc8mNirxkVtvMfWdENUNZQgIbWV5OlO6tDFGIxVm-AaDC8KqBrrVGOdaqH-1Zn4yT54WDVm_YZf-0vg6x5g1OhtwFa7-N8JzqEQoyt2btv53oT42w9bE9SjQd8_KjpuJgXmjMJ4JM3Hp5L_Be7ni90</recordid><startdate>20111116</startdate><enddate>20111116</enddate><creator>Souer, J Sebastiaan</creator><creator>Ring, David</creator><creator>Jupiter, Jesse</creator><creator>Matschke, Stefan</creator><creator>Audigé, Laurent</creator><creator>Marent-Huber, Marta</creator><general>Copyright by The Journal of Bone and Joint Surgery, Incorporated</general><general>Journal of Bone and Joint Surgery Incorporated</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>20111116</creationdate><title>Comparison of Intra-Articular Simple Compression and Extra-Articular Distal Radial Fractures</title><author>Souer, J Sebastiaan ; Ring, David ; Jupiter, Jesse ; Matschke, Stefan ; Audigé, Laurent ; Marent-Huber, Marta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3657-8cc37c74562aa3b386c7f56832a18942f88c1f1a21fe0174bcb9431cd956f8293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Bone Plates</topic><topic>Bone Screws</topic><topic>Cohort Studies</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fracture Fixation, Internal - instrumentation</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Fracture Healing - physiology</topic><topic>Fractures, Compression - diagnostic imaging</topic><topic>Fractures, Compression - surgery</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Intra-Articular Fractures - diagnostic imaging</topic><topic>Intra-Articular Fractures - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Orthopedic surgery</topic><topic>Radiography</topic><topic>Radius Fractures - diagnostic imaging</topic><topic>Radius Fractures - surgery</topic><topic>Range of Motion, Articular - physiology</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Time Factors</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Souer, J Sebastiaan</creatorcontrib><creatorcontrib>Ring, David</creatorcontrib><creatorcontrib>Jupiter, Jesse</creatorcontrib><creatorcontrib>Matschke, Stefan</creatorcontrib><creatorcontrib>Audigé, Laurent</creatorcontrib><creatorcontrib>Marent-Huber, Marta</creatorcontrib><creatorcontrib>LCP Distal Radius Study Group</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>Journal of bone and joint surgery. American volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Souer, J Sebastiaan</au><au>Ring, David</au><au>Jupiter, Jesse</au><au>Matschke, Stefan</au><au>Audigé, Laurent</au><au>Marent-Huber, Marta</au><aucorp>LCP Distal Radius Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Intra-Articular Simple Compression and Extra-Articular Distal Radial Fractures</atitle><jtitle>Journal of bone and joint surgery. American volume</jtitle><addtitle>J Bone Joint Surg Am</addtitle><date>2011-11-16</date><risdate>2011</risdate><volume>93</volume><issue>22</issue><spage>2093</spage><epage>2099</epage><pages>2093-2099</pages><issn>0021-9355</issn><eissn>1535-1386</eissn><coden>JBJSA3</coden><abstract>BACKGROUND:The impact of a single well-reduced or stable intra-articular fracture oriented in the sagittal plane on the outcome of internal fixation of a distal radial fracture is uncertain. We tested the hypothesis that wrist motion and function scores would not differ between patients with an extra-articular fracture and those with a single sagittal intra-articular fracture following open fracture reduction and internal fixation with use of a volar locking plate.
METHODS:Thirty-seven patients with a single sagittal intra-articular fracture of the distal aspect of the radius and seventy-four age and sex-matched patients with an extra-articular distal radial fracture were retrospectively analyzed with use of data gathered in a cohort study of plate and screw fixation of distal radial fractures. A volar locking plate was used in all patients. The two cohorts were analyzed for differences in motion, grip strength, pain, and Gartland and Werley, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores six, twelve, and twenty-four months after surgery. Differences between the cohorts and differences within each cohort over time were determined with use of regression analysis and the likelihood ratio test.
RESULTS:Patients with a single sagittal intra-articular fracture and those an extra-articular fracture did not differ significantly with respect to motion, grip strength, Gartland and Werley score, or DASH score at any time point. However, there was a trend toward less pronation (95% compared with 98% of that in the contralateral arm) and less grip strength (76% compared with 81% of that in the contralateral arm) at six months and toward a smaller flexion-extension arc (118° compared with 128°) at one year after surgery in patients with a single sagittal intra-articular fracture.
CONCLUSIONS:Open reduction and volar locking plate and screw fixation of extra-articular fractures and of simple intra-articular fractures of the distal aspect of the radius are associated with comparable impairment and disability within two years of surgery.
LEVEL OF EVIDENCE:Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.</abstract><cop>Boston, MA</cop><pub>Copyright by The Journal of Bone and Joint Surgery, Incorporated</pub><pmid>22262381</pmid><doi>10.2106/JBJS.J.01069</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Bone Plates Bone Screws Cohort Studies Diseases of the osteoarticular system Female Follow-Up Studies Fracture Fixation, Internal - instrumentation Fracture Fixation, Internal - methods Fracture Healing - physiology Fractures, Compression - diagnostic imaging Fractures, Compression - surgery Humans Injuries of the limb. Injuries of the spine Intra-Articular Fractures - diagnostic imaging Intra-Articular Fractures - surgery Male Medical sciences Middle Aged Orthopedic surgery Radiography Radius Fractures - diagnostic imaging Radius Fractures - surgery Range of Motion, Articular - physiology Recovery of Function Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Time Factors Traumas. Diseases due to physical agents Treatment Outcome Young Adult |
| title | Comparison of Intra-Articular Simple Compression and Extra-Articular Distal Radial Fractures |
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