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 ({approx}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
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Jaremko, J L;
[1]
Lambert, R G.W.;
[1]
Rowe, B H;
[2]
Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)];
Johnson, J A;
[3]
Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)];
Majumdar, S R
[4]
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta (Canada)
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta (Canada)
- Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)
- Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada) and Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)
Citation Formats
Jaremko, J L, Lambert, R G.W., Rowe, B H, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)], Johnson, J A, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)], and Majumdar, S R.
Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?.
United Kingdom: N. p.,
2007.
Web.
doi:10.1016/j.crad.2006.08.013.
Jaremko, J L, Lambert, R G.W., Rowe, B H, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)], Johnson, J A, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)], & Majumdar, S R.
Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?.
United Kingdom.
https://doi.org/10.1016/j.crad.2006.08.013
Jaremko, J L, Lambert, R G.W., Rowe, B H, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)], Johnson, J A, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)], and Majumdar, S R.
2007.
"Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?"
United Kingdom.
https://doi.org/10.1016/j.crad.2006.08.013.
@misc{etde_20839637,
title = {Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?}
author = {Jaremko, J L, Lambert, R G.W., Rowe, B H, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)], Johnson, J A, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)], and Majumdar, S R}
abstractNote = {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 ({approx}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.}
doi = {10.1016/j.crad.2006.08.013}
journal = []
issue = {1}
volume = {62}
place = {United Kingdom}
year = {2007}
month = {Jan}
}
title = {Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?}
author = {Jaremko, J L, Lambert, R G.W., Rowe, B H, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada)], Johnson, J A, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)], and Majumdar, S R}
abstractNote = {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 ({approx}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.}
doi = {10.1016/j.crad.2006.08.013}
journal = []
issue = {1}
volume = {62}
place = {United Kingdom}
year = {2007}
month = {Jan}
}