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J Wrist Surg
DOI: 10.1055/s-0044-1791949
Scientific Article

Postoperative Grip Strength and Range of Motion Correlated with Better Patient-Reported Outcomes Following Surgical Management of Distal Radius Fractures

Dor Yaakobi
1   The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
,
Itay Ron 
1   The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
,
Hanan Agbaria
1   The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
,
Mitchell J Yelton
2   Michigan State University College of Human Medicine, East Lansing, Michigan
,
Bezalel Peskin
3   Orthopedic Department, Rambam Medical Center, Haifa, Israel
,
Nabil Ghrayeb
3   Orthopedic Department, Rambam Medical Center, Haifa, Israel
,
Doron Norman
1   The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
3   Orthopedic Department, Rambam Medical Center, Haifa, Israel
,
Jacob Shapira
1   The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
3   Orthopedic Department, Rambam Medical Center, Haifa, Israel
› Author Affiliations Funding None.
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Abstract

Background The common methods for assessing postoperative outcomes in patients with distal radius fractures (DRFs) are mostly observational. In contrast to these traditional assessment tools, postoperative assessments based on patient-reported outcomes (PROs) are becoming more popular. The aim of this study was to analyze the postoperative radiological measurements and physical examination measures as predictive measures for patient-reported satisfying outcomes defined by the Disabilities of the Arm, Shoulder, and Hand (DASH) score and the Gartland and Werley score.

Purpose The aim of this study was to inspect whether postoperative radiological and physical examination measurements are associated with better PROs. This correlation would be beneficial to assess surgery's success and predict patient's recovery process, helping with coordination of patient's expectations postsurgery.

Study Design This is a retrospective cohort study.

Methods Eligible patients were those who underwent Open Reduction Internal Fixation (ORIF) of DRFs and answered the DASH and Gartland and Werley questionnaires with a minimal follow-up period of 6 months and a 2-year median follow-up time; during follow-up, physical examination measures and radiographic measures were taken.

Results This study has found that older patients have a higher probability to achieve better PROs postsurgery and ROM has been found as a factor correlated with DASH score and Gartland and Werley score. A model combining grip strength, supination, and extension was able to predict the DASH score with 63% of variance: DASH score = 88.864–(0.288 × grip strength) – (0.371 × supination) – (0.270 × extension).

Conclusions Due to the high prevalence of DRFs and their debilitating effect on patients' functionality, a credible assessment tool must be defined to predict postsurgery patient satisfaction and help in the patient selection process.

Level of Evidence III.

Keywords

distal - radius

* Dor Yaakobi and Itay Ron contributed equally contributed equally.




Publication History

Received: 07 August 2024

Accepted: 19 September 2024

Article published online:
04 November 2024

© 2024. Thieme. All rights reserved.

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  • References

  • 1 Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006; 37 (08) 691-697
    CrossrefPubMedGoogle Scholar
  • 2 MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther 2016; 29 (02) 136-145
    CrossrefPubMedGoogle Scholar
  • 3 Azad A, Kang HP, Alluri RK, Vakhshori V, Kay HF, Ghiassi A. Epidemiological and treatment trends of distal radius fractures across multiple age groups. J Wrist Surg 2019; 8 (04) 305-311
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC. A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am 2011; 36 (05) 824-35.e2
    CrossrefPubMedGoogle Scholar
  • 5 Chung KC, Kotsis SV, Kim HM. Predictors of functional outcomes after surgical treatment of distal radius fractures. J Hand Surg Am 2007; 32 (01) 76-83
    CrossrefPubMedGoogle Scholar
  • 6 Batra S, Gupta A. The effect of fracture-related factors on the functional outcome at 1 year in distal radius fractures. Injury 2002; 33 (06) 499-502
    CrossrefPubMedGoogle Scholar
  • 7 Yuan K, Wang F, Lu H. Analysis of postoperative complications and related factors affecting prognosis in 50 patients with distal radius fractures. Evid Based Complement Alternat Med 2021; 2021: 8005945
    CrossrefPubMedGoogle Scholar
  • 8 Beaulé PE, Dervin GF, Giachino AA, Rody K, Grabowski J, Fazekas A. Self-reported disability following distal radius fractures: the influence of hand dominance. J Hand Surg Am 2000; 25 (03) 476-482
    CrossrefPubMedGoogle Scholar
  • 9 Christersson A. Fractures of the distal radius: factors related to radiographic evaluation, conservative treatment and fracture healing. 2017 . Accessed April 5, 2022 at: https://www.semanticscholar.org/paper/Fractures-of-the-distal-radius-%3A-Factors-related-to-Christersson/4fca56a17022f517954494bd52ee63a9bc371213
    PubMedGoogle Scholar
  • 10 Michlovitz SL, LaStayo PC, Alzner S, Watson E. Distal radius fractures: therapy practice patterns. J Hand Ther 2001; 14 (04) 249-257
    CrossrefPubMedGoogle Scholar
  • 11 Xie L, Chen C, Yu X, Hu W, Chen H, Sun L. Management of distal radius fracture: a comparison of actual and theoretical treatments. Int J Surg 2018; 60: 137-140
    CrossrefPubMedGoogle Scholar
  • 12 Hurov JR. Fractures of the distal radius: what are the expectations of therapy? A two-year retrospective study. J Hand Ther 1997; 10 (04) 269-276
    CrossrefPubMedGoogle Scholar
  • 13 Gartland Jr JJ, Werley CW. Evaluation of healed Colles' fractures. J Bone Joint Surg Am 1951; 33-A (04) 895-907
    CrossrefPubMedGoogle Scholar
  • 14 Swart E, Nellans K, Rosenwasser M. The effects of pain, supination, and grip strength on patient-rated disability after operatively treated distal radius fractures. J Hand Surg Am 2012; 37 (05) 957-962
    CrossrefPubMedGoogle Scholar
  • 15 Kumar S, Penematsa S, Sadri M, Deshmukh SC. Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?. Int Orthop 2008; 32 (04) 505-509
    CrossrefPubMedGoogle Scholar
  • 16 Jaremko JL, Lambert RGW, Rowe BH, Johnson JA, Majumdar SR. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?. Clin Radiol 2007; 62 (01) 65-72
    CrossrefPubMedGoogle Scholar
  • 17 Hegeman JH, Oskam J, Vierhout PAM, Ten Duis HJ. External fixation for unstable intra-articular distal radial fractures in women older than 55 years. Acceptable functional end results in the majority of the patients despite significant secondary displacement. Injury 2005; 36 (02) 339-344
    CrossrefPubMedGoogle Scholar
  • 18 Goldhahn J, Angst F, Simmen BR. What counts: outcome assessment after distal radius fractures in aged patients. J Orthop Trauma 2008; 22 (8, Suppl): S126-S130
    CrossrefPubMedGoogle Scholar
  • 19 van Leerdam RH, Huizing F, Termaat F. et al. Patient-reported outcomes after a distal radius fracture in adults: a 3-4 years follow-up. Acta Orthop 2019; 90 (02) 129-134
    CrossrefPubMedGoogle Scholar
  • 20 Irrgang JJ, Lubowitz JH. Measuring arthroscopic outcome. Arthroscopy 2008; 24 (06) 718-722
    CrossrefPubMedGoogle Scholar
  • 21 Lichtman DM, Bindra RR, Boyer MI. et al. Treatment of distal radius fractures. J Am Acad Orthop Surg 2010; 18 (03) 180-189
    CrossrefPubMedGoogle Scholar
  • 22 Marsh JL, Slongo TF, Agel J. et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma 2007; 21 (10) S1-S6
    CrossrefPubMedGoogle Scholar
  • 23 Tang JB, Giddins G. Why and how to report surgeons' levels of expertise. J Hand Surg Eur Vol 2016; 41 (04) 365-366
    CrossrefPubMedGoogle Scholar
  • 24 Hamoudi C, Sapa MC, Facca S, Xavier F, Goetsch T, Liverneaux P. Influence of surgical performance on clinical outcome after osteosynthesis of distal radius fracture. Hand Surg Rehabil 2023; 42 (05) 430-434
    CrossrefPubMedGoogle Scholar
  • 25 Dowrick AS, Gabbe BJ, Williamson OD, Cameron PA. Outcome instruments for the assessment of the upper extremity following trauma: a review. Injury 2005; 36 (04) 468-476
    CrossrefPubMedGoogle Scholar
  • 26 Ilyas AM, Jupiter JB. Distal radius fractures–classification of treatment and indications for surgery. Orthop Clin North Am 2007; 38 (02) 167-173 , v
    CrossrefPubMedGoogle Scholar
  • 27 Kamal RN, Shapiro LM. American Academy of Orthopaedic Surgeons/American Society for Surgery of the Hand Clinical Practice Guideline Summary Management of Distal Radius Fractures. J Am Acad Orthop Surg 2022; 30 (04) e480-e486
    CrossrefPubMedGoogle Scholar
  • 28 Luokkala T, Laitinen MK, Hevonkorpi TP, Raittio L, Mattila VM, Launonen AP. Distal radius fractures in the elderly population. EFORT Open Rev 2020; 5 (06) 361-370
    CrossrefPubMedGoogle Scholar
  • 29 Altissimi M, Antenucci R, Fiacca C, Mancini GB. Long-term results of conservative treatment of fractures of the distal radius. Clin Orthop Relat Res 1986; 206: 202-210
    CrossrefPubMedGoogle Scholar
  • 30 Wilcke MKT, Abbaszadegan H, Adolphson PY. Patient-perceived outcome after displaced distal radius fractures. A comparison between radiological parameters, objective physical variables, and the DASH score. J Hand Ther 2007; 20 (04) 290-298 , quiz 299
    CrossrefPubMedGoogle Scholar
  • 31 Karnezis IA, Fragkiadakis EG. Association between objective clinical variables and patient-rated disability of the wrist. J Bone Joint Surg Br 2002; 84 (07) 967-970
    CrossrefPubMedGoogle Scholar
  • 32 Finsen V, Rod O, Rød K, Rajabi B, Alm-Paulsen PS, Russwurm H. The relationship between displacement and clinical outcome after distal radius (Colles') fracture. J Hand Surg Eur Vol 2013; 38 (02) 116-126
    CrossrefPubMedGoogle Scholar