Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.

• BACKGROUND AND PURPOSE: Distal radius fractures are most often treated nonoperatively, but sometimes they are treated surgically when deemed unstable. Based on the literature, a consensus protocol for treatment has been developed in southern Sweden to aid clinicians in their decision making. We evaluated the results of this protocol prospectively using a validated outcome instrument (DASH) in a large consecutive and population based series of unselected patients. METHODS: 581 patients were treated according the protocol. Age, sex, fracture side, and type of treatment were registered. The subjective outcome was measured by DASH. 133 patients were operated. RESULTS: 75% of the patients returned the questionnaire. The median DASH score at 3 months was 18.3 and at 12 months it was 7.5. All treatment groups had low DASH scores at the final follow-up. Reduced, nonoperated fractures had a worse score (11.6) than undisplaced (4.2) or operated fractures (6.0). Age was the only other predictor, with older patients having a worse score. A correlation was found between the short-version 11-item QuickDASH questionnaire and the full 30-item DASH, both at 3 months (r = 0.98) and at 1 year (r = 0.97) (p< 0.001 for both). INTERPRETATION: Most patients have residual symptoms at 3 months after the fracture but are normalized at 1 year. Good final subjective result was achieved with the proposed protocol regardless of initial severity and treatment of the fracture, as indicated by a low median DASH score in all groups. There was correlation between QuickDASH and the full DASH, and the former could be used in future studies.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Nyckelord

Fractures

Malunited: surgery

Fracture Fixation: methods

Malunited: therapy

Ununited: surgery

Ununited: therapy

Radius Fractures: therapy

Radius Fractures: surgery

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)