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Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?

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Abstract

The purpose of this study was to evaluate the relationship between radiological and functional results in patients with extra-articular fractures of the distal radius. We conducted a prospective study of radiological and functional assessment in 95 consecutively selected extra-articular distal radius fractures. There were two patient groups: more than 60 and less than 60 years of age. The final fracture union radiographs were analysed for their functional outcome using the Michigan Hand Outcomes Questionnaire (MHQ) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. In patients with acceptable radiological results, 62% (MHQ group) and 72% (DASH group) of patients had satisfactory functional outcome. Analysing patients with satisfactory functional results, 56% (MHQ group) and 59% (DASH group) had satisfactory radiological results. There was a higher proportion of patients with better functional results, despite poor radiological results, in both of the age groups. There was a statistically significant correlation between satisfactory radial tilt and functional outcome in the younger patients. In the older age group, patients with satisfactory radiological results had satisfactory functional outcome (p < 0.05). However, in the older age group, satisfactory functional results were achieved, despite unsatisfactory radiological results.

Résumé

Le propos de cette étude est d’évaluer les relations entre les résultats radiologiques et fonctionnels des patients ayant présenté une fracture extra articulaire de l’extrémité distale du radius. Une étude prospective et radiologique a été menée chez 95 patients consécutifs présentant ce type de fractures. Ils ont été divisés en deux groupes, le groupe de plus de 60 ans et le groupe de moins de 60 ans. La consolidation finale, radiographique, a été analysée de même que le résultat fonctionnel en utilisant le score de Michigan et le questionnaire DASH. Si l’on prend les patients présentant un résultat radiologique acceptable, 62% selon le score Michigan et 72% selon le score DASH, ceux-ci ont un résultat fonctionnel satisfaisant. Si l’on analyse les patients à partir du score fonctionnel : 56% ayant un score Michigan satisfaisant et 59% un score DASH satisfaisant ceux-ci ont une consolidation radiologique également satisfaisante. Les résultats montrent qu’il existe une proportion élevée de patients ayant un score fonctionnel satisfaisant en dépit d’un résultat radiologique peu satisfaisant dans chaque groupe d’âge. De même il existe une relation statistiquement significative entre la bascule de l’extrémité distale du radius et le résultat fonctionnel chez les patients jeunes. Dans le groupe des patients âgés de plus de 60 ans ceux qui ont un résultat radiologique satisfaisant ont également un résultat cliniquement satisfaisant (p < 0.05). Cependant dans le groupe des patients les plus âgés les résultats fonctionnels satisfaisants sont observés malgré des résultats radiologiques peu satisfaisants.

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Authors and Affiliations

  1. Nuffield Orthopaedic Centre, Oxford, UK

    Skand Kumar & Subbaraju Penematsa

  2. Birmingham City Hospital, Birmingham, UK

    Maziar Sadri & Subodh C. Deshmukh

  3. Flat 4, Girdlestone Close, Headington, Oxford, OX3 7NS, UK

    Skand Kumar

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  1. Skand Kumar
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  2. Subbaraju Penematsa
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  3. Maziar Sadri
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  4. Subodh C. Deshmukh
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Correspondence to Skand Kumar.

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Kumar, S., Penematsa, S., Sadri, M. et al. Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?. International Orthopaedics (SICO 32, 505–509 (2008). https://doi.org/10.1007/s00264-007-0355-4

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  • DOI: https://doi.org/10.1007/s00264-007-0355-4

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