An Hospital Based Observational Study Assessing Factors Associated with the Incidence of Radiocarpal Stiffness Following Management of Distal Radius Fractures Surgically
Authors/Creators
- 1. Assistant Professor, Department of Orthopaedics, Katihar Medical College and Hospital, Katihar, Bihar, India
- 2. Senior Resident, Department of Physiology, Nalanda Medical College and Hospital, Patna, Bihar, India
- 3. Senior Resident, Department of Physical Medicine and Rehabilitation, ESIC Medical College, Bihta, Patna, Bihar, India
- 4. Professor and Head, Department of Orthopaedics, Katihar Medical College and Hospital, Katihar, Bihar, India
Description
Abstract
Aim: The aim of the present study to assess factors associated with the incidence of radiocarpal stiffness
following management of distal radius fractures surgically.
Material & Methods: This study reviewed a series of patients who suffered from DRFs at Department of
Orthopedics. The inclusion criteria were adult patients with closed DRFs confirmed by x-ray test or computed
tomography (CT) scan and underwent surgical treatment with volar locking plate fixation. A total of 150
patients who underwent distal radius volar locking plate fixation were included in the current study.
Results: Among these patients, 40 (26.66%) were male, and 110 (73.33%) were female. The mean age at the
time of surgery was 54.6 ± 10.6 with stiffness and 52.8 ± 9.1 without stiffness. Preoperative swelling was considered
to be slight in 57 patients (38%) and was severe in 93 patients (62%). Extra-articular fractures were seen in 30
patients (20%), and intra-articular fractures were in 120 patients (80%). During surgery, 78 fractures (52%)
were fixed with plate only, and the other 72 fractures (48%) were fixed with plate and Kirschner wire. The
incidence of RJS, we found that age, preoperative swelling, types of internal fixation, fracture type, postoperative volar tile and improper rehabilitation exercise were potential risk factors, while gender, BMI, history
of smoking or alcohol, diabetes mellitus, osteoporosis, dominant hand, time from injury to operation, ulnar
styloid process fracture, post-operative radial inclination, post- operative ulnar variance, assisted cast or splint
fixation, postoperative infection, or removal of internal fixation was not. In the further multivariate logistic
regression analysis, intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile
and improper rehabilitation exercise were demonstrated to be associated with the incidence of RJS during
follow-up.
Conclusion: Factors such as intra-articular extension, preoperative severe swelling, use of additional k-wire,
unsatisfied volar tilt, improper rehabilitation is associated with a higher incidence of radiocarpal joint stiffness
in patients with distal radius fracture. Re-operative risk notification and postoperative precautions are necessary
for relevant patients
Abstract (English)
Abstract
Aim: The aim of the present study to assess factors associated with the incidence of radiocarpal stiffness
following management of distal radius fractures surgically.
Material & Methods: This study reviewed a series of patients who suffered from DRFs at Department of
Orthopedics. The inclusion criteria were adult patients with closed DRFs confirmed by x-ray test or computed
tomography (CT) scan and underwent surgical treatment with volar locking plate fixation. A total of 150
patients who underwent distal radius volar locking plate fixation were included in the current study.
Results: Among these patients, 40 (26.66%) were male, and 110 (73.33%) were female. The mean age at the
time of surgery was 54.6 ± 10.6 with stiffness and 52.8 ± 9.1 without stiffness. Preoperative swelling was considered
to be slight in 57 patients (38%) and was severe in 93 patients (62%). Extra-articular fractures were seen in 30
patients (20%), and intra-articular fractures were in 120 patients (80%). During surgery, 78 fractures (52%)
were fixed with plate only, and the other 72 fractures (48%) were fixed with plate and Kirschner wire. The
incidence of RJS, we found that age, preoperative swelling, types of internal fixation, fracture type, postoperative volar tile and improper rehabilitation exercise were potential risk factors, while gender, BMI, history
of smoking or alcohol, diabetes mellitus, osteoporosis, dominant hand, time from injury to operation, ulnar
styloid process fracture, post-operative radial inclination, post- operative ulnar variance, assisted cast or splint
fixation, postoperative infection, or removal of internal fixation was not. In the further multivariate logistic
regression analysis, intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile
and improper rehabilitation exercise were demonstrated to be associated with the incidence of RJS during
follow-up.
Conclusion: Factors such as intra-articular extension, preoperative severe swelling, use of additional k-wire,
unsatisfied volar tilt, improper rehabilitation is associated with a higher incidence of radiocarpal joint stiffness
in patients with distal radius fracture. Re-operative risk notification and postoperative precautions are necessary
for relevant patients
Files
IJCPR,Vol15,Issue11,Article26.pdf
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Additional details
Dates
- Accepted
-
2023-09-17