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A Comparison of the Long-Term Outcome of Partial Articular (AO Type B) and Complete Articular (AO Type C) Distal Radius Fractures

2013; Elsevier BV; Volume: 38; Issue: 4 Linguagem: Inglês

10.1016/j.jhsa.2012.12.027

1531-6564

Annelies Bolmers, Willem E. Luiten, Job N. Doornberg, Kim M. Brouwer, J. Carel Goslings, David Ring, Peter Kloen,

Elbow and Forearm Trauma Treatment

Purpose A short-term comparison of AO type B (shearing) and type C (compression) articular fractures of the distal radius found no significant differences in functional outcome, but long-term studies would provide important information. We tested the null hypothesis that there is no difference in arm-specific disability between patients with type B and C fractures in long-term follow-up. Methods We evaluated 46 patients (17 with type B fractures and 29 patients with 31 type C fractures of the distal radius) with a mean age of 39 years at the time of injury at a mean of 20 years after operative treatment. We used the Disabilities of the Arm, Shoulder, and Hand questionnaire and 2 physician-based rating systems, the modified Mayo wrist score and the modified Gartland and Werley score. We performed bivariate and multivariable analyses to identify the factors that contributed most to the variation in these scores. Results There were no significant differences between patients with type B and C fractures on the Disabilities of the Arm, Shoulder, and Hand, modified Mayo wrist, or Gartland and Werley scores, or with respect to range of motion, grip strength, and arthrosis. The only statistical difference was in volar tilt of the articular surface on lateral radiographs. Conclusions On average, patients undergoing operative treatment of type B and type C articular fractures of the distal radius have similar impairment, symptoms, and disability in the long-term. Type of study/level of evidence Therapeutic III. A short-term comparison of AO type B (shearing) and type C (compression) articular fractures of the distal radius found no significant differences in functional outcome, but long-term studies would provide important information. We tested the null hypothesis that there is no difference in arm-specific disability between patients with type B and C fractures in long-term follow-up. We evaluated 46 patients (17 with type B fractures and 29 patients with 31 type C fractures of the distal radius) with a mean age of 39 years at the time of injury at a mean of 20 years after operative treatment. We used the Disabilities of the Arm, Shoulder, and Hand questionnaire and 2 physician-based rating systems, the modified Mayo wrist score and the modified Gartland and Werley score. We performed bivariate and multivariable analyses to identify the factors that contributed most to the variation in these scores. There were no significant differences between patients with type B and C fractures on the Disabilities of the Arm, Shoulder, and Hand, modified Mayo wrist, or Gartland and Werley scores, or with respect to range of motion, grip strength, and arthrosis. The only statistical difference was in volar tilt of the articular surface on lateral radiographs. On average, patients undergoing operative treatment of type B and type C articular fractures of the distal radius have similar impairment, symptoms, and disability in the long-term.