Does Intraarticular Involvement Affect Patient-reported Outcomes? A Retrospective Study of Surgically-treated Distal Radius Fracture Patients
Stephen A Doxey, DO1, Rebekah M Kleinsmith, MD1, Deborah C Bohn, MD2 and Brian P Cunningham, MD3, (1)TRIA Orthopedic Center, Bloomington, MN, (2)Orthopaedics, University of Minnesota, Minneapolis, MN, (3)Park Nicollet Methodist Hospital, Minneapolis, MN
Distal radius fractures(DRFs) are a very common injury. The amount of articular involvement of fractures has been shown to affect outcomes in other injury patterns. Currently there is a paucity of literature evaluating the effect of fracture pattern on PROs in DRFs. The purpose of this study was to evaluate the influence of intraarticular vs extraarticular fracture patterns on PROs at six-week and three-month follow-up.
A prospectively collected PRO database was retrospectively reviewed for patients who underwent surgical fixation with a VLP. Patients were excluded for skeletal immaturity, polytrauma, fixation besides a VLP, or missing PROs at any time point. Patient demographics, surgical characteristics and PROs were collected for all patients. The AO/OTA classification was used in radiographic evaluation. The Patient-rated Wrist Evaluation(PRWE) was collected at preoperative baseline, six-week, and three-month follow-up. Analysis of variance(ANOVA), Fisher Exact Test, and Independent Samples t-Tests were performed.
A total of 130 patients were identified for analysis. Most patients were female (n=111, 85.4%), and on average were 59.2±13.6 years old. Sex, age, injury to the dominant wrist, depression, anxiety, and smoking status did not significantly differ between patients with an extraarticular fracture pattern and those with an intraarticular fracture pattern. Fracture pattern was not associated with PRWE scores at any time point. Changes in PROs were also not different between the groups at six weeks or three months (p=0.972, p=0.863, respectively).
This study found that PROs were not influenced by articular involvement in DRFs at any time point. Both groups achieved relatively good outcomes. These results may indicate that when a VLP is used in fixation, patients and surgeons can expect similar outcomes in early recovery even with significant intraarticular involvement. Future research should focus on identifying specific fracture patterns that are associated with worse patient outcomes.
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