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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Surgically treated Closed Distal Radius Fractures in adult working patients – Outcome analysis in occupational vs nonoccupational injuries

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  • presenting/speaker Luís Mata Ribeiro - Hospital São José, Centro Hospitalar Lisboa Central, Lisbon, Portugal
  • Miguel Botton - Hospital CUF Descobertas, Lisbon, Portugal
  • Mota Da Costa - Hospital CUF Descobertas, Lisbon, Portugal

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1513

doi: 10.3205/19ifssh0537, urn:nbn:de:0183-19ifssh05371

Published: February 6, 2020

© 2020 Mata Ribeiro et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Distal radius fractures (DRF) are one of the most common traumatic injuries worldwide.The main goal of this study is evaluating the clinical outcome of patients treated with internal fixation for an accidental DRF in comparison to an occupational injury. Secondary goals are identifying good/bad prognostic factors that impact the clinical outcomes.

Methods: Retrospective study including all adult patient (with less than 65 years old) with closed distal radius fractures operated in an orthopaedic department since June 2015 to June 2017 (2 years). Patients with concomitant ulnar or hand fractures, with cognitive deficits or with a history of degenerative or traumatic wrist injuries were excluded from the study.

Variables studied included age, sex, associated injuries, dominant hand function, comorbidities as well as complications after surgery.

Preoperative radiographs were analysed and patients were operated by two senior surgeons using internal fixation with a volar locking plate. In type B and C fractures (AO classification), arthroscopic assistance was used during the procedure.

To assess the clinical outcomes, DASH score, PRWE score and satisfaction and pain Visual Analog Scale were completed 12 months after surgery. Radiographic assessment and range of motion measurement were also evaluated.

Results: A total of 51 patients were included in the study comprising 28 female and 23 male patients. 19 cases were work related and 32 were caused by accidental injuries.

On average, all outcomes were worse in the occupational group. DASH score was 46,4 vs 15,8 (non-occupational group). PRWE score was 52,86 in the work-related group against 19,7 in the accidental group. Accordingly, the scores for pain at rest in the occupational group were also higher (4,14) against 1,45 in the other group. scores for patient satisfaction were very similar between the two groups (8,3 vs 8,5).

Conclusions/Discussion: The surgical treatment of distal radius fractures with internal fixation seems to be highly effective and reliable. Nevertheless, it seems that patients injured in work-related activities have a worse result. Prospective studies are needed to confirm these results.

The main limitations of the study are the low number of cases, the multiple types and patterns of fractures analysed and its retrospective nature.