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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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Prognostic Factors Affecting Clinical Outcomes of Arthroscopic Assisted Reduction and Volar Plating Through Pronator Quadratus Preservation for Intra-Articular Distal Radius Fracture

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  • Jong-Pil Kim - Dankook University, Cheonan, South Korea
  • Ja Hea Gu - Dankook University, Cheonan, South Korea
  • Ji-Won Kim - Dankook University, Cheonan, South Korea
  • presenting/speaker Jae-Uk Jung - Dankook University, Cheonan, South Korea

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. DocIFSSH19-1636

doi: 10.3205/19ifssh0757, urn:nbn:de:0183-19ifssh07573

Published: February 6, 2020

© 2020 Kim 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: The purpose of this study was to evaluate the clinical and radiological outcomes of arthroscopic reduction and volar plating (AR-VP) through pronator quadratus (PQ) preservation for the treatment of intra-articular distal radius fracture (DRF) and to assess prognostic factors that affect its functional outcomes.

Methods: Between March 2014 to February 2017, a total of 54 patients who had intra-articular DRF (AO/OTA classification C-type), and underwent AR-VP through PQ preservation technique, and completed 1-year follow-up were enrolled. They were 23 males and 31 females with an average of 50.9 years old (ranges, 17 to 73 years). Clinical outcome data including visual analogue scale (VAS) score, disabilities of arm, shoulder, and hand (DASH) questionnaire, Patient-Rated Wrist Evaluation (PRWE) questionnaire, range of motion, grip strength, and radiographic parameters were collected at 3, 6, and 12 months after surgery. We conducted a simple and multiple linear regression analysis to identify clinical and radiologic factors affecting clinical outcomes based on the modified Mayo wrist scoring system (MMWS) at 1-year follow-up: satisfactory group (excellent and good results) versus unsatisfactory group (fair and poor results).

Results and Conclusions: All clinical outcome measures significantly improved at 12 month follow-ups. The MMWS were 10 excellent, 22 good, 14 fair, and 8 poor. According to univariate analysis, all radiographic parameters at injury, sex, and a presence of intra-articular comminution show a significant difference between the groups (p < 0.05). In the multivariate analysis, female gender, a presence of intra-articular comminution, and the difference of dorsal or palmar tilt more than 20.1º compared to uninjured wrist at initial injury were considered as significant poor prognostic factors of functional outcome.

In conclusion, AR-VP through PQ preservation for intra-articular DRF provides reliable clinical and radiological outcomes. However, female gender, a presence of intra-articular comminution, and the difference of palmar or dorsal tilt more than 20.1 º compared to uninjured wrist at initial injury are considered as poor prognostic factors of AR-VP through PQ preservation for intra-articular DRF.