gms | German Medical Science

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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Do patients with inferior subjective outcome after one year improve over time? A register study with a 2 to 12 year follow-up

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  • presenting/speaker Benjamin Hägglund - Department of Orthopedics, Lund, Sweden
  • Vendela Teurneau - Department of Orthopedics, Lund, Sweden
  • Antonio Abramo - Department of Orthopedics, Lund, Sweden
  • Magnus Tagil - Department of Orthopedics, Lund, Sweden
  • Marcus Landgren - Department of Orthopedics, Lund, Sweden

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. DocIFSHT19-1325

doi: 10.3205/19ifssh1561, urn:nbn:de:0183-19ifssh15619

Published: February 6, 2020

© 2020 Hägglund 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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Objective: Most patients recover well from a distal radius fracture (DRF). However, approximately one-fifth have severe disability after 1 year when evaluated using the Disability of the Arm, Shoulder and Hand (DASH). In the present study, we used our distal radius fracture register to evaluate this subgroup of patients with inferior outcome. We hypothesized that the patient reported outcome would improve with time.

Materials and Methods: Since 2001, patients 18 years and older with a DRF, are prospectively registered. We have previously defined a DASH score above 35 at the 1-year follow-up as the cut-off of major disability. Between 2003 and 2012, 17% of the patients (445/2571) in the register exceeded this cut-off. 388 were women and 57 men and the mean age was 69 (18-95) years. In December 2014, 2 to12 year after the fracture, a follow-up DASH questionnaire was sent to the 346/445 patients still alive.

Results: 73 patients (27%) had initially been treated surgically and 196 (73%) non-operatively. 269 of 346 (78%) patients returned the follow-up DASH questionnaire at 2 to 12 (mean 5.5) years after the fracture. The overall median DASH score improved from 50 at 1 year to 36 at the 2 to 12 year follow-up, (p<0.05). 47% had improved to a score below the cut-off 35, but 53% remained at a high suboptimal level.

Conclusions: The subjective outcome after a DRF improves over time for patients with an inferior result at 1 year, but more than half of the patients continue to have major disability.