Correlación entre los parámetros radiológicos y la valoración de pacientes…(I)

"Correlación entre los parámetros radiológicos y la valoración de pacientes con disfunción de muñeca siguientes a las fracturas de radio distal."

I.A. Karnezisa, c, , , E. Panagiotopoulosb, M. Tyllianakisb, P. Megasb and E. Lambirisb

aDepartment of Orthopaedic Surgery, University of Bristol, UK bDepartment of Orthopaedic Surgery, University of Patras, Greece cAthens Medical Centre (Psychiko Clinic), Orthopaedics, Andersen 1, 115 25 Athens, Greece

Summary

The present study investigates the correlation between radiological parameters of wrist fractures and the clinical outcome expressed by objective clinical parameters and the level of patient-rated wrist dysfunction. Thirty consecutive cases of unstable distal radial fractures treated with closed reduction and percutaneous fixation were prospectively studied for a period of one year. The outcome parameters included objective clinical and radiological parameters and the previously described and validated patient-rated wrist evaluation (PRWE) score. Analysis showed that for unstable (AO classification types 23-A2, -A3, -C1 and -C2) fractures the fracture type affects the range of wrist palmarflexion (p = 0.04) and that the presence of postoperative articular ‘step-off’ affects the range of wrist dorsiflexion and the patient-rated wrist function at the final time of the study (p < 0.01 and p = 0.02, respectively). It is also shown that permanent radial shortening and loss of the palmar angle were associated with prolonged wrist pain (p < 0.01 and p = 0.03, respectively). Our finding that residual articular incongruity correlates with persisting loss of wrist dorsiflexion and wrist dysfunction contradicts the view that loss of articular congruity is associated with late development of articular degeneration but not with early wrist dysfunction. Additionally, this study failed to show any association between the fracture type and the functional outcome as rated by the patients.

Injury Volume 36, Issue 12 , December 2005, Pages 1435-1439.