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Scientific Articles   |    
Quality of Life After Volar Plate Fixation of Articular Fractures of the Distal Part of the Radius
Gerald Gruber, MD1; Max Zacherl, MD1; Christian Giessauf, MD2; Mathias Glehr, MD1; Florentine Fuerst, MD3; Walter Liebmann, MD4; Karl Gruber, MD2; Gerwin Alexander Bernhardt, MD5
1 Department of Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5-7, A-8036 Graz, Austria. E-mail address for G. Gruber: gerald_gruber@klinikum-graz.at. E-mail address for M. Zacherl: max_zacherl@hotmail.com. E-mail address for M. Glehr: mathias.glehr@klinikum-graz.at
2 Department of Surgery, District Hospital of Weiz, Franz-Pichler-Strasse 85, A-8160 Weiz, Austria. E-mail address for C. Giessauf: christian_giessauf@yahoo.de. E-mail address for K. Gruber: karl.gruber@lkh-weiz.at
3 Division of Rheumatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 2/4, A-8036 Graz, Austria. E-mail address for F. Fuerst: florentine.fuerst@meduni-graz.at
4 Department of Radiology, District Hospital of Feldbach, Ottokar-Kernstock-Strasse 18, A-8330 Feldbach, Austria. E-mail address: walter.liebmann@lkh-feldbach.at
5 Division of General Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 36, A-8036 Graz, Austria. E-mail address for G.A. Bernhardt: gerwin.bernhardt@klinikum-graz.at
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the District Hospital of Weiz, Weiz, Austria and the Medical University of Graz, Graz, Austria

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 May 01;92(5):1170-1178. doi: 10.2106/JBJS.I.00737
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Abstract

Background: 

Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked plate fixation of unstable intra-articular distal radial fractures with functional and radiographic results as well as with quality-of-life data from population norms.

Methods: 

Fifty-four consecutive patients with intra-articular distal radial fractures and a mean age of sixty-three years were managed with a volar locked plate system. Range of motion, grip strength, and radiographs were assessed at a mean of six years postoperatively. The wrist-scoring systems of Gartland and Werley and Castaing were adopted for the assessment of objective outcomes. The Disabilities of the Arm, Shoulder and Hand and Short Form-36 questionnaires were completed as subjective outcome measures, and the results were compared with United States and Austrian population norms.

Results: 

Functional improvement continued for two years postoperatively. At the time of the latest follow-up, >90% of all patients had achieved good or excellent results according to the scoring systems of Gartland and Werley and Castaing. The results of the Short Form-36 questionnaire were similar to the United States and Austrian population norms. The mean Disabilities of the Arm, Shoulder and Hand score was 5 points at two years, and it increased to 13 points at six years. The twenty patients with radiocarpal arthritis had significantly poorer results in the physical component summary measure of the Short Form-36 questionnaire (p = 0.012).

Conclusions: 

The results of the present single-center study show that, following distal radial fracture fixation, wrist arthritis may affect the patient's subjective well-being, as documented with the Short Form-36, without influencing the functional outcome. Well-designed longitudinal clinical trials are needed to confirm the findings of the present investigation in terms of quality of life after surgical treatment of intra-articular distal radial fractures.

Level of Evidence: 

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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