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Scientific/Clinical Article| Volume 20, ISSUE 4, P290-299, October 2007

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Patient-perceived Outcome after Displaced Distal Radius Fractures

A Comparison between Radiological Parameters, Objective Physical Variables, and the DASH Score
Published:August 03, 2007DOI:https://doi.org/10.1197/j.jht.2007.06.001

      Abstract

      Outcome after distal radius fractures has traditionally been measured by radiological parameters and objective physical variables. To what extent these measurements reflect outcome as perceived by the patient has been questioned. We evaluated the association between radiological position, objective physical result (grip strength and range of movement), and the patient-perceived outcome, measured with the Disabilities of the Arm, Shoulder, and Hand outcome (DASH) score, in 78 patients with a healed unilateral distal radius fracture treated with either closed reduction and plaster splint or external fixation. Fifty-seven females and 21 males (median age 59 yr; range, 22–95) were retrospectively assessed after a mean of 22 months and the mean DASH score was 13 points. Linear correlations between final radiological and objective physical measurements and DASH score were weak or insignificant. However, radial shortening ≥2 mm, dorsal angulation >15°, and radial angulation >10° were each significantly associated with a poorer DASH score. Reduced grip strength, extension, and ulnar deviation correlated with a poorer DASH score. In conclusion, we found that better final radiological and objective physical results were associated with a better patient-perceived outcome, as measured by the DASH score, in this patient group.
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      JHT Read for Credit

      Quiz: Article #072

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue. There is only one best answer for each question.
      • #1.
        The study revealed that the following had a positive effect on DASH outcomes
        • a.
          longer time in rehab
        • b.
          gender differences
        • c.
          objective physical measures
        • d.
          dominant handedness
      • #2.
        The study sample was confined to
        • a.
          displaced fractures treated with closed reduction
        • b.
          fractures treated with ORIF
        • c.
          bilateral displaced fractures
        • d.
          patients between 60-75 years old
      • #3.
        Poor DASH scores were correlated with
        • a.
          radial shortening
        • b.
          dorsal angulation
        • c.
          radial angulation
        • d.
          all of the above
      • #4.
        The median patient satisfaction score (on the DASH) was
        • a.
          2 points
        • b.
          5 points
        • c.
          8 points
        • d.
          10 points
      • #5.
        There was no correlation found between grip scores and outcome as measured by the DASH
        • a.
          true
        • b.
          false
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.