Patient-reported outcomes after a distal radius fracture in adults: a 3–4 years follow-up

Roderick H Van Leerdam,Floortje Huizing,Frank Termaat,Sanne Kleinveld,Steven J Rhemrev,Pieta Krijnen,Inger B Schipper

doi:10.1080/17453674.2019.1568098

Roderick H Van Leerdam, Floortje Huizing + Show 5 more

Open Access

https://doi.org/10.1080/17453674.2019.1568098

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Abstract

Background and purpose — There are few reports on the outcome of distal radius fractures after 1 year. Therefore we investigated the long-term patient-reported functional outcome and health-related quality of life after a distal radius fracture in adults.Patients and methods — We reviewed 823 patients, treated either nonoperatively or operatively in 2012. After a mean follow-up of 3.8 years 285 patients (35%) completed the Patient-Rated Wrist Evaluation (PRWE) and EuroQol-5D.Results — The mean PRWE score was 11. The mean EQ-5D index value was 0.88 and the mean EQ VAS for self-rated health status was 80. Nonoperatively treated type A and type B fractures had lower PRWE scores compared with operatively treated patients, whereas the EQ-5D was similar between groups. The EQ VAS for patients aged 65 and older was statistically significantly lower than that of younger patients.Interpretation — Patients had a good overall long-term functional outcome after a distal radius fracture. Patients with fractures that were possible to treat nonoperatively had less pain and better wrist function after long-term follow-up than patients who needed surgical fixation.

Highlights

Treated type A and type B fractures had lower Patient Rated Wrist Evaluation (PRWE) scores compared with operatively treated patients, whereas the EQ-5D was similar between groups
The available validated PROMs for distal radius fractures have been mainly used for research purposes
Not yet implemented in daily clinical practice, it is assumed that PROMs can be a valuable tool for monitoring outcome during routine clinical follow-up (MacDermid et al 2004)

Summary

Introduction

Interpretation — Patients had a good overall long-term functional outcome after a distal radius fracture. Patients with fractures that were possible to treat nonoperatively had less pain and better wrist function after long-term follow-up than patients who needed surgical fixation. The outcome was predominantly determined by physicianreported parameters such as the radiographic properties of the fracture or range of motion of the injured joint or limb. Patient-relevant long-term results include functional recovery, return to work, and the ability to perform daily activities. Several PROMs have been developed and validated such as the Patient Rated Wrist Evaluation (PRWE) (Abramo et al 2008, Kleinlugtenbelt et al 2016, Landgren et al 2017, MacDermid 2011) and the Disability of the Arm, Shoulder and Hand score (DASH) (Hudak et al 1996). Not yet implemented in daily clinical practice, it is assumed that PROMs can be a valuable tool for monitoring outcome during routine clinical follow-up (MacDermid et al 2004)

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