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J Wrist Surg 2024; 13(03): 230-235
DOI: 10.1055/s-0043-1771045
Scientific Article

Trajectory of Recovery following ORIF for Distal Radius Fractures

Gabriel Larose 
1   Faculty of Medicine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
,
Darren M. Roffey
1   Faculty of Medicine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
2   Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, BC, Canada
,
Henry M. Broekhuyse
1   Faculty of Medicine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
2   Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, BC, Canada
,
Pierre Guy
1   Faculty of Medicine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
2   Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, BC, Canada
,
Peter O'Brien
1   Faculty of Medicine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
2   Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, BC, Canada
,
Kelly A. Lefaivre
1   Faculty of Medicine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
2   Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver, BC, Canada
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Funding/Sponsorship This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Background Distal radius fractures are commonly seen among the elderly, though studies examining their long-term outcomes are limited.

Purpose The aim of this study was to describe the 5-year trajectory of recovery of distal radius fractures treated with open reduction and internal fixation (ORIF).

Methods Patients with distal radius fractures (AO/OTA 23.A-C) treated by ORIF were prospectively studied. Patient-Rated Wrist Evaluation (PRWE) score was measured at baseline (preinjury recall) and postoperatively at 6 months, 1 year, and 5 years. Clinically relevant change in PRWE score was assessed using the minimal clinically important difference (MCID).

Results A total of 390 patients were included, of which 75% completed 5-year follow-up. Mean baseline PRWE score was 1.25 (standard deviation, SD: 2.9). At 6 months, mean PRWE score was at its highest up to 20.2 (SD: 18.4; p < 0.01). A significant improvement in mean PRWE score was observed at 1 year down to 15.2 (SD: 17.6; p < 0.01); 44% of patients were still one MCID outside of their baseline PRWE score at 1 year. Further significant improvement in mean PRWE score occurred at 5 years down to 9.4 (SD: 13.4; p < 0.01); 29% of patients remained one MCID outside of their baseline PRWE score at 5 years.

Conclusion Recovery after ORIF for distal radius fractures showed significant worsening after surgery, followed by significant improvements up to 1 year and between years 1 and 5, albeit to a lesser extent. Statistically and clinically relevant wrist pain and disability persisted at 5 years. Future research should examine different treatment modalities and include a nonoperative treatment arm for comparison.

Level of Evidence Prognostic level II.

Keywords

radius - fracture - wrist - PRWE - MCID - patient-reported outcome measure - trajectory - disability - ORIF - trauma

Informed Consent

Necessary and appropriate informed consent was obtained from all patients before enrollment.


Institutional Ethical Committee Approval (for All Human Studies)

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and received ethics approval from the clinical research ethics board at our institution.




Publication History

Received: 06 February 2023

Accepted: 15 June 2023

Article published online:
13 July 2023

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