Radius Distal Uç Kırığı Volar Plaklama Sonrası Fizyoterapi Uygulanan Hastalarda Radyolojik Ölçümler ile Fonksiyonel Ölçümler İlişkili Midir?
Öz
Amaç:
Radius distal uç kırığına bağlı volar plaklama yapılan hastaların radyolojik
ölçümleri ile eklem hareket açıklıkları, kavrama kuvveti ve fonksiyonel
sonuçları arasındaki ilişkiyi araştırmaktı. Gereç ve Yöntem: Çalışmaya radius
distal uç kırığı sonrası volar plaklama yapılan ve 12 haftalık süpervize
fizyoterapi programını tamamlayan 31 hasta (18 kadın, 13 erkek) alındı.
Hastaların radyolojik ölçümleri postoperatif 1. haftada içinde çekilen direkt
grafileri üzerinde yapıldı. Volar tilt, radiyal uzunluk, radiyal inklinasyon ve
ulnar varyans değerleri kaydedildi. Postoperatif 12 haftada hastaların el
bileği ve önkol eklem hareket açıklıkları, kavrama kuvveti ve fonksiyonel
düzeyleri (Hasta Bazlı El Bileği Değerlendirme Anketi “PRWE” ve Kol, Omuz ve El
Yaralanması Anketi “DASH”) ölçüldü. Radyolojik sonuçlar ile fonksiyonel sonuçlar arasındaki ilişkiyi
belirlemek için Spearman Korelasyon Analizi yapıldı. Bulgular: Radyolojik
ölçümlerden “ulnar varyans değeri” ile PRWE ağrı skoru ve PRWE toplam skoru
arasında pozitif yönde anlamlı ilişki belirlendi (sırasıyla p=0.030, r=0.443;
p=0.039, r=0.424). Diğer radyolojik ölçümler ile hiçbir parametre arasında
istatististiksel olarak anlamlı korelasyon yoktu (p>0.05). El bileği
fleksiyon ve ekstansiyon dereceleri de kavrama kuvveti ile (sırasıyla, r=0,660,
r=0.619) ve PWRE fonksiyon skorları ile (sırasıyla, r=-0.497, r=-0.520) anlamlı
korelasyon gösterdi (p<0.05). Sonuç: Bu çalışma radius distal uç kırığı
sonrası volar plaklama yapılan ve fizyoterapi programına alınan hastalarda,
radyolojik ölçümlerden yalnızca ulnar varyans değerinin fonksiyonel sonuçları
etkilediğini göstermiştir. Daha kesin sonuçlar için farklı redüksiyon
tiplerinde ve farklı hasta sayılarında çalışmalara ihtiyaç bulunmaktadır.
Anahtar Kelimeler
Kaynakça
- O'Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, et al. Incidence of distal forearm fracture in British men and women. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2001;12(7):555-8.
- Wakefield AE, McQueen MM. The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius. The Journal of bone and joint surgery British volume. 2000;82(7):972-6.
- Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. The Journal of hand surgery. 2001;26(5):908-15.
- Wiemer P, Koster G, Felderhoff J, Weber U. Frakturen am distalen Radius: Wandel der therapeutischen Strategien. Der Orthopäde. 1999;28(10):846-52.
- Dekkers M, Soballe K. Activities and impairments in the early stage of rehabilitation after Colles' fracture. Disability and rehabilitation. 2004;26(11):662-8.
- Hegeman JH, Oskam J, van der Palen J, Ten Duis HJ, Vierhout PA. The distal radial fracture in elderly women and the bone mineral density of the lumbar spine and hip. Journal of hand surgery (Edinburgh, Scotland). 2004;29(5):473-6.
- Handoll HH, Madhok R, Howe TE. Rehabilitation for distal radial fractures in adults. The Cochrane database of systematic reviews. 2006(3):CD003324.
- Valdes K, Naughton N, Michlovitz S. Therapist supervised clinic-based therapy versus instruction in a home program following distal radius fracture: a systematic review. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2014;27(3):165-73; quiz 74.
- Handoll HH, Madhok R. Conservative interventions for treating distal radial fractures in adults. The Cochrane database of systematic reviews. 2003(2):CD000314.
- Sato K, Furumachi K, Nishida J, Tajima K, Kaiyama J, Suzuki Y, et al. Comparison of the volar locking plate and the bridging external fixator in the treatment of distal radius fracture based on range of wrist motion assessed by functional radiography. Medical Science Monitor. 2010;16(5):CR207-CR12.
- Wilcke MK, Abbaszadegan H, Adolphson PY. Patient-perceived outcome after displaced distal radius fractures: a comparison between radiological parameters, objective physical variables, and the DASH score. Journal of Hand Therapy. 2007;20(4):290-9.
- Bentohami A, Bijlsma T, Goslings J, de Reuver P, Kaufmann L, Schep N. Radiological criteria for acceptable reduction of extra-articular distal radial fractures are not predictive for patient-reported functional outcome. Journal of Hand Surgery (European Volume). 2013;38(5):524-9.
- Shauver MJ, Chang KW-C, Chung KC. Contribution of functional parameters to patient-rated outcomes after surgical treatment of distal radius fractures. The Journal of hand surgery. 2014;39(3):436-42.
- Kumar S, Penematsa S, Sadri M, Deshmukh SC. Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures? International orthopaedics. 2008;32(4):505-9.
- Smilovic J, Bilic R. Conservative treatment of extra-articular Colles' type fractures of the distal radius: prospective study. Croatian medical journal. 2003;44(6):740-5.
- Broos P, Fourneau I, Stoffelen D. Fractures of the distal radius. Current concepts for treatment. Acta orthopaedica belgica. 2001;67(3):211-8.
- Gliatis J, Plessas S, Davis T. Outcome of distal radial fractures in young adults. Journal of Hand Surgery. 2000;25(6):535-43.
- Stewart HD, Innes AR, Burke FD. Factors affecting the outcome of Colles' fracture: an anatomical and functional study. Injury. 1985;16(5):289-95.
- Karnezis I, Panagiotopoulos E, Tyllianakis M, Megas P, Lambiris E. Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius. Injury. 2005;36(12):1435-9.
- Jaremko J, Lambert R, Rowe B, Johnson J, Majumdar S. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment? Clinical radiology. 2007;62(1):65-72.
- Young C, Nanu A, Checketts R. Seven-year outcome following Colles’ type distal radial fracture. A comparison of two treatment methods. Journal of Hand Surgery. 2003;28(5):405-8.
- Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. The Journal of hand surgery. 2000;25(1):19-28.
- MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. Journal of orthopaedic trauma. 1998;12(8):577-86.
- Ozturk O, Sari Z, Ozgul B, Tasyikan L. Validity and reliability of the Turkish "Patient-Rated Wrist Evaluation" questionnaire. Acta orthopaedica et traumatologica turcica. 2015;49(2):120-5.
- Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). American journal of industrial medicine. 1996;29(6):602-8.
- Düger T, Yakut E, Öksüz Ç, Yörükan S, Bilgütay BS, Ayhan Ç, et al. Kol, Omuz ve El Sorunları (Disabilities of the Arm, Shoulder and Hand - DASH) Anketi Türkçe uyarlamasının güvenirliği ve geçerliği. Fizyoter Rehabil. 2006;17(3):99-107.
- Shechtman O, Gestewitz L, Kimble C. Reliability and validity of the DynEx dynamometer. Journal of Hand Therapy. 2005;18(3):339-47.
- Budziareck MB, Pureza Duarte RR, Barbosa-Silva MC. Reference values and determinants for handgrip strength in healthy subjects. Clinical nutrition (Edinburgh, Scotland). 2008;27(3):357-62.
- Green DP. Rockwood and Green's fractures in adults: Lippincott Williams & Wilkins; 2010.
- Nana AD, Joshi A, Lichtman DM. Plating of the distal radius. Journal of the American Academy of Orthopaedic Surgeons. 2005;13(3):159-71.
- McQueen M, Hajducka C. Redisplaced unstable fractures of the distal radius. Bone & Joint Journal. 1996;78(3):404-9.
- Dixon S, Allen P, Bannister G. Which Colles’ fractures should be manipulated? Injury. 2005;36(1):81-3.
- McQueen M, Caspers J. Colles fracture: does the anatomical result affect the final function? Bone & Joint Journal. 1988;70(4):649-51.
- Chung KC, Kotsis SV, Kim HM. Predictors of functional outcomes after surgical treatment of distal radius fractures. The Journal of hand surgery. 2007;32(1):76-83.
- Hove LM, Fjeldsgaard K, Skjeie R, Solheim E. Anatomical and functional results five years after remanipulated Colles' fractures. Scandinavian journal of plastic and reconstructive surgery and hand surgery. 1995;29(4):349-55.
- Villar R, Marsh D, Rushton N, Greatorex R. Three years after Colles' fracture. A prospective review. Bone & Joint Journal. 1987;69(4):635-8.
- Forward D, Sithole J, Davis T. The internal consistency and validity of the Patient Evaluation Measure for outcomes assessment in distal radius fractures. The Journal of Hand Surgery: European Volume. 2007;32(3):262-7.
- Sammer DM, Rizzo M. Ulnar impaction. Hand clinics. 2010;26(4):549-57.
- Karnezis I, Fragkiadakis E. Association between objective clinical variables and patient-rated disability of the wrist. Bone & Joint Journal. 2002;84(7):967-70.
Do Radiological and Functional Outcomes Correlated for Patients Receiving Physiotherapy After Volar Plating of Distal Radius Fracture?
Öz
Objective:
The aim of this study was to investigate the relationships between radiological
outcomes and range of motions, grip strength, and functional outcomes in
patients receiving physiotherapy after volar plating of distal radius fracture.
Methods: 31 patients (18 female, 13 male) who completed the 12-week supervised
physiotherapy program after volar plating of distal radius fracture were
enrolled. Radiographic measurements of the patients were made by direct
radiographs taken at 1 week postoperatively. Volar tilt, radial length, radial
inclination and ulnar variance values were recorded. Wrist and forearm range of
motions, grip strength and functional level (Patient Rated Wrist Evaluation
“PRWE” and Disabilities of Arm, Hand and Shoulder “DASH”) were assessed at the
end of the 12-week physiotherapy program postoperatively. Functional scores of
the wrist, grip strength and range of motions were measured. Spearman’s
correlation analysis was performed to determine the relationship between
radiological and functional outcomes. Results: Significant positive
correlations were found between "ulnar variance value", which is one
of the radiological measurements, and PRWE pain score and PRWE total score
(p=0.030, r=0.443; p=0.039, r=0.424, respectively). There was no statistically
significant correlation between other radiological measurements and none of the
parameters (p>0.05). Wrist flexion and extension were significantly
correlated with grip strength (r=0,660, r=0.619, respectively) and PRWE
function score (r=-0.497, r=-0.520, respectively). Conclusion: This study
showed that only ulnar variance value has an effect on functional outcomes in
patients receiving physiotherapy after volar plating of distal radius fracture.
For more precise results, studies with various reduction types and different
number of patients were needed.
Anahtar Kelimeler
Radius fracture physiotherapy radiological functional outcome
Kaynakça
- O'Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, et al. Incidence of distal forearm fracture in British men and women. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2001;12(7):555-8.
- Wakefield AE, McQueen MM. The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius. The Journal of bone and joint surgery British volume. 2000;82(7):972-6.
- Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. The Journal of hand surgery. 2001;26(5):908-15.
- Wiemer P, Koster G, Felderhoff J, Weber U. Frakturen am distalen Radius: Wandel der therapeutischen Strategien. Der Orthopäde. 1999;28(10):846-52.
- Dekkers M, Soballe K. Activities and impairments in the early stage of rehabilitation after Colles' fracture. Disability and rehabilitation. 2004;26(11):662-8.
- Hegeman JH, Oskam J, van der Palen J, Ten Duis HJ, Vierhout PA. The distal radial fracture in elderly women and the bone mineral density of the lumbar spine and hip. Journal of hand surgery (Edinburgh, Scotland). 2004;29(5):473-6.
- Handoll HH, Madhok R, Howe TE. Rehabilitation for distal radial fractures in adults. The Cochrane database of systematic reviews. 2006(3):CD003324.
- Valdes K, Naughton N, Michlovitz S. Therapist supervised clinic-based therapy versus instruction in a home program following distal radius fracture: a systematic review. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2014;27(3):165-73; quiz 74.
- Handoll HH, Madhok R. Conservative interventions for treating distal radial fractures in adults. The Cochrane database of systematic reviews. 2003(2):CD000314.
- Sato K, Furumachi K, Nishida J, Tajima K, Kaiyama J, Suzuki Y, et al. Comparison of the volar locking plate and the bridging external fixator in the treatment of distal radius fracture based on range of wrist motion assessed by functional radiography. Medical Science Monitor. 2010;16(5):CR207-CR12.
- Wilcke MK, Abbaszadegan H, Adolphson PY. Patient-perceived outcome after displaced distal radius fractures: a comparison between radiological parameters, objective physical variables, and the DASH score. Journal of Hand Therapy. 2007;20(4):290-9.
- Bentohami A, Bijlsma T, Goslings J, de Reuver P, Kaufmann L, Schep N. Radiological criteria for acceptable reduction of extra-articular distal radial fractures are not predictive for patient-reported functional outcome. Journal of Hand Surgery (European Volume). 2013;38(5):524-9.
- Shauver MJ, Chang KW-C, Chung KC. Contribution of functional parameters to patient-rated outcomes after surgical treatment of distal radius fractures. The Journal of hand surgery. 2014;39(3):436-42.
- Kumar S, Penematsa S, Sadri M, Deshmukh SC. Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures? International orthopaedics. 2008;32(4):505-9.
- Smilovic J, Bilic R. Conservative treatment of extra-articular Colles' type fractures of the distal radius: prospective study. Croatian medical journal. 2003;44(6):740-5.
- Broos P, Fourneau I, Stoffelen D. Fractures of the distal radius. Current concepts for treatment. Acta orthopaedica belgica. 2001;67(3):211-8.
- Gliatis J, Plessas S, Davis T. Outcome of distal radial fractures in young adults. Journal of Hand Surgery. 2000;25(6):535-43.
- Stewart HD, Innes AR, Burke FD. Factors affecting the outcome of Colles' fracture: an anatomical and functional study. Injury. 1985;16(5):289-95.
- Karnezis I, Panagiotopoulos E, Tyllianakis M, Megas P, Lambiris E. Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius. Injury. 2005;36(12):1435-9.
- Jaremko J, Lambert R, Rowe B, Johnson J, Majumdar S. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment? Clinical radiology. 2007;62(1):65-72.
- Young C, Nanu A, Checketts R. Seven-year outcome following Colles’ type distal radial fracture. A comparison of two treatment methods. Journal of Hand Surgery. 2003;28(5):405-8.
- Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. The Journal of hand surgery. 2000;25(1):19-28.
- MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. Journal of orthopaedic trauma. 1998;12(8):577-86.
- Ozturk O, Sari Z, Ozgul B, Tasyikan L. Validity and reliability of the Turkish "Patient-Rated Wrist Evaluation" questionnaire. Acta orthopaedica et traumatologica turcica. 2015;49(2):120-5.
- Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). American journal of industrial medicine. 1996;29(6):602-8.
- Düger T, Yakut E, Öksüz Ç, Yörükan S, Bilgütay BS, Ayhan Ç, et al. Kol, Omuz ve El Sorunları (Disabilities of the Arm, Shoulder and Hand - DASH) Anketi Türkçe uyarlamasının güvenirliği ve geçerliği. Fizyoter Rehabil. 2006;17(3):99-107.
- Shechtman O, Gestewitz L, Kimble C. Reliability and validity of the DynEx dynamometer. Journal of Hand Therapy. 2005;18(3):339-47.
- Budziareck MB, Pureza Duarte RR, Barbosa-Silva MC. Reference values and determinants for handgrip strength in healthy subjects. Clinical nutrition (Edinburgh, Scotland). 2008;27(3):357-62.
- Green DP. Rockwood and Green's fractures in adults: Lippincott Williams & Wilkins; 2010.
- Nana AD, Joshi A, Lichtman DM. Plating of the distal radius. Journal of the American Academy of Orthopaedic Surgeons. 2005;13(3):159-71.
- McQueen M, Hajducka C. Redisplaced unstable fractures of the distal radius. Bone & Joint Journal. 1996;78(3):404-9.
- Dixon S, Allen P, Bannister G. Which Colles’ fractures should be manipulated? Injury. 2005;36(1):81-3.
- McQueen M, Caspers J. Colles fracture: does the anatomical result affect the final function? Bone & Joint Journal. 1988;70(4):649-51.
- Chung KC, Kotsis SV, Kim HM. Predictors of functional outcomes after surgical treatment of distal radius fractures. The Journal of hand surgery. 2007;32(1):76-83.
- Hove LM, Fjeldsgaard K, Skjeie R, Solheim E. Anatomical and functional results five years after remanipulated Colles' fractures. Scandinavian journal of plastic and reconstructive surgery and hand surgery. 1995;29(4):349-55.
- Villar R, Marsh D, Rushton N, Greatorex R. Three years after Colles' fracture. A prospective review. Bone & Joint Journal. 1987;69(4):635-8.
- Forward D, Sithole J, Davis T. The internal consistency and validity of the Patient Evaluation Measure for outcomes assessment in distal radius fractures. The Journal of Hand Surgery: European Volume. 2007;32(3):262-7.
- Sammer DM, Rizzo M. Ulnar impaction. Hand clinics. 2010;26(4):549-57.
- Karnezis I, Fragkiadakis E. Association between objective clinical variables and patient-rated disability of the wrist. Bone & Joint Journal. 2002;84(7):967-70.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | ARAŞTIRMA YAZILARI |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Ekim 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 5 Sayı: 3 |
