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Niels W L Schep - One of the best experts on this subject based on the ideXlab platform.
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Analysis of variation in the surgical treatment of distal Radius Fracture
Nederlands tijdschrift voor geneeskunde, 2017Co-Authors: Monique M. J. Walenkamp, J.c. Goslings, M.a.m. Mulders, Caroline A. Selles, Gert P. Westert, Niels W L SchepAbstract:OBJECTIVE: The optimum treatment of patients with distal Radius Fracture has not been entirely clarified resulting in possible major variations between hospitals in the number of patients undergoing surgical treatment. The objective of this study was to examine the variation in surgical treatment rates of patients with distal Radius Fractures across Dutch hospitals. DESIGN: Retrospective study. METHOD: Aggregated data for all patients with a distal Radius Fracture were obtained for 2012 and 2013 on the basis of reimbursement codes. The surgical rate across hospitals was corrected for several variables using linear regression analysis. RESULTS: We analysed a total of 95,754 reimbursements. The operative rate ranged from 0% to 23%, with a mean of 9.6%. Hospital type, the percentage of females, the percentage of patients over 65, the mean age, average socioeconomic status, and the total number of patients treated explained only 2.6% of the observed differences in operative rate between hospitals in 2012 and 11.6% in 2013. CONCLUSION: Our results suggest that non-scientific factors, such as surgeon's age, background, and local culture, influence therapeutic decisions in patients with distal Radius Fractures.
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The Unstable Distal Radius Fracture-How Do We Define It? A Systematic Review.
Journal of wrist surgery, 2015Co-Authors: Monique M. J. Walenkamp, Lara M. Vos, Simon D. Strackee, J.c. Goslings, Niels W L SchepAbstract:Background Unstable distal Radius Fractures are a popular research subject. However, to appreciate the findings of studies that enrolled patients with unstable distal Radius Fractures, it should be clear how the authors defined an unstable distal Radius Fracture. Questions In what percentage of studies involving patients with unstable distal Radius Fractures did the authors define unstable distal Radius Fracture? What are the most common descriptions of an unstable distal Radius Fracture? And is there one preferred evidence-based definition for future authors? Methods A systematic search of literature was performed to identify any type of study with the term unstable distal Radius Fracture. We assessed whether a definition was provided and determined the level of evidence for the most common definitions. Results The search yielded 2,489 citations, of which 479 were included. In 149 studies, it was explicitly stated that patients with unstable distal Radius Fractures were enrolled. In 54% (81/149) of these studies, the authors defined an unstable distal Radius Fracture. Overall, we found 143 different definitions. The seven most common definitions were: displacement following adequate reduction; Lafontaine's definition; irreducibility; an AO type C2 Fracture; a volarly displaced Fracture; Poigenfurst's criteria; and Cooney's criteria. Only Lafontaine's definition originated from a clinical study (level IIIb). Conclusion In only half of the studies involving patients with an unstable distal Radius Fracture did the authors defined what they considered an unstable distal Radius Fracture. None of the definitions stood out as the preferred choice. A general consensus definition could help to standardize future research.
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ulnar styloid process nonunion and outcome in patients with a distal Radius Fracture a meta analysis of comparative clinical trials
Injury-international Journal of The Care of The Injured, 2014Co-Authors: M M E Wijffels, J Keizer, G A Buijze, Y Zenke, Pieta Krijnen, Niels W L Schep, Inger B SchipperAbstract:Abstract Purpose There is no consensus on the relation between ulnar styloid process nonunion and outcome in patients with distal Radius Fractures. The aim of this study was to analyze whether patient-reported outcome is influenced by the nonunion of the accompanying ulnar styloid Fracture in distal Radius Fracture patients. Methods A meta-analysis of published studies comparing outcomes after distal Radius Fractures with a united versus a non-united ulnar styloid process was performed. In addition, if provided by the authors, the raw data of these studies were pooled and analysed as one study. The outcome measures of the analyses included patient-reported outcome, functional outcome, grip-strength, pain, and distal radioulnar joint (DRUJ) instability. Results Data from six comparative studies were included, concerning 365 patients with a distal Radius Fracture. One hundred and thirty-five patients with an ulnar styloid union were compared with 230 patients with a nonunion of the ulnar styloid. No significant differences were found between groups regarding any outcome measure. Conclusion Based on this meta-analysis, there is no relation between the nonunion of the ulnar styloid process and function in patients with a distal Radius Fracture.
Inger B Schipper - One of the best experts on this subject based on the ideXlab platform.
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ulnar styloid process nonunion and outcome in patients with a distal Radius Fracture a meta analysis of comparative clinical trials
Injury-international Journal of The Care of The Injured, 2014Co-Authors: M M E Wijffels, J Keizer, G A Buijze, Y Zenke, Pieta Krijnen, Niels W L Schep, Inger B SchipperAbstract:Abstract Purpose There is no consensus on the relation between ulnar styloid process nonunion and outcome in patients with distal Radius Fractures. The aim of this study was to analyze whether patient-reported outcome is influenced by the nonunion of the accompanying ulnar styloid Fracture in distal Radius Fracture patients. Methods A meta-analysis of published studies comparing outcomes after distal Radius Fractures with a united versus a non-united ulnar styloid process was performed. In addition, if provided by the authors, the raw data of these studies were pooled and analysed as one study. The outcome measures of the analyses included patient-reported outcome, functional outcome, grip-strength, pain, and distal radioulnar joint (DRUJ) instability. Results Data from six comparative studies were included, concerning 365 patients with a distal Radius Fracture. One hundred and thirty-five patients with an ulnar styloid union were compared with 230 patients with a nonunion of the ulnar styloid. No significant differences were found between groups regarding any outcome measure. Conclusion Based on this meta-analysis, there is no relation between the nonunion of the ulnar styloid process and function in patients with a distal Radius Fracture.
K H Wong - One of the best experts on this subject based on the ideXlab platform.
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hand numbness and carpal tunnel syndrome after volar plating of distal Radius Fracture
Hand, 2011Co-Authors: S C Koo, K H WongAbstract:We report the incidence of late onset post-operative carpal tunnel syndrome (late carpal tunnel syndrome) and late median nerve neuropathy after volar plating of distal Radius Fracture by conducting a retrospective study on volar plating for distal Radius Fracture performed during 2002 to 2006. Two hundred eighty-two volar plating were performed for acute distal Radius Fracture after exclusion. Post-operative hand numbness occurred in 24 patients of which nine had carpal tunnel syndrome. Thus, the incidence of late carpal tunnel syndrome was 3.2% (9/282). Of the eight (8/24, 33%) patients with post-operative hand numbness that failed to respond to conservative treatment, five had carpal tunnel release and three had neurolysis of median nerve at distal forearm. All had clinical improvement except in one patient. The incidence of late carpal tunnel syndrome after volar plating of distal Radius in the present series is similar to the prevalence of carpal tunnel syndrome in general population. The incidence is low compared with other series, regardless of treatment method (conservative treatment, volar or dorsal plating). The outcome of post-operative hand numbness is generally favourable.
Guixin Sun - One of the best experts on this subject based on the ideXlab platform.
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Clinical efficacy analysis of double plate fixation in the treatment of distal Radius Fracture combined with ulnar head Fracture
Chinese Journal of Hand Surgery, 2020Co-Authors: Yue Zhang, Qin Shao, Chensong Yang, Liu Fang, Chunhua Chen, Zhao Jinglei, Guixin SunAbstract:Objective To investigate the clinical efficacy of double plate fixation in the treatment of distal Radius Fracture combined with ulnar head Fracture. Methods From March 2014 to August 2017, 16 cases of distal Radius Fracture combined with ulnar head Fracture were treated with open reduction and double plate fixation. Postoperative active rehabilitation exercise was performed after operation. According to the general situation of patients, postoperative radiographic parameters and Gartland-Werley wrist score, the operation effect was evaluated. The feasibility, indications and key points of this method in the treatment of distal Radius Fracture combined with ulnar head Fracture were analyzed. Results Fourteen patients were follow-up and 2 patients were lost. The follow-up period ranged from 12 to 15 months with an average of 13 months. The radiographic results showed that all the Fractures healed and achieved anatomical reduction. According to Gartland-Werley wrist score, the results were rated as excellent in 10 cases, good in 2 cases, fair in 2 cases. The average angle of the affected wrist was (69.51±1.97)° in flexion, (70.26±2.71)° in extension, (76.55±3.41)° in pronation and (71.35±1.54)° in supination. There was no significant difference in range of motion between the affected side and the healthy side (P>0.05). Conclusion The function of the wrist recovered well after the treatment of distal Radius Fracture combined with ulnar head Fracture with double plate fixation, which is worthy of clinical application. Key words: Radius Fractures; Treatment outcome; Double plate fixation; Ulnar head
Kristina Åkesson - One of the best experts on this subject based on the ideXlab platform.
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Disability and Pain are the Best Predictors of Sick Leave After a Distal Radius Fracture in Men
Journal of Occupational Rehabilitation, 2020Co-Authors: Lisa Egund, Karin Önnby, Fiona Mcguigan, Kristina ÅkessonAbstract:Purpose Distal Radius Fracture often compromises working ability, but clinical implications are less studied in men due to its lower incidence. This study therefore describes sick leave in men with distal Radius Fracture, specifically exploring the impact of patient- and Fracture-related factors. Methods Professionally active men aged 20–65 with distal Radius Fracture were followed prospectively for 1-year (n = 88). Data included treatment method, radiographic parameters pre/post treatment, complications, health, lifestyle and occupational demand. Patient outcomes were self-reported sick leave; Disability of the Arm, Shoulder and Hand (DASH) score; pain (5 likert scale); SF-36: Physical Component Scale (PCS) and Mental Component Scale (MCS). Results Median sick leave was 4 weeks (IQR 0; 8); almost a third reported taking no sick leave. Categorizing sick leave into 3 groups (0–6, 7–12 and > 12 weeks), men with the longest sick leave had 22 points higher DASH score (p = 0.001) and 5 points lower PCS (p = 0.02) at 1 week and the difference remained over time; they were also older and more often treated surgically. The strongest predictors of length of sick leave were one-week post-Fracture DASH score (rs = 0.4, p
