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• W2177686947 abstract "We evaluated the fragment specific articular surface reduction with computed tomography (CT), and determined which joint fragment is mostly related to the outcome of distal radius fracture surgically treated with volar locking plate (VLP). Total 124 patients with surgically treated distal radius fracture using VLP were eligible for current study. At final, 99 patients had met the selection criteria and permitted to participate in current study, and their wrist was evaluated with CT at final follow-up. To evaluate the fragment specific articular surface reduction, it was divided into six specific fragments; scaphoid, volar lunate and dorsal lunate facet, central portion, dorsal and volar rim. The articular surface mismatch within each fragment were evaluated with three-grade ordinal scale; “no mismatch”, “mismatch less than 2mm”, “mismatch more than 2mm”. To evaluate the alignment of the distal radius, simple radiograph were examined. For clinical evaluation, the Disability of the Arm, Shoulder and Hand (DASH), and modified Mayo wrist score (MMWS), were completed at final follow-up. Subjects were divided into two groups according to final DASH and MMWS score, and compared. Correlation analysis between several parameters and DASH, MMWS were performed. Multiple logistic regression analysis was performed to evaluate cause-effect relationship between surgical outcome and various parameters, and to control confounding effect of each parameter. Mean follow-up period was 13.9 (range, 12 to 52) months. There were no parameters showing significant difference between two groups divided by the result of DASH score. Parameters showed significant correlation with DASH score were dorsal lunate facet, central depression. The dorsal lunate facet showed the strongest correlation with DASH score (spearman’s rho= 0.218, P = 0.030). Articular surface mismatch at dorsal lunate facet, central depression, and volar rim were significantly greater in the group with worse MMWS score (P < 0.001, 0.036, 0.042). Variables showed significant correlation with MMWS were the articular surface mismatch at scaphoid facet and dorsal lunate facet, and central portion. The mismatch of dorsal lunate facet also showed strongest correlation with MMWS (spearman’s rho= -0.367, P < 0.001). The result of multiple logistic regression analysis showed that the mismatch of the dorsal lunate facet has significantly high odds ratio of having worse result of MMWS. •The degree of articular surface mismatch within dorsal lunate facet seems to the surgical treatment of distal radius fracture.•With the case involved the dorsal lunate facet, surgeons should be cautious about its reduction during surgery using VLP." @default.
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• W2177686947 date "2015-09-01" @default.
• W2177686947 modified "2023-09-25" @default.
• W2177686947 title "Which Joint Fragment is Mostly Related to the Surgical Outcome of the Distal Radius Fracture? An Analysis Using Postoperative Computed Tomography" @default.
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• W2177686947 doi "https://doi.org/10.1016/j.jhsa.2015.06.031" @default.
• W2177686947 hasPublicationYear "2015" @default.
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