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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 August;63(4):279-88
The relationship between anatomical alignment and functions with the grip strength obtained after treatment of distal radius fractures
Botanlioglu H. 1, Kaynak G. 1, Kesmezacar F. 2, Can Unlu M. 1, Caliskan G. 1, Ozsahin K. 1, Babacan M. 1
1 Department of Orthopedics and Traumatology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey:
2 Department of Anatomy, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
Aim. We conducted a retrospective study to evaluate the relationship between anatomical alignment and functions with the grip strength obtained after treatment of distal radius fractures.
Methods. Twenty-one patients treated for distal radius fracture (12 conservatively, 9 surgically) are included in this study. The mean follow-up time was 8.2 months (range, 4 to 27). Radial inclination (RI), radial shortness (RS), volar tilt angle (VTA), radiolunat angle (RLA), effective radiolunat angle (ERLA), scapholunat angle (SLA) and radioscaphodial angle (RSA) are evaluated in the x-rays of the patients. Range of motion of the wrist was measured. Stewart Radiological Score and Gartland Werley Functional Scoring System used for the evaluation. The relationship between expected grip strength and measured with anatomical alignment parameters and wrist functions were evaluated statistically.
Results. There was not any statistically significant difference between RLA, ERLA, RI, RS, VTA, SLA, RSA values and obtained grip strength at the affected wrist when compared to the control group (unaffected side) whether treated by surgical or conservative. Statistically significant difference found between the expected grip strength and measured grip strength (P=0.021 or the right side, P=0.005 for the left side). There wasn’t any correlation between the grip strengths and wrist function at the affected sides and control sides. According to Stewart radiological criteria’s, the result was 93.3% excellent and good (6: excellent, 14: good 1: moderate [case which treated surgically]). According to Gartland Werley Scoring System excellent and good results were 85.7% (14: excellent, 4: good, 2: moderate [closed reduction and casting], 1: bad [treated surgically]; at the group who performed surgery: 77.8%; 1 case bad, 1 case moderate; at the group who treated conservatively 92%; 1 case moderate). Mean grip strength loss found to be 25.7% for the 18 (86%) patients who had grip strength loss due to the expected value.
Conclusion. No relationship found between anatomical alignment and grip strength for the patients who treated for distal radius fracture. Grip strength is not related to the radiological outcome of distal radius fracture but it is related to post-treatment rehabilitation. Our study demonstrates the necessity for a professionally supervised rehabilitation program along with the home exercises, after surgical or conservative treatment of the distal radius fractures. Despite the acquisition of high radiological scores due to satisfactory radiological alignment, failure to achieve satisfactory grip strength along with a high functional outcome requires reconsideration of the grip strength’s significance in Gartland and Werley scoring systems.