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Double trouble! Concomitant distal ulna fractures predict worse 1-year outcome in distal radius fractures: a registry-based cohort study of 5,536 patients

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Title: Double trouble! Concomitant distal ulna fractures predict worse 1-year outcome in distal radius fractures: a registry-based cohort study of 5,536 patients
Authors: Arvidsson, Linnea, Landgren, Marcus, Harding, Anna Kajsa, Abramo, Antonio, Tägil, Magnus
Contributors: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Clinical and experimental bone healing, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Klinisk och experimentell benläkning, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Building Bone Killing Bugs, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Building Bone Killing Bugs, Originator
Source: Acta Orthopaedica Distal Radius Fractures in the Elderly. 96:606-611
Subject Terms: Medical and Health Sciences, Clinical Medicine, Orthopaedics, Medicin och hälsovetenskap, Klinisk medicin, Ortopedi
Description: BACKGROUND AND PURPOSE: Data on distal radius fractures (DRFs) with concomitant metaphyseal distal ulna fractures is limited. We aimed to determine whether a combined DRF and distal ulna fracture (DRUF) predicts a worse patient-reported outcome, measured by the Disabilities of the Arm, Shoulder, and Hand (DASH) score, 1 year after injury. METHODS: This prospective registry-based cohort study included 5,536 adult patients with a DRF between 2003 and 2018. The 1-year DASH scores were recorded. All DRUFs were identified. Multivariable binary logistic regression assessed whether the presence of a distal ulna fracture predicted a 1-year DASH score > 35, indicating severe upper-extremity symptoms. RESULTS: 259 of 5,536 patients (4.7%) had a DRUF. Their mean age was 73 years (SD 15), and 86% were women. The median 1-year DASH score was higher in the combined fracture group compared with those with a DRF only (23, interquartile range [IQR] 5-45] vs 9, IQR 2-27, P < 0.001). A DRUF increased the odds of a 1-year DASH> 35 by 97% (OR 1.97, 95% confidence interval [CI] 1.40-2.75, P < 0.001). Surgical fixation of the DRF in DRUF patients was associated with lower odds of a worse outcome (OR 0.44, CI 0.23-0.85, P = 0.02). Distal ulna fracture fixation did not affect 1-year DASH (P = 0.7). CONCLUSION: The odds of having a DASH > 35, indicating severe symptoms, almost doubled at 1 year in patients with a DRUF compared with those with a DRF only.
Access URL: https://doi.org/10.2340/17453674.2025.44352
Database: SwePub
Description
Abstract:BACKGROUND AND PURPOSE: Data on distal radius fractures (DRFs) with concomitant metaphyseal distal ulna fractures is limited. We aimed to determine whether a combined DRF and distal ulna fracture (DRUF) predicts a worse patient-reported outcome, measured by the Disabilities of the Arm, Shoulder, and Hand (DASH) score, 1 year after injury. METHODS: This prospective registry-based cohort study included 5,536 adult patients with a DRF between 2003 and 2018. The 1-year DASH scores were recorded. All DRUFs were identified. Multivariable binary logistic regression assessed whether the presence of a distal ulna fracture predicted a 1-year DASH score > 35, indicating severe upper-extremity symptoms. RESULTS: 259 of 5,536 patients (4.7%) had a DRUF. Their mean age was 73 years (SD 15), and 86% were women. The median 1-year DASH score was higher in the combined fracture group compared with those with a DRF only (23, interquartile range [IQR] 5-45] vs 9, IQR 2-27, P < 0.001). A DRUF increased the odds of a 1-year DASH> 35 by 97% (OR 1.97, 95% confidence interval [CI] 1.40-2.75, P < 0.001). Surgical fixation of the DRF in DRUF patients was associated with lower odds of a worse outcome (OR 0.44, CI 0.23-0.85, P = 0.02). Distal ulna fracture fixation did not affect 1-year DASH (P = 0.7). CONCLUSION: The odds of having a DASH > 35, indicating severe symptoms, almost doubled at 1 year in patients with a DRUF compared with those with a DRF only.
ISSN:17453682
DOI:10.2340/17453674.2025.44352