The Impact of Sigmoid Notch Involvement on the Outcomes of Distal Radius Fractures: Radiological and Clinical Assessments after a Minimum of 5 Years of Follow-up
Posttraumatic osteoarthritis (OA) is one of the complications of distal radius fractures (DRFs). Involvement of the sigmoid notch (SN) is a risk factor, but there are few studies that support this. In this study, we hypothesized that SN involvement can affect the radiological and clinical outcomes o...
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| Vydáno v: | Clinics in orthopedic surgery Ročník 17; číslo 4; s. 568 - 574 |
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Korea (South)
The Korean Orthopaedic Association
01.08.2025
대한정형외과학회 |
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| ISSN: | 2005-291X, 2005-4408, 2005-4408 |
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| Abstract | Posttraumatic osteoarthritis (OA) is one of the complications of distal radius fractures (DRFs). Involvement of the sigmoid notch (SN) is a risk factor, but there are few studies that support this. In this study, we hypothesized that SN involvement can affect the radiological and clinical outcomes of surgically treated DRFs and that there would be differences based on the degree of SN involvement.
The authors reviewed patients who underwent surgical treatment for DRF at our institution and were followed up for over 5 years. The patients were divided into 2 groups based on SN involvement. All patients underwent postoperative plain radiographs at the last follow-up to evaluate posttraumatic OA at the distal radioulnar joint (DRUJ). On computed tomography (CT) scans of the SN involvement group, articular step-off and gap distance were measured. Posttraumatic OA was graded using the Knirk and Jupiter radiographic criteria. For clinical evaluation, grip strength, wrist range of motion, pain visual analog scale score, Disabilities of the Arm, Shoulder, and Hand questionnaires, and Modified Mayo Wrist Score were assessed.
Radiologically, the DRUJ OA grades were significantly higher in the SN involvement group. The step-off and gap distance measured on CT scans revealed no significant correlation with the grades. Clinical outcomes were not significantly different between the 2 groups.
SN involvement did not affect clinical outcomes in DRF patients with a minimum of 5 years of follow-up. However, radiologically, the OA grades were significantly higher in the SN involvement group. Therefore, in cases of DRF with SN involvement, there is no significant difference in clinical outcome, but it is necessary to explain to patients that posttraumatic DRUJ arthritis may occur in the future. |
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| AbstractList | Posttraumatic osteoarthritis (OA) is one of the complications of distal radius fractures (DRFs). Involvement of the sigmoid notch (SN) is a risk factor, but there are few studies that support this. In this study, we hypothesized that SN involvement can affect the radiological and clinical outcomes of surgically treated DRFs and that there would be differences based on the degree of SN involvement.
The authors reviewed patients who underwent surgical treatment for DRF at our institution and were followed up for over 5 years. The patients were divided into 2 groups based on SN involvement. All patients underwent postoperative plain radiographs at the last follow-up to evaluate posttraumatic OA at the distal radioulnar joint (DRUJ). On computed tomography (CT) scans of the SN involvement group, articular step-off and gap distance were measured. Posttraumatic OA was graded using the Knirk and Jupiter radiographic criteria. For clinical evaluation, grip strength, wrist range of motion, pain visual analog scale score, Disabilities of the Arm, Shoulder, and Hand questionnaires, and Modified Mayo Wrist Score were assessed.
Radiologically, the DRUJ OA grades were significantly higher in the SN involvement group. The step-off and gap distance measured on CT scans revealed no significant correlation with the grades. Clinical outcomes were not significantly different between the 2 groups.
SN involvement did not affect clinical outcomes in DRF patients with a minimum of 5 years of follow-up. However, radiologically, the OA grades were significantly higher in the SN involvement group. Therefore, in cases of DRF with SN involvement, there is no significant difference in clinical outcome, but it is necessary to explain to patients that posttraumatic DRUJ arthritis may occur in the future. Background: Posttraumatic osteoarthritis (OA) is one of the complications of distal radius fractures (DRFs). Involvement of the sigmoid notch (SN) is a risk factor, but there are few studies that support this. In this study, we hypothesized that SN involvement can affect the radiological and clinical outcomes of surgically treated DRFs and that there would be differences based on the degree of SN involvement. Methods: The authors reviewed patients who underwent surgical treatment for DRF at our institution and were followed up for over 5 years. The patients were divided into 2 groups based on SN involvement. All patients underwent postoperative plain radiographs at the last follow-up to evaluate posttraumatic OA at the distal radioulnar joint (DRUJ). On computed tomography (CT) scans of the SN involvement group, articular step-off and gap distance were measured. Posttraumatic OA was graded using the Knirk and Jupiter radiographic criteria. For clinical evaluation, grip strength, wrist range of motion, pain visual analog scale score, Disabilities of the Arm, Shoulder, and Hand questionnaires, and Modified Mayo Wrist Score were assessed. Results: Radiologically, the DRUJ OA grades were significantly higher in the SN involvement group. The step-off and gap distance measured on CT scans revealed no significant correlation with the grades. Clinical outcomes were not significantly different between the 2 groups. Conclusions: SN involvement did not affect clinical outcomes in DRF patients with a minimum of 5 years of follow-up. However, radiologically, the OA grades were significantly higher in the SN involvement group. Therefore, in cases of DRF with SN involvement, there is no significant difference in clinical outcome, but it is necessary to explain to patients that posttraumatic DRUJ arthritis may occur in the future. KCI Citation Count: 0 Posttraumatic osteoarthritis (OA) is one of the complications of distal radius fractures (DRFs). Involvement of the sigmoid notch (SN) is a risk factor, but there are few studies that support this. In this study, we hypothesized that SN involvement can affect the radiological and clinical outcomes of surgically treated DRFs and that there would be differences based on the degree of SN involvement.BackgroundPosttraumatic osteoarthritis (OA) is one of the complications of distal radius fractures (DRFs). Involvement of the sigmoid notch (SN) is a risk factor, but there are few studies that support this. In this study, we hypothesized that SN involvement can affect the radiological and clinical outcomes of surgically treated DRFs and that there would be differences based on the degree of SN involvement.The authors reviewed patients who underwent surgical treatment for DRF at our institution and were followed up for over 5 years. The patients were divided into 2 groups based on SN involvement. All patients underwent postoperative plain radiographs at the last follow-up to evaluate posttraumatic OA at the distal radioulnar joint (DRUJ). On computed tomography (CT) scans of the SN involvement group, articular step-off and gap distance were measured. Posttraumatic OA was graded using the Knirk and Jupiter radiographic criteria. For clinical evaluation, grip strength, wrist range of motion, pain visual analog scale score, Disabilities of the Arm, Shoulder, and Hand questionnaires, and Modified Mayo Wrist Score were assessed.MethodsThe authors reviewed patients who underwent surgical treatment for DRF at our institution and were followed up for over 5 years. The patients were divided into 2 groups based on SN involvement. All patients underwent postoperative plain radiographs at the last follow-up to evaluate posttraumatic OA at the distal radioulnar joint (DRUJ). On computed tomography (CT) scans of the SN involvement group, articular step-off and gap distance were measured. Posttraumatic OA was graded using the Knirk and Jupiter radiographic criteria. For clinical evaluation, grip strength, wrist range of motion, pain visual analog scale score, Disabilities of the Arm, Shoulder, and Hand questionnaires, and Modified Mayo Wrist Score were assessed.Radiologically, the DRUJ OA grades were significantly higher in the SN involvement group. The step-off and gap distance measured on CT scans revealed no significant correlation with the grades. Clinical outcomes were not significantly different between the 2 groups.ResultsRadiologically, the DRUJ OA grades were significantly higher in the SN involvement group. The step-off and gap distance measured on CT scans revealed no significant correlation with the grades. Clinical outcomes were not significantly different between the 2 groups.SN involvement did not affect clinical outcomes in DRF patients with a minimum of 5 years of follow-up. However, radiologically, the OA grades were significantly higher in the SN involvement group. Therefore, in cases of DRF with SN involvement, there is no significant difference in clinical outcome, but it is necessary to explain to patients that posttraumatic DRUJ arthritis may occur in the future.ConclusionsSN involvement did not affect clinical outcomes in DRF patients with a minimum of 5 years of follow-up. However, radiologically, the OA grades were significantly higher in the SN involvement group. Therefore, in cases of DRF with SN involvement, there is no significant difference in clinical outcome, but it is necessary to explain to patients that posttraumatic DRUJ arthritis may occur in the future. |
| Author | Kim, Myung-Sun Kim, Yu-Seok Lim, Jun-Hyuk |
| AuthorAffiliation | Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Korea |
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| Cites_doi | 10.1016/j.otsr.2014.02.015 10.1016/j.hcl.2009.08.015 10.1055/s-0033-1333892 10.2106/JBJS.J.01744 10.2106/00004623-200612000-00016 10.1016/j.hcl.2017.07.011 10.1007/s12178-019-09544-8 10.1016/j.injury.2010.08.003 10.2106/JBJS.RVW.16.00005 10.2106/00004623-198062040-00016 10.1186/s13018-020-02091-w 10.1055/s-0035-1570742 10.1016/j.injury.2018.11.009 10.1016/j.jhsa.2010.09.033 10.2106/00004623-198668050-00003 10.1016/j.injury.2005.08.019 |
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| Keywords | Posttraumatic osteoarthritis Distal radius fracture Sigmoid notch |
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| SubjectTerms | Adult Aged Female Follow-Up Studies Humans Male Middle Aged Original Osteoarthritis - diagnostic imaging Osteoarthritis - etiology Radius Fractures - complications Radius Fractures - diagnostic imaging Radius Fractures - surgery Range of Motion, Articular Retrospective Studies Tomography, X-Ray Computed Treatment Outcome Wrist Fractures Wrist Joint - diagnostic imaging Wrist Joint - physiopathology 정형외과학 |
| Title | The Impact of Sigmoid Notch Involvement on the Outcomes of Distal Radius Fractures: Radiological and Clinical Assessments after a Minimum of 5 Years of Follow-up |
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