The Role of Wrist Circumference (Regional Obesity Versus Local Swelling) in Conservatively Treated Distal Radius Fractures: A Single Center Experience

Öz

Aim: Regional obesity around the wrist due to local excessive fat or local swelling due to edema has not been studied as a risk factor to predict the possibility of reduction loss during conservative treatment of distal radius fractures. We aimed to investigate the impact of wrist circumference on reduction loss risk in conservatively treated distal radius fractures. Material and Methods: Patients with distal radius fractures who were conservatively in our institution between January 2021 and December 2021 are retrospectively reviewed. Patients’ demographics, wrist circumference, radiographic parameters were obtained from hospital registry notes. Wrist circumference was measured with an unstretchable tape positioned on a line passing from lister tubercle of the distal radius and distal ulna. The difference in the wrist circumferences between the injured and uninjured extremities represented local swelling. The association of these factors with reduction loss was evaluated. Results: A total of 73 consecutive patients (19 male, 54 female) with a mean age of 61.1 ± 12.9 were included. There were 18 reduction losses. There was no association with reduction loss between injured and uninjured wrist circumferences (p>0.05). However, local swelling, initial displacement at dorsal angulation and radial inclination, presence of dorsal comminution, and accompanying ulnar styloid fracture were associated with reduction loss (p<0.05). Local swelling had an odd ratio of 6.661 (1.848 – 24.006, p= 0.004). Conclusion: Excessive local swelling is found to be a risk factor to predict reduction loss in conservative treatment of distal radius fractures while regional obesity is not.

Anahtar Kelimeler

• wrist circumference
• regional obesity
• local fat
• distal radius fracture
• redisplacement

Konservatif Olarak Tedavi Edilen Distal Radius Kırıklarında El Bilek Çevresinin Rolü (Bölgesel Obeziteye Karşı Lokal Şişlik): Tek Merkez Deneyimi

Öz

Amaç: Distal radius kırıklarının konservatif tedavisi sırasında redüksiyon kaybı olasılığını öngörmek için lokal aşırı yağ dokusuna bağlı bölgesel obezite veya ödeme bağlı lokal şişlik araştırılmamıştır. Konservatif olarak tedavi edilen distal radius kırıklarında bilek çevresinin redüksiyon kaybı riski üzerindeki etkisini araştırmayı amaçladık. Gereç ve Yöntemler: Ocak 2021-Aralık 2021 tarihleri arasında kliniğimizde konservatif olarak izlenen distal radius kırığı olan hastalar retrospektif olarak incelendi. Hastaların demografik bilgileri, bilek çevresi, radyografik parametreleri hastane kayıt notlarından elde edildi. Bilek çevresi, distal radius ve lister tüberkülü ve distal ulnadan geçen bir hat üzerinde konumlandırılan ve gerilemez bir bant ile ölçüldü. Kırık ve sağlam ekstremiteler arasındaki el bilek çevrelerindeki fark, lokal şişlik olarak tanımlandı. Bu faktörlerin redüksiyon kaybı ile ilişkisi değerlendirildi. Bulgular: Yaş ortalaması 61.1 ± 12.9 olan toplam 73 ardışık hasta (19 erkek, 54 kadın) çalışmaya dahil edildi. 18 adet redüksiyon kaybı görüldü. Kırık ve sağlam el bilek çevresi ölçüleri ile redüksiyon kaybı ile ilişki yoktu (p>0.05). Ancak lokal şişlik, dorsal açılanma ve radyal eğimdeki ilk yer değiştirme, dorsal parçalanma varlığı ve eşlik eden ulnar stiloid kırığı; redüksiyon kaybı ile ilişkiliydi (p<0.05). Lokal şişliğin odd oranı 6,661 idi (1,848 – 24,006, p= 0,004). Sonuç: Aşırı lokal şişlik, distal radius kırıklarının konservatif tedavisinde redüksiyon kaybını öngörmek için bir risk faktörü olarak bulunurken, bölgesel obezite bulunmamıştır.

Anahtar Kelimeler

• el bilek çapı
• bölgesel obezite
• bölgesel yağlanma
• distal radius kırığı
• redüksiyon kaybı

Kaynakça

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