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

Yıl 2023, Cilt: 7 Sayı: 1, 75 - 80, 28.04.2023
https://doi.org/10.29058/mjwbs.1232968

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.

Kaynakça

  • 1. Singer BR, McLauchlan GJ, Robinson CM, Christie J. Epidemiology of fractures in 15,000 adults: The influence of age and gender. J Bone Joint Surg Br 1998;80(2):243-248.
  • 2. Chung KC, Shauver MJ, Birkmeyer JD. Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am 2009;91(8):1868-1873.
  • 3. Mackenney PJ, McQueen MM, Elton R. Prediction of instability in distal radial fractures. J Bone Joint Surg Am 2006;88(9):1944- 1951.
  • 4. Makhni EC, Ewald TJ, Kelly S, Day CS. Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment. J Hand Surg Am 2008;33(8):1301- 1308.
  • 5. Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 2003;27(1):1-6.
  • 6. Walenkamp MM, Goslings JC, Beumer A, Haverlag R, Leenhouts PA, Verleisdonk EJ, Liem RS, Sintenie JB, Bronkhorst MW, Winkelhagen J, Schep NW. Surgery versus conservative treatment in patients with type A distal radius fractures, a randomized controlled trial. BMC Musculoskelet Disord 2014;15:90.
  • 7. Li M, McDermott RA. Using anthropometric indices to predict cardio-metabolic risk factors in Australian indigenous populations. Diabetes Res Clin Pract 2010;87(3):401-406.
  • 8. Campagna G, Zampetti S, Gallozzi A, Giansanti S, Chiesa C, Pacifico L, Buzzetti R. Excellent intra and inter-observer reproducibility of wrist circumference measurements in obese children and adolescents. PLoS One 2016;11(6):e0156646.
  • 9. Shafiee G, Qorbani M, Heshmat R, Djalalinia S, Motlagh ME, Arefirad T, Mahdavi Gorabi A, Najafi F, Asayesh H, Kelishadi R. Wrist circumference as a novel predictor of obesity in children and adolescents: The CASPIAN-IV study. J Pediatr Endocrinol Metab 2018;31(7):717-725.
  • 10. Walenkamp MM, Aydin S, Mulders MA, Goslings JC, Schep NW. Predictors of unstable distal radius fractures: A systematic review and meta-analysis. J Hand Surg Eur Vol 2016;41(5):501- 515.
  • 11. Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury 1989;20(4):208-210.
  • 12. Jung HW, Hong H, Jung HJ, Kim JS, Park HY, Bae KH, Jeon IH. Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors. Clin Orthop Surg 2015;7(3):377-382.
  • 13. Vescio A, Testa G, Sapienza M, Caldaci A, Montemagno M, Andreacchio A, Canavese F, Pavone V. Is obesity a risk factor for loss of reduction in children with distal radius fractures treated conservatively? Children (Basel) 2022;9(3):425.
  • 14. Mousapour P, Barzin M, Valizadeh M, Mahdavi M, Hadaegh F, Azizi F, Hosseinpanah F. Wrist circumference as a novel predictor of transition from metabolically healthy to unhealthy phenotype in overweight/obese adults: A gender-stratified 15.5-year follow-up. BMC Public Health 2021;21(1):2276.
  • 15. Jayakumar P, Teunis T, Giménez BB, Verstreken F, Di Mascio L, Jupiter JB. AO distal radius fracture classification: Global perspective on observer agreement. J Wrist Surg 2017;6(1):46- 53.
  • 16. Ghodasra JH, Yousaf IS, Sanghavi KK, Rozental TD, Means KR Jr, Giladi AM. Assessing the relationship between bone density and loss of reduction in nonsurgical distal radius fracture treatment. J Hand Surg Am 2021;46(5):377-385.e2.
  • 17. Ebinger T, Koehler DM, Dolan LA, McDonald K, Shah AS. Obesity increases complexity of distal radius fracture in fall from standing height. J Orthop Trauma 2016;30(8):450-455.
  • 18. Kozin SH, Wood MB. Early soft-tissue complications after fractures of the distal part of the radius. J Bone Joint Surg Am 1993;75(1):144-153.
  • 19. Ward CM. Vacuum splintage of the hand. Hand 1977;9(1):71- 75.
  • 20. Mader K, Kirchner S, Wolfgarten B, Pennig D. Efficacy of the A-V Impulse System versus cryotherapy in the reduction of postoperative oedema of the hand: A prospective randomised trial. Strategies Trauma Limb Reconstr 2006;1(1):36-41.

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

Yıl 2023, Cilt: 7 Sayı: 1, 75 - 80, 28.04.2023
https://doi.org/10.29058/mjwbs.1232968

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.

Kaynakça

  • 1. Singer BR, McLauchlan GJ, Robinson CM, Christie J. Epidemiology of fractures in 15,000 adults: The influence of age and gender. J Bone Joint Surg Br 1998;80(2):243-248.
  • 2. Chung KC, Shauver MJ, Birkmeyer JD. Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am 2009;91(8):1868-1873.
  • 3. Mackenney PJ, McQueen MM, Elton R. Prediction of instability in distal radial fractures. J Bone Joint Surg Am 2006;88(9):1944- 1951.
  • 4. Makhni EC, Ewald TJ, Kelly S, Day CS. Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment. J Hand Surg Am 2008;33(8):1301- 1308.
  • 5. Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 2003;27(1):1-6.
  • 6. Walenkamp MM, Goslings JC, Beumer A, Haverlag R, Leenhouts PA, Verleisdonk EJ, Liem RS, Sintenie JB, Bronkhorst MW, Winkelhagen J, Schep NW. Surgery versus conservative treatment in patients with type A distal radius fractures, a randomized controlled trial. BMC Musculoskelet Disord 2014;15:90.
  • 7. Li M, McDermott RA. Using anthropometric indices to predict cardio-metabolic risk factors in Australian indigenous populations. Diabetes Res Clin Pract 2010;87(3):401-406.
  • 8. Campagna G, Zampetti S, Gallozzi A, Giansanti S, Chiesa C, Pacifico L, Buzzetti R. Excellent intra and inter-observer reproducibility of wrist circumference measurements in obese children and adolescents. PLoS One 2016;11(6):e0156646.
  • 9. Shafiee G, Qorbani M, Heshmat R, Djalalinia S, Motlagh ME, Arefirad T, Mahdavi Gorabi A, Najafi F, Asayesh H, Kelishadi R. Wrist circumference as a novel predictor of obesity in children and adolescents: The CASPIAN-IV study. J Pediatr Endocrinol Metab 2018;31(7):717-725.
  • 10. Walenkamp MM, Aydin S, Mulders MA, Goslings JC, Schep NW. Predictors of unstable distal radius fractures: A systematic review and meta-analysis. J Hand Surg Eur Vol 2016;41(5):501- 515.
  • 11. Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury 1989;20(4):208-210.
  • 12. Jung HW, Hong H, Jung HJ, Kim JS, Park HY, Bae KH, Jeon IH. Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors. Clin Orthop Surg 2015;7(3):377-382.
  • 13. Vescio A, Testa G, Sapienza M, Caldaci A, Montemagno M, Andreacchio A, Canavese F, Pavone V. Is obesity a risk factor for loss of reduction in children with distal radius fractures treated conservatively? Children (Basel) 2022;9(3):425.
  • 14. Mousapour P, Barzin M, Valizadeh M, Mahdavi M, Hadaegh F, Azizi F, Hosseinpanah F. Wrist circumference as a novel predictor of transition from metabolically healthy to unhealthy phenotype in overweight/obese adults: A gender-stratified 15.5-year follow-up. BMC Public Health 2021;21(1):2276.
  • 15. Jayakumar P, Teunis T, Giménez BB, Verstreken F, Di Mascio L, Jupiter JB. AO distal radius fracture classification: Global perspective on observer agreement. J Wrist Surg 2017;6(1):46- 53.
  • 16. Ghodasra JH, Yousaf IS, Sanghavi KK, Rozental TD, Means KR Jr, Giladi AM. Assessing the relationship between bone density and loss of reduction in nonsurgical distal radius fracture treatment. J Hand Surg Am 2021;46(5):377-385.e2.
  • 17. Ebinger T, Koehler DM, Dolan LA, McDonald K, Shah AS. Obesity increases complexity of distal radius fracture in fall from standing height. J Orthop Trauma 2016;30(8):450-455.
  • 18. Kozin SH, Wood MB. Early soft-tissue complications after fractures of the distal part of the radius. J Bone Joint Surg Am 1993;75(1):144-153.
  • 19. Ward CM. Vacuum splintage of the hand. Hand 1977;9(1):71- 75.
  • 20. Mader K, Kirchner S, Wolfgarten B, Pennig D. Efficacy of the A-V Impulse System versus cryotherapy in the reduction of postoperative oedema of the hand: A prospective randomised trial. Strategies Trauma Limb Reconstr 2006;1(1):36-41.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Erdi Özdemir 0000-0002-3147-9355

Ozan Altun 0000-0002-0901-5247

Yılmaz Ergişi 0000-0003-2456-6802

Uygar Daşar 0000-0002-2039-7426

Muhammed Nadir Yalçın 0000-0003-3158-200X

Yayımlanma Tarihi 28 Nisan 2023
Kabul Tarihi 31 Mart 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 7 Sayı: 1

Kaynak Göster

Vancouver Özdemir E, Altun O, Ergişi Y, Daşar U, Yalçın MN. The Role of Wrist Circumference (Regional Obesity Versus Local Swelling) in Conservatively Treated Distal Radius Fractures: A Single Center Experience. Med J West Black Sea. 2023;7(1):75-80.

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