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1.
Bone Joint J ; 102-B(11): 1542-1548, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33135431

ABSTRACT

AIMS: The primary aim of this study was to describe patient satisfaction and health-related quality of life (HRQoL) following corrective osteotomy for a symptomatic malunion of the distal radius. METHODS: We retrospectively identified 122 adult patients from a single centre over an eight-year period who had undergone corrective osteotomy for a symptomatic malunion of the distal radius. The primary long-term outcome was the Patient-Rated Wrist Evaluation (PRWE) score. Secondary outcomes included the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, the EQ-5D-5L score, complications, and the Net Promoter Score (NPS). Multivariate regression analysis was used to determine factors associated with the PRWE score. RESULTS: Long-term outcomes were available for 89 patients (72%). The mean age was 57 years (SD 15) and 68 were female (76%). The median time from injury to corrective osteotomy was nine months (interquartile range (IQR) 6 to 13). At a mean follow-up of six years (1 to 11) the median PRWE score was 22 (IQR 7 to 40), the median QuickDASH score was 11.4 (IQR 2.3 to 31.8), and the median EQ-5D-5L score was 0.84 (IQR 0.69 to 1). The NPS was 69. Multivariate regression analysis showed that the presence of an associated ulnar styloid fracture was the only significant independent factor associated with a worse PRWE score when adjusting for confounding variables (p = 0.004). CONCLUSION: We found that corrective osteotomy for malunion of the distal radius can result in good functional outcomes and high levels of patient satisfaction. However, the presence of an ulnar styloid fracture may adversely affect function. Level of Evidence: III (cohort study). Cite this article: Bone Joint J 2020;102-B(11):1542-1548.


Subject(s)
Fractures, Malunited/surgery , Osteotomy/methods , Patient Reported Outcome Measures , Radius/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Patient Satisfaction , Quality of Life , Recovery of Function , Retrospective Studies , Wrist Joint/surgery
2.
J Shoulder Elbow Surg ; 16(6): 748-51, 2007.
Article in English | MEDLINE | ID: mdl-18061115

ABSTRACT

Diabetes mellitus is a known risk factor for frozen shoulder. This study was performed to quantify this association and test any relationship with other risk factors for diabetic complications. Patients attending diabetic (n = 865) and general medical (n = 202) clinics were interviewed and examined. External rotation was measured in both shoulders. Glycated hemoglobin A(1c) was measured in all diabetic patients. Frozen shoulder was defined as pain for more than 3 months and external rotation of less than 50% of the unaffected shoulder. Bilateral frozen shoulder was defined as external rotation of less than 30 degrees in both shoulders. Shoulder pain was present in 25.7% of diabetic patients compared with 5.0% of general medical patients. The criteria for frozen shoulder were fulfilled in 4.3% of diabetic patients and in 0.5% of the general medical patients. Only duration of diabetes had a positive association. The prevalence of painful or stiff shoulder was greater in diabetic patients than general medical patients. The prevalence of frozen shoulder is less than previously reported but still greater in diabetic patients.


Subject(s)
Diabetes Complications/epidemiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Joint Diseases/epidemiology , Shoulder Joint/pathology , Case-Control Studies , Female , Humans , Male , Middle Aged , Pain , Prevalence , Risk Factors
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