Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors

J Orthop Surg Res. 2020 Aug 11;15(1):313. doi: 10.1186/s13018-020-01857-6.

Abstract

Background: Postoperative radiocarpal joint stiffness (RJS) is common in patients with distal radius fractures (DRFs). The purpose of this study was to record the incidence of RJS and to determine potential risk factors that may be associated with it.

Methods: We retrospectively included a series of patients who suffered from DRFs and underwent volar plate fixation. Patients' basic data, radiographic data, and postoperative data were collected. The incidence of RJS during follow-up was recorded, and both univariate analyses and multivariate logistic regression were used to determine factors associated with it.

Results: A total of 119 patients were included in this study. After surgical procedures, there were 42 (35.3%) patients with RJS and 77 (64.7%) patients without. The incidence of RJS after surgical treatment is 35.3%. Multivariate analysis showed that intra-articular fracture (OR, 1.43; 95% CI, 1.13-1.81), pre-operative severe swelling (OR, 1.35; 95% CI, 1.05-1.74), post-operative unsatisfied volar tile (OR, 1.38; 95% CI, 1.01-1.89), and improper rehabilitation exercise (OR, 1.72; 95% CI, 1.18-2.51) were correlated with the incidence of RJS during follow-up.

Conclusions: Patients with intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile, and improper rehabilitation exercise were factors associated with the incidence of wrist stiffness. Preoperative risk notification and postoperative precautions are necessary for relevant patients.

Keywords: Distal radius; Prevalence; Prognosis; Stiffness; Wrist.

MeSH terms

  • Aged
  • Bone Plates
  • Female
  • Fracture Fixation, Internal / methods*
  • Humans
  • Incidence
  • Intra-Articular Fractures / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Radius Fractures / surgery*
  • Range of Motion, Articular / physiology*
  • Retrospective Studies
  • Risk Factors
  • Wrist Joint / physiopathology*