Medicine and Health Sciences Commons^™

The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms.

Electronic Thesis and Dissertation Repository

Background: Distal radius fracture (DRF) is a common upper extremity fracture that causes significant impairment and leads to difficulties in fulfilling important life roles such as indoor and outdoor cleaning, meal preparation, grocery shopping, caring for others, and earning and managing family income. However, clinicians do not routinely address home and family life roles after a DRF. Patient and rehabilitation factors are crucial in addressing home and family work roles (HFWRs). The HFWR questionnaire consists of tasks that are typically performed at home.

Objective: The overarching objective of this thesis is to explore the role of patient and rehabilitation …

The Role And Importance Of Social Support During Recovery Following Distal Radius Fracture, Ogheneruona Mi Idoghor Ikpen

Electronic Thesis and Dissertation Repository

This thesis explored how social support changes with time and differs across genders within 1-year post distal radius fracture (DRF). It also examines the effect of social support on the patient-rated wrist evaluation (PRWE) score and health-related quality of life (HRQoL) of DRF patients at 3 months post-fracture. In this cohort study, patient-reported social support (emotional/informational, tangible, affectionate and positive social interaction) was measured using the Medical Outcomes Study (MOS) social support survey, and HRQoL was measured using the 36-Item Short-Form Survey (SF-36). Social support significantly decreased at 3 months in comparison to baseline, 6 months and 1 year (with …

Early Post-Immobilization Pain At Rest, Movement Evoked Pain, And Their Ratio As Potential Predictors Of Pain And Disability At Six- And 12-Months After Distal Radius Fracture, Maryam Farzad, Joy C. Mcdermid, Saurabh Mehta, Ruby Grewal, Erfan Shafiee

Physical Therapy Faculty Research

Background: Removal of immobilization is a critical phase of distal radius fracture (DRF) rehabilitation, typically occurring by 2 months post injury. This study examined the extent to which pain at rest (PAR), movement evoked pain (MEP), or the ratio between those (MEPR) assessed at 2-months after DRF predicts the occurrence of chronic pain or disability at 6- and 12-months after the injury.

Methods: This secondary analysis of a prospective cohort study was done at the Hand and Upper Limb Centre (HULC), London, Ontario, Canada. A total of 229 patients with DRF (159 (69.4%) women) were included. Scores for the pain …

Distal Radius Fractures: Comparing Surgical Approaches To Identify Functional Outcomes, Sonia Morales

OT Student Capstones

Distal radius fractures (DRF) are the most commonly encountered fracture in clinical settings. Although the volar approach has gained recognition as the standard surgical treatment method to treat DRF there is still great debate as to what exactly the surgery should consist of. Individuals who suffer from a DRF have a high prevalence of developing carpal tunnel syndrome (CTS) (Cherubino, Bini, & Marcolli, 2010; Niver & Ilyas, 2012; Wang et al., 2018). Surgeons are unsure if individuals will benefit more from solely performing a volar open reduction and internal fixation (ORIF) surgery or to perform the volar ORIF along with …

Radiographic Thresholds With Increased Odds Of A Poor Outcome Following Distal Radius Fractures In Patients Over 65 Years Old, Caitlin J. Symonette, Joy C. Macdermid, Ruby Grewal

Bone and Joint Institute

© 2019 Purpose: Older patients (aged older than 65 years)appear to tolerate a great degree of anatomic deformity after DRFs; however, the threshold beyond which the deformity becomes unacceptable is unknown. The purposes of this study were to identify the acceptable threshold for radiographic parameters after DRFs in patients aged over 65 years according to a patient-rated pain and disability outcome measure and to determine whether baseline activity levels influenced these parameters. Methods: A cohort of 190 older adults (aged 65 years and older)with DRF were selected from an existing prospectively collected database. The influence of specific radiographic parameters (ulnar …

Impact Of Shoulder Pathology On Individuals With Distal Radius Fracture: A Mixed Methods Study, Sarah Beth Doerrer

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this convergent parallel mixed methods study was to expand the understanding of the impact of shoulder pathology on individuals with distal radius fracture (DRF). This included describing the population that had shoulder pathology, comparing participants who had shoulder pathology with participants who did not, and exploring their experiences. The occupational adaptation model guided this study. Recruitment for this study included 45 patients post DRF. Each participant completed a short questionnaire after informed consent was obtained which asked demographic information such as age, gender, race, date of injury, and if the dominant hand was fractured. Over 9 weeks, …

Comparison Of 2-Year Clinical And Radiological Outcomes Between Volar Plating And External Fixation With Additional K-Wires For Ao Type C Distal Radius Fractures, Özgür Çi̇çekli̇, Erhan Şükür, Alauddi̇n Kochai̇, Levent Bayam, İzzet Bi̇ngöl, Uğur Özdemi̇r

Turkish Journal of Medical Sciences

Background/aim: Surgical treatment of distal intraarticular radius fractures remains controversial. Our aim was to compare the clinical and radiological outcomes between volar plating (VP) and external fixation (EF) for distal intraarticular radius fractures two years postoperatively. Materials and methods: This retrospective study included 59 patients with 62 intraarticular AO Type C distal radius fractures. We distinguished two groups: patients treated with internal fixation (volar locking plate, VP group: 41 fractures), and patients treated with an external fixator and K-wires (EF group: 21 fractures). The clinical assessment included range of motion, grip strength, disability of the arm, shoulder, and hand (DASH), …

Optimizing The Composition And Delivery Of Assessment And Treatment Following Distal Radius Fracture, Michael L. Szekeres

Electronic Thesis and Dissertation Repository

Distal radius fracture (DRF) is the most common fracture.¹ The most recent Cochrane review indicated “The available evidence from randomized controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius”.²

Since the relative effectiveness of the various interventions used for rehabilitation after DRF is unknown, the main goal of this thesis is to focus on one aspect of both assessment and treatment to add to the current literature base. The first paper (Chapter 2) describes a new method using a modified finger goniometer …

Evaluating Factors That Affect Hand Dexterity After Distal Radius Fracture, Pavlos Bobos

Electronic Thesis and Dissertation Repository

Abstract

Objectives: The primary objective of this study was to determine the effect of age and gender on hand dexterity after distal radius fracture (DRF). The second aim of this study was to evaluate the recovery of hand dexterity in 1-year follow-up of DRF. The third purpose of this study was to determine the extent to which loss of range of motion (ROM) and grip strength predicts hand dexterity 6-months after injury

Methods: A prospective cohort study of 242 patients with DRF examined the recovery of hand dexterity across 3 time-points (3, 6 and 12 months). Dexterity testing was performed …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …

Predicting Risk For Adverse Outcomes Following Distal Radius Fracture, Saurabh Mehta Phd

Saurabh Mehta

Some individuals remain at risk for adverse outcomes such as chronic wrist/hand pain, falls, and fall-related osteoporotic fractures after distal radius fracture (DRF) remain. This thesis includes five studies that were conducted to establish prediction rules or assessing the risk of these adverse outcomes following DRF. The first manuscript outlines a theoretical framework (RACE - Reducing pain, Activating, Cognitive reshaping, Empowering) for managing the risk of adverse outcomes, mainly chronic pain, in individuals with DRF. The RACE is one of the first frameworks to suggest a risk-based management approach for individuals with DRF. The Patient-Rated Wrist Evaluation (PRWE) is a …

Intra-Articular Distal Radius Fractures: Postoperative Roentgenographic And Functional Outcomes, Muhammad Shahid Khan, Shahryar Noordin, Pervaiz Hashmi

Department of Surgery

Abstract

OBJECTIVE:

To assess the outcome of volarlocking compression plate fixation for intra-articular distal radius fractures with respect to function of hand and roentgenographic parameters.

METHODS:

The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised patients who underwent locking compression plate fixation for intra-articular distal radius fractures between June 2009 and July 2012. Case notes, radiographic assessment and functional outcomes were noted. Functional outcome was determined with the help of telephone-based quick-dash score questionnaire administered atleast 6 months post-surgery. Radiological assessment of radial inclination, radial height and volar tilt was measured on immediate postoperative radiographs …

Estimating Osteoporotic Fracture Risk Following A Wrist Fracture: A Tale Of Two Systems, Karen Beattie, Jonathan Adachi, George Ioannidis, Alexandra Papaioannou, William D. Leslie, Ruby Grewal, Joy Macdermid, Anthony B. Hodsman

Bone and Joint Institute

© 2015, The Author(s). Summary: The WHO fracture risk assessment (FRAX) and Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tools can both be used to determine an individual’s 10-year risk of osteoporotic fracture. However, these tools differ in their risk calculation. For participants fracture, FRAX provides a lower fracture risk estimate than CAROC resulting in fewer decisions to initiate therapy.Purpose: The purpose of the current report is to compare fracture risk prediction rates using the CAROC and the FRAX® tools.Methods: Individuals ≥50 years with a distal radius fracture resulting from a fall from standing height or less were recruited …

Use Of High-Speed X Ray And Video To Analyze Distal Radius Fracture Pathomechanics., Christina Gutowski, Kurosh Darvish, Frederic E. Liss, Asif M. Ilyas, Christopher M. Jones

Department of Orthopaedic Surgery Faculty Papers

The purpose of this study is to investigate the failure sequence of the distal radius during a simulated fall onto an outstretched hand using cadaver forearms and high-speed X ray and video systems. This apparatus records the beginning and propagation of bony failure, ultimately resulting in distal radius or forearm fracture. The effects of 3 different wrist guard designs are investigated using this system. Serving as a proof-of-concept analysis, this study supports this imaging technique to be used in larger studies of orthopedic trauma and protective devices and specifically for distal radius fractures.

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Saurabh Mehta

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …

Short Term Sensory And Vascular Responses To Physical Agent Modalities And Exercise In Healthy Volunteers And Patients With Distal Radius Fracture., Shaguftha Shaik

Electronic Thesis and Dissertation Repository

Currently, there is weak evidence on the effectiveness of different rehabilitation regimens following distal radius fracture (DRF). This thesis evaluated sensory and vascular effects of exercise, thermal and ultrasound interventions that can be used in the mobilization phase (cast removal) after DRF.

Methods

• This thesis includes 3 studies. The first study compared responses to Immersion in Cold water Evaluation (ICE) in the DRF and uninjured hands. Skin blood flow (Sbf), skin temperature (temp.) and sensory perception thresholds (sPT) at 2000Hz for A –beta fibres and at 5 Hz for C fibres were obtained before, immediately after ICE and 10 min …

Predicting Risk For Adverse Outcomes Following Distal Radius Fracture, Saurabh Mehta Phd

Physical Therapy Faculty Research

Some individuals remain at risk for adverse outcomes such as chronic wrist/hand pain, falls, and fall-related osteoporotic fractures after distal radius fracture (DRF) remain. This thesis includes five studies that were conducted to establish prediction rules or assessing the risk of these adverse outcomes following DRF.

The first manuscript outlines a theoretical framework (RACE - Reducing pain, Activating, Cognitive reshaping, Empowering) for managing the risk of adverse outcomes, mainly chronic pain, in individuals with DRF. The RACE is one of the first frameworks to suggest a risk-based management approach for individuals with DRF.

The Patient-Rated Wrist Evaluation (PRWE) is a …

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Physical Therapy Faculty Research

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …