PRWE application in distal radius fracture: comparison and correlation with established outcomes☆

Paranaíba, Vinícius Ferreira; Santos, João Baptista Gomes dos; Raduan, Jorge; Moraes, Vinícius Ynoe; Belotti, João Carlos; Faloppa, Flávio

doi:10.1016/j.rboe.2016.07.007

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Revista Brasileira de Ortopedia

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ORIGINAL ARTICLE • Rev. bras. ortop. 52 (03) • May-Jun 2017 • https://doi.org/10.1016/j.rboe.2016.07.007 copy

PRWE application in distal radius fracture: comparison and correlation with established outcomes^☆ ☆ Study conducted at the Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Ortopedia e Traumatologia, Disciplina de Cirurgia da Mão e Membro Superior, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

The study aimed to evaluate the correlation between the PRWE score with other measurements that are already widely used.

METHODS:

This was a prospective, cross-sectional, single-center study. Sixty-eight consecutive patients underwent surgical treatment for distal radius fractures (internal fixation by locked volar plate or transarticular external fixation). They were evaluated independently by PRWE, DASH, VAS range of motion, strength, and radiographic criteria, in one year of follow up. The Mann-Whitney test was used to compare continuous variables and the Spearman correlation to correlate the outcomes of interest.

RESULTS:

PRWE correlated significantly with DASH (p < 0.001) and VAS (p < 0.001). There were no significant correlations with other outcome measures.

CONCLUSION:

PRWE presents significant moderate correlation only with DASH and VAS. Range of motion, strength, and radiographic criteria do not interfere in the PRWE outcome.

Keywords:
Radius fractures; Outcome assessment; Wrist

	Operated side (n = 68)	Contralateral side (n = 68)	Difference^a (n = 68)
Flexion (degrees)
Mean	70.8	78.8	8.0
Minimum-maximum	45-90	45-95	-25 to 35

Extension (degrees)
Mean	61.4	68.2	6.8
Minimum-maximum	30-80	45-90	-20 to 60

Pronation (degrees)
Mean	83.2	86.6	3.4
Minimum-maximum	50-100	55-100	-5 to 20

Supination (degrees)
Mean	90.1	93.3	3.2
Minimum-maximum	66-125	80-130	-15 to 25

Radial bending (degrees)
Mean	21.9	24.6	2.7
Minimum-maximum	10-40	12-45	-15 to 20
Ulnar bending (degrees)
Mean	39.7	42.8	3.0
Minimum-maximum	10-60	20-70	-15.0 to 25

Grip strength (kgf)
Mean	24.8	28.2	3.4
Minimum-maximum	6.7-60.2	13.3-50.9	-13.2 to 20.2

Pulp pinch (kgf)
Mean	3.5	4.0	0.4
Minimum-maximum	0.9-7.5	1.6-8.0	-2.8 to 4.1
Lateral pinch (kgf)
Mean	5.8	5.6	-0.2
Minimum-maximum	1.8-11.4	2.5-11.0	-4.3 to 3.4
Three-digit pinch (kgf)
Mean	4.5	4.8	0.3
Minimum-maximum	1.4-8.2	2.0-8.7	-3.0 to 2.7

	Operated side (n = 68)	Contralateral side (n = 68)	Difference^a (n = 68)
Radial height (mm)
Mean	10.1	11.3	Difference^a (n = 68)	1.2
Minimum-maximum	0-16	4-16	-4 to 9

Radial inclination (degrees)
Mean	19.9	21.2	1.3
Minimum-maximum	12-28	14-28	-6 to 10

Ulnar variance (mm)
Mean	-0.4	0.8	1.1
Minimum-maximum	-8 to 4	-4 to 5	-2 to 8

Volar inclination (degrees)
Mean	6.9	13.3	6.4
Minimum-maximum	-8 to 20	2-24	-6 to 24

Step-off (mm)
Mean	0.2	0	-0.2
Minimum-maximum	0-3	0-0	-3 to 0

Joint gap (mm)
Mean	0.3	0	-0.3
Minimum-maximum	0-5	0-0	-5 to 0

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: viniciusparanaiba@gmail.com (V.F. Paranaíba).

Gender
Male	26	38.2%
Female	42	61.8%
Fixation devices
External fixation	36	52.9%
Locked volar plate	32	47.1%
Age (years)
Mean		52.0
Minimum-maximum		19-87
Dominant side
Right	63	92.6%
Left	5	7.4%
Operated side
Right	33	48.5%
Left	35	51.5%
*Dominant side was operated*	36	52.9%
*Non-dominant side was operated*	32	47.1%
PRWE
Mean	8.2
Minimum-maximum	0-80
DASH
Mean	3.0
Minimum-maximum	0.0-27.5

Pair of correlated measures	Spearman's correlation coefficient	p
PRWE and DASH	0.609	<0.001^a
PRWE and VAS	0.495	<0.001^a
PRWE and flexion	0.075	0.545
PRWE and extension	0.111	0.366
PRWE and pronation	0.033	0.788
PRWE and supination	0.066	0.595
PRWE and radial bending	0.011	0.932
PRWE and ulnar bending	0.023	0.851
PRWE and grip strength	0.095	0.440
PRWE and pulp pinch	0.144	0.240
PRWE and lateral pinch	0.124	0.315
PRWE and three-digit pinch	0.096	0.438
PRWE and radial height	-0.041	0.738
PRWE and radial inclination	-0.042	0.733
PRWE and ulnar variance	-0.106	0.389
PRWE and volar inclination	-0.161	0.189
PRWE and step-off	-0.095	0.443
PRWE and joint gap	0.063	0.610