Murat TOMRUK, Nihal GELECEK, Onur BAŞÇI, Mustafa ÖZKAN

Radius Distal Uç Kırığı Volar Plaklama Sonrası Fizyoterapi Uygulanan Hastalarda Radyolojik Ölçümler ile Fonksiyonel Ölçümler İlişkili Midir?

Amaç: Radius distal uç kırığına bağlı volar plaklama yapılan hastaların radyolojik ölçümleri ile eklem hareket açıklıkları, kavrama kuvveti ve fonksiyonel sonuçları arasındaki ilişkiyi araştırmaktı. Gereç ve Yöntem: Çalışmaya radius distal uç kırığı sonrası volar plaklama yapılan ve 12 haftalık süpervize fizyoterapi programını tamamlayan 31 hasta (18 kadın, 13 erkek) alındı. Hastaların radyolojik ölçümleri postoperatif 1. haftada içinde çekilen direkt grafileri üzerinde yapıldı. Volar tilt, radiyal uzunluk, radiyal inklinasyon ve ulnar varyans değerleri kaydedildi. Postoperatif 12 haftada hastaların el bileği ve önkol eklem hareket açıklıkları, kavrama kuvveti ve fonksiyonel düzeyleri (Hasta Bazlı El Bileği Değerlendirme Anketi “PRWE” ve Kol, Omuz ve El Yaralanması Anketi “DASH”) ölçüldü. Radyolojik sonuçlar ile fonksiyonel sonuçlar arasındaki ilişkiyi belirlemek için Spearman Korelasyon Analizi yapıldı. Bulgular: Radyolojik ölçümlerden “ulnar varyans değeri” ile PRWE ağrı skoru ve PRWE toplam skoru arasında pozitif yönde anlamlı ilişki belirlendi (sırasıyla p=0.030, r=0.443; p=0.039, r=0.424). Diğer radyolojik ölçümler ile hiçbir parametre arasında istatististiksel olarak anlamlı korelasyon yoktu (p>0.05). El bileği fleksiyon ve ekstansiyon dereceleri de kavrama kuvveti ile (sırasıyla, r=0,660, r=0.619) ve PWRE fonksiyon skorları ile (sırasıyla, r=-0.497, r=-0.520) anlamlı korelasyon gösterdi (p<0.05). Sonuç: Bu çalışma radius distal uç kırığı sonrası volar plaklama yapılan ve fizyoterapi programına alınan hastalarda, radyolojik ölçümlerden yalnızca ulnar varyans değerinin fonksiyonel sonuçları etkilediğini göstermiştir. Daha kesin sonuçlar için farklı redüksiyon tiplerinde ve farklı hasta sayılarında çalışmalara ihtiyaç bulunmaktadır.

Anahtar Kelimeler:

Radius kırıkları, fizyoterapi, radyolojik, fonksiyonel, sonuç

Do Radiological and Functional Outcomes Correlated for Patients Receiving Physiotherapy After Volar Plating of Distal Radius Fracture?

Objective: The aim of this study was to investigate the relationships between radiological outcomes and range of motions, grip strength, and functional outcomes in patients receiving physiotherapy after volar plating of distal radius fracture. Methods: 31 patients (18 female, 13 male) who completed the 12-week supervised physiotherapy program after volar plating of distal radius fracture were enrolled. Radiographic measurements of the patients were made by direct radiographs taken at 1 week postoperatively. Volar tilt, radial length, radial inclination and ulnar variance values were recorded. Wrist and forearm range of motions, grip strength and functional level (Patient Rated Wrist Evaluation “PRWE” and Disabilities of Arm, Hand and Shoulder “DASH”) were assessed at the end of the 12-week physiotherapy program postoperatively. Functional scores of the wrist, grip strength and range of motions were measured. Spearman’s correlation analysis was performed to determine the relationship between radiological and functional outcomes. Results: Significant positive correlations were found between "ulnar variance value", which is one of the radiological measurements, and PRWE pain score and PRWE total score (p=0.030, r=0.443; p=0.039, r=0.424, respectively). There was no statistically significant correlation between other radiological measurements and none of the parameters (p>0.05). Wrist flexion and extension were significantly correlated with grip strength (r=0,660, r=0.619, respectively) and PRWE function score (r=-0.497, r=-0.520, respectively). Conclusion: This study showed that only ulnar variance value has an effect on functional outcomes in patients receiving physiotherapy after volar plating of distal radius fracture. For more precise results, studies with various reduction types and different number of patients were needed.

Keywords:

Radius fracture, physiotherapy, radiological, functional, outcome,

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