Bone and Joint Institute

Title

The effect of diabetes on functional outcomes among individuals with distal radial fractures

Document Type

Article

Publication Date

10-1-2019

Journal

Journal of Hand Therapy

Volume

32

Issue

4

First Page

476

Last Page

482

URL with Digital Object Identifier

10.1016/j.jht.2018.02.008

Abstract

© 2018 Hanley & Belfus Study Design: Prospective cohort study. Introduction: Diabetes is reported to adversely affect outcomes; however, its effect on distal radial fractures (DRF) is not well examined. Purpose of the Study: This study investigated the effect of diabetes on pain, hand function, physical health status, grip strength, and wrist and forearm range of motion among patients with DRF. Methods: A total of 479 patients with DRF were classified into patients with and without diabetes based on self-report. Patient-Rated Wrist Evaluation assessed pain and hand function. The Short Form-12 assessed physical health status. Both questionnaires examined DRF recovery at baseline, 3 month, and 1 year. Results: There was a significant improvement in Patient-Rated Wrist Evaluation scores over time (69 [19] to 25 [22]; 76 [15] to 20 [20] for patients with and without diabetes respectively, P < .01) with a significant interaction between time and diabetes (P < .01), indicating that patients with diabetes recovered more slowly than the rest of the cohort. There was an improvement over time on physical status (36 [12] to 45 [12]; 39 [9] to 50 [9], P < .01), grip strength (16 [7] to 24 [10]; 15 [9] to 24 [10], P < .01), and range of motion (flexion [42 {14} to 49 {15}; 43 {15} to 54 {14}, P < .01], extension [45 {11} to 52 {11}; 46 {13} to 53 {12}, P < .01], pronation [73 {10} to 77 {9}; 73 {11} to 78 {9}, P < .01], and supination [58 {17} to 65 {14}; 61 {17} to 70 {12}, P < .01]) for patients with and without diabetes, respectively. Patients with diabetes did not differ significantly in these secondary outcomes compared to the rest of the cohort. Discussion and Conclusion: Although individuals with diabetes had good outcomes, their recovery was slower than the rest of the cohort. This may be due to the adverse effect of hyperglycemia on bone tissues and small blood vessels. Future studies are required to assess how severity and duration of diabetes affect outcomes after DRF.

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