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Abstract
INTRODUCTION:
Distal radius fractures are one of the commonest fractures experienced by the Orthopaedic surgeons. Pain on the ulnar aspect of the wrist is the most usual complication of such fractures. Corticosteroid injection is a simple and effective method for elevating pain of such nature.
OBJECTIVE: To compare the mean pain score with prophylactic corticosteroid injection versus placebo in management of wrist pain on ulnar aspect in patients presenting with fracture of distal radius.
MATERIAL AND METHODS:
Study Design: Randomized controlled trial
Setting: Orthopedic Surgery Department, Benazir Bhutto Hospital, Rawalpindi
Duration: Six months (March 5, 2018 to Sept 5, 2018)
Data Collection Procedure:
80 patients were included by using non-probability consecutive sampling after fulfilling the selection criteria. Demographic profile (patient name, age, gender, anatomical side and contact details) was obtained. Patients were splitted in two random groups by simple lottery method. Patients of group A were given one shot of 80mg corticosteroid in the area of ulnar styloid process near TFCC and group B patients were given a shot of distilled water (2 cc). Both group of patients were followed in OPD for 3 months in their postoperative visits. Visual analogue scale (VAS) score was recorded. Data was analyzed using SPSS version 21.
Results:
The mean age of the patients was 41.05 ± 11.05 years and age range of 40 years. The mean age in the corticosteroid and placebo groups was 39.68±10.67 years and 42.42 ± 11.39 years respectively. There were 42 (52.50%) male and 38 (47.50%) female patients with a higher male ratio i.e., 1.10:1. In corticosteroid and placebo groups there were 21 (52.50%) male and 19 (47.50%) female cases. The mean pain at baseline was 7.72 ± 1.66 while in the corticosteroid and placebo group, the mean pain was 7.60 ± 1.67 and 7.85 ± 1.65 respectively with statistically equal mean pain p-value = 0.504. After 3 months of treatment, mean pain in the corticosteroid group was 1.30 ± 0.66 and was 2.60 ± 1.58 in the placebo group, p-value < 0.001.
Conclusion:
Our findings suggested that prophylactic corticosteroid injection is more effective in reducing pain in patients with distal radial fracture than placebo. By using prophylactic corticosteroid injections in the future, we can reduce pain to achieve more satisfaction of patients.
References
Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin 2012; 28(2):113-25. DOI: 10.1016/j.hcl.2012.02.001.
Davis DI, Baratz M. Soft tissue complications of distal radius fractures. Hand Clin 2010; 26(2):229-35. DOI: 10.1016/j.hcl.2009.11.002.
Żyluk A, Piotuch B. Distal radioulnar joint instability: A review of literature. Polish Orthop Traumatol 2013; 78:77-84.
Tan V, Bratchenko W, Nourbakhsh A, Capo J. Comparative analysis of intramedullary nail fixation versus casting for treatment of distal radius fractures. J Hand Surg 2012; 37(3):460-8. DOI: 10.1016/j.jhsa.2011.10.041.
Watanabe A, Souza F, Vezeridis PS, Blazar P, Yoshioka H. Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol 2010; 39(9):837-57. DOI: 10.1007/s00256-009-0842-3.
Saied A, Heshmati A, Sadeghifar A, Mousavi AA, Arabnejad F, Pooladsanj A. Prophylactic corticosteroid injection in ulnar wrist pain in distal radius fracture. Indian J Orthop 2015; 49(4):393. DOI: 10.4103/0019-5413.159595.
Fu Q, Zhu L, Yang P, Chen A: Volar locking plate versus external fixation for distal radius fractures: a meta-analysis of randomized controlled trials. Indian J Orthop. 2018; 52:602-610. DOI: 10.4103%2Fortho.IJOrtho_601_16.
Micic I, Kholinne E, Sun Y, Kwak JM, Jeon IH: The role of additional K-wires on AO type C distal radius fracture treatment with external fixator in young population. Adv Orthop. 2019:8273018. DOI: 10.1155/2019/8273018.
Costa ML, Achten J, Rangan A, Lamb SE, Parsons NR: Percutaneous fixation with Kirschner wires versus volar locking-plate fixation in adults with dorsally displaced fracture of distal radius: five-year follow-up of a randomized controlled trial. Bone Joint J. 2019; 101:978-983. DOI: 10.1302/0301-620X.101B8.
Johnson NA, Dias J: The current evidence-based management of distal radial fractures: UK perspectives. J Hand Surg Eur. 2019; 44:450-455.DOI: 10.1177/1753193419843201.
Adult Distal Radius Fracture Management, Chhabra, A. Bobby MD; Yildirim, Baris MD, Journal of the American Academy of Orthopaedic Surgeons. 2021; 29(22):e1105-e1116. DOI: 10.5435/JAAOS-D-20-01335. DOI: 10.5435/JAAOS-D-20-01335.
Lutsky KF, Lucenti L, Beredjiklian PK. Outcomes of Distal Ulna Fractures Associated with Operatively Treated Distal Radius Fractures. Hand (N Y). 2020; 15(3):418-421. DOI: 10.1177/1558944718812134.
Ou Yang O, McCombe DB, Keating C, Maloney PP, Berger AC, Tham SKY. Ulnar-sided wrist pain: a prospective analysis of diagnostic clinical tests. ANZ J Surg. 2021; 91(10):2159-2162. DOI: 10.1111/ans.17169.
Meaike JJ, Kakar S. Management of Comminuted Distal Radius Fractures: A Critical Analysis Review. JBJS Rev. 2020; 8(8):e2000010. DOI:10.2106/JBJS.RVW.20.00010.
Mitrousias V, Amprazis V, Baltas C, Karachalios T. Isolated Salter-Harris Type II Fracture of the Distal Ulna. Cureus 2021; 13(6):e15552. DOI: 10.7759/cureus.15552.
The treatment of complex intra-articular distal radius fractures with turning radius and distal volaris radius plate fixation. European Journal of Medical Research 25, Article number: 66 (2020).
Clesham K, Piggott RP, Sheehan E. Displaced Salter-Harris I fracture of the distal ulna physis. BMJ Case Rep. 2019; 12(8).DOI: 10.1136/bcr-2019-230783.
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