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

Year 2018, Volume: 5 Issue: 3, 424 - 434, 14.10.2018

Murat Tomruk , Nihal Gelecek , Onur Başçı , Mustafa Özkan

https://doi.org/10.17681/hsp.383062

Abstract

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.   

Keywords

Radius kırıkları, fizyoterapi, radyolojik, fonksiyonel, sonuç

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

Abstract

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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