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Effect of low appendicular lean mass, grip strength, and gait speed on the functional outcome after surgery for distal radius fractures

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Abstract

Summary

Patients with low appendicular lean mass plus slow gait speed or weak grip strength are at risk for poor functional recovery after surgery for distal radius fracture, even when they have similar radiologic outcomes.

Introduction

Loss of skeletal muscle mass and consequent loss in muscle function associate with aging, and this condition negatively impacts the activities of daily living and increases elderly individuals’ frailty to falls. Thus, patients with low appendicular lean mass would show different functional recovery compared to those without this condition after surgery for distal radius fracture (DRF). This study compares the functional outcomes after surgery for DRF in patients with or without low appendicular lean mass plus slowness or weakness.

Methods

A total of 157 patients older than 50 years of age with a DRF treated via volar plate fixation were enrolled in this prospective study. A definition of low appendicular lean mass with slowness or weakness was based on the consensus of the Asian Working Group for Sarcopenia. The researchers compared functional assessments (wrist range of motion and Michigan Hand Questionnaire [MHQ]) and radiographic assessments (radial inclination, volar tilt, ulnar variance, and articular congruity) 12 months after surgery between patients with and without low appendicular lean mass plus slowness or weakness. Multivariable regression analyses were performed to determine whether appendicular lean mass, grip strength, gait speed, patient demographic, or injury characteristics accounted for the functional outcomes.

Results

Patients with low appendicular lean mass plus slowness or weakness showed a significantly lower recovery of MHQ score than those in the control group throughout 12 months. There was no significant difference in the range of motion between the groups. The radiologic outcomes showed no significant difference between groups in terms of volar tilt, radial inclination, or ulnar variance. According to multivariable regression analysis, the poor recovery of MHQ score was associated with an increase in age, weak grip strength, and lower appendicular lean mass, and these three factors accounted for 37% of the variation in the MHQ scores.

Conclusion

Patients with low appendicular lean mass plus slowness or weakness are at risk for poor functional recovery after surgery for DRF, even when they have similar radiologic outcomes.

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Acknowledgments

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2017R1C1B1002544).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, South Korea

    Young Hak Roh

  2. Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon-si, Gangwon-do, 200-722, South Korea

    Jung Ho Noh

  3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Hyun Sik Gong & Goo Hyun Baek

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  1. Young Hak Roh
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  2. Jung Ho Noh
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  3. Hyun Sik Gong
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  4. Goo Hyun Baek
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Corresponding author

Correspondence to Jung Ho Noh.

Ethics declarations

This study was approved by our institutional review board, and all patients provided informed consent.

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None.

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Roh, Y.H., Noh, J.H., Gong, H.S. et al. Effect of low appendicular lean mass, grip strength, and gait speed on the functional outcome after surgery for distal radius fractures. Arch Osteoporos 12, 41 (2017). https://doi.org/10.1007/s11657-017-0335-2

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  • DOI: https://doi.org/10.1007/s11657-017-0335-2

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