Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion

Objectives: Distal radius malunion can result in pain and functional complaints. One of the functional problems that can affect daily life is impaired forearm rotation. The primary aim of this study was to investigate the effect of corrective osteotomy for distal radius malunion on forearm rotation at 12 months after surgery. We secondarily studied the effect on grip strength, radiological measurements, and patient-reported outcome measurements (PROMs). Patients and methods: This cohort study analysed prospectively collected data of adult patients with symptomatic distal radius malunion. All patients underwent corrective osteotomy for malunion and were followed for 1 year. We measured forearm rotation (pronation and supination) and grip strength and analysed radiographs. PROMs consisted of the Patient-Rated Hand/Wrist Evaluation (PRWHE) questionnaire, Visual Analogue Scale for pain, and satisfaction with hand function. Results:Preoperative total forearm rotation was 112° (SD: 34°), of which supination of 49° (SD: 25°) was more impaired than pronation of 63° (SD: 17°). Twelve months after surgery, an unpaired Student's t-test showed a significant improvement of total forearm rotation to 142° (SD: 17°) (p &lt; 0.05). Pronation improved to 72° (SD: 10°), and supination to 69° (SD: 13°) (p &lt; 0.05). Grip strength, PROMs, as well as inclination and volar tilt on radiographs improved significantly during the first year after surgery (p &lt; 0.05). Conclusion: In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment that significantly improves forearm rotation. In addition, this intervention improves grip strength, the PRWHE-score, pain, and satisfaction with hand function.</p

Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion

Objectives: Distal radius malunion can result in pain and functional complaints. One of the functional problems that can affect daily life is impaired forearm rotation. The primary aim of this study was to investigate the effect of corrective osteotomy for distal radius malunion on forearm rotation at 12 months after surgery. We secondarily studied the effect on grip strength, radiological measurements, and patient-reported outcome measurements (PROMs). Patients and methods: This cohort study analysed prospectively collected data of adult patients with symptomatic distal radius malunion. All patients underwent corrective osteotomy for malunion and were followed for 1 year. We measured forearm rotation (pronation and supination) and grip strength and analysed radiographs. PROMs consisted of the Patient-Rated Hand/Wrist Evaluation (PRWHE) questionnaire, Visual Analogue Scale for pain, and satisfaction with hand function. Results:Preoperative total forearm rotation was 112° (SD: 34°), of which supination of 49° (SD: 25°) was more impaired than pronation of 63° (SD: 17°). Twelve months after surgery, an unpaired Student's t-test showed a significant improvement of total forearm rotation to 142° (SD: 17°) (p &lt; 0.05). Pronation improved to 72° (SD: 10°), and supination to 69° (SD: 13°) (p &lt; 0.05). Grip strength, PROMs, as well as inclination and volar tilt on radiographs improved significantly during the first year after surgery (p &lt; 0.05). Conclusion: In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment that significantly improves forearm rotation. In addition, this intervention improves grip strength, the PRWHE-score, pain, and satisfaction with hand function.</p

Vegetation characteristics and eco-hydrological processes in a pristine mire in the Ob River valley (Western Siberia)

Relations between vegetation characteristics and eco-hydrological processes were assessed in a pristine mire in the valley of the Ob River (Western Siberia). Along a transect from the terrace scarp to the river, field data were collected on vegetation composition, peat stratigraphy, peat chemistry, hydrology and hydrochemistry. Based on floristic composition, eight vegetation communities were distinguished. Hydraulic head measurements were used to obtain an indication of groundwater flow directions. The water balance of the mire was calculated with a two-dimensional steady-state numerical groundwater model. Water types were defined based on cluster analysis of hydrochemical data. The results revealed that the dominant hydrological factor in the Ob mire is the discharge of groundwater, which supplies about threefold more water than net precipitation. Although the discharge flux decreases with increasing distance from the terrace scarp, high water levels and a ‘‘groundwater-like’’ mire water composition were observed in the major part of the study site. Precipitation and river water play only a minor role. Despite dilution of discharging groundwater with rainwater, spatial differences in pH and solute concentrations of the surficial mire water are small and not reflected in the vegetation composition. Although small amounts of silt and clay were found in the peat in the proximity of the river, indicating the occurrence of river floods in former times, no river-flood zone could be recognized based on hydrochemical characteristics or vegetation composition. A comparison of the Ob mire with well-studied and near-natural mires in the Biebrza River valley (Poland) revealed substantial differences in both vegetation characteristics and the intensity and spatial pattern of eco-hydrological processes. Differences in the origin and ratios of water fluxes as well as a dissimilar land use history would seem to be key factors explaining the differences observed