S Trnavac

Publications (2)4.78 Total impact

• Article: Can the displacement of a conservatively treated distal radius fracture be predicted at the beginning of treatment?

  T Einsiedel, W Freund, S Sander, S Trnavac, F Gebhard, M Kramer
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  ABSTRACT: The aim of this study was to investigate whether the final displacement of conservatively treated distal radius fractures can be predicted after primary reduction. We analysed the radiographic documents of 311 patients with a conservatively treated distal radius fracture at the time of injury, after reduction and after bony consolidation. We measured the dorsal angulation (DA), the radial angle (RA) and the radial shortening (RS) at each time point. The parameters were analysed separately for metaphyseally "stable" (A2, C1) and "unstable" (A3, C2, C3) fractures, according to the AO classification system. Spearman's rank correlations and regression functions were determined for the analysis. The highest correlations were found for the DA between the time points 'reduction' and 'complete healing' (r = 0.75) and for the RA between the time points 'reduction' and 'complete healing' (r = 0.80). The DA and the RA after complete healing can be predicted from the regression functions.
  International Orthopaedics 06/2008; 33(3):795-800. · 2.03 Impact Factor
• Article: [Complaints in the follow-up of conservatively treated distal radius fractures--predictors in the initial radiograph].

  W Freund, T Einsiedel, S Trnavac, A J Aschoff, M Kramer
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  ABSTRACT: Radius fractures are frequent in adults, and the long-term results of conservative treatment remain disappointing. This study examines predictors for the clinical outcome in the initial radiograph. This will help to identify patients who will benefit from surgical treatment. A cohort study including a standardized telephone interview (Cooney score) was used to identify all conservatively treated patients with a distal radius fracture over a five-year period. The additional selection criteria were: over 15 years old, initial X-ray available, patient reachable by phone for the follow-up interview. The following measurements were taken from the initial radiograph: radius-base angle, radial shortening, radiopalmar angle and intraarticular displacement. Correlations and a simple test to predict negative outcome were computed. Of the initially identified 2211 patients with distal radius fracture, 179 also fulfilled the other criteria. The patients were 56.2 years old on average (standard deviation SD = +/- 22.45 years) and 72 % were female. 60 % of the fractures were on the right side. The average follow-up was 4.3 years (SD +/- 1.66). The Cooney score results averaged 85 points (with 100 being the optimal and maximum score), indicating good or very good functional results in the long term follow-up for 61 % of patients. However, 31 % received a rating of fair or poor and therefore had an unfavorable outcome. With respect to the correlations, age and shortening of the radius (but not gender) had a significant influence on the functional result. Using an age of 75 years or above and a radial shortening of at least 4 mm to predict an unfavorable outcome, the sensitivity is only 16 %, but the positive predictive value is 73 % and the specificity is 96 %. In the analysis of the initial radiographs after distal radius fracture, age and radial shortening primarily correlate with functional results after four years after conservative treatment. Using the values age > or = 75 and radial shortening > or = 4 mm, it is possible to predict an unfavorable functional outcome with a positive predictive value of 73 %. This could aid in the indication of operative treatment.
  RöFo - Fortschritte auf dem Gebiet der R 06/2007; 179(6):627-33. · 2.76 Impact Factor