Long-term outcomes of XXXX of both bones of the forearm.

@entity1 @entity308 @entity174 @entity158 @entity717
BACKGROUND: Previous studies identified limited @entity717 several years after diaphyseal @entity174 of both the radius and ulna, although the relationship between @entity717 was inconsistent. This investigation studied skeletally mature and immature @entity1 more than ten years after injury and addressed the hypotheses that (1) objective measurements of impairment correlate with disability, (2) @entity308 and misinterpretation of nociception correlate with disability, and (3) @entity1 injured when skeletally mature or immature have comparable @entity717 . METHODS: Seventy-one @entity1 with diaphyseal @entity174 of the radius and ulna were evaluated at an average of twenty-one years after injury. Twenty-five of the thirty-five @entity1 who were skeletally immature at the time of injury were treated nonoperatively, and thirty-one of the thirty-six skeletally mature @entity1 were treated operatively. Objective evaluation included radiographs, functional assessment, and grip strength. Validated questionnaires were used to measure arm-specific disability (the Disabilities of the Arm, Shoulder and Hand [DASH] score), misinterpretation of @entity158 ( @entity158 Catastrophizing Scale [PCS]), and @entity308 (the validated Dutch form of the Center for Epidemiologic Studies- @entity308 scale [CES-D]). RESULTS: The average DASH score was 8 points (range, 0 to 54); 97% of @entity1 had excellent or satisfactory results according to the criteria of Anderson et al., and 72% reported no @entity158 . Both the @entity717 and the wrist flexion/extension arc was 91% of that seen on the uninjured side; grip strength was 94%. There were small but significant differences in rotation (151   versus 169  , p = 0.004) and wrist flexion-extension (123   versus 142  , p = 0.002) compared with the results in the uninjured arm. There was no difference in disability between @entity1 who were skeletally mature or immature at the time of injury. @entity158 , @entity158 catastrophizing (misinterpretation of nociception), and grip strength were the most important predictors of disability. CONCLUSIONS: An average of twenty-one years after sustaining diaphyseal @entity174 of both the radius and the ulna, @entity1 who were skeletally immature or mature at the time of @entity174 have comparable disability. Disability correlates better with subjective and psychosocial aspects of illness, such as @entity158 and @entity158 catastrophizing, than with objective measurements of impairment. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
