Mohammad Shabir, Muhammad Inam, Abdul Satar, Mohammad Saeed Waqar Hassan, Mohammad Arif, Alamzeb Durrani.
Factors contributing to poor follow up rates in the management of distal radius fractures.
J Pak Orthop Assoc Jan ;24(1):9-16.

Objective: The objective of this study was to identify the patients factors contributing in poor follow up rates Place and Duration of Study: This study was conducted from 2008 to 2011,in Department of Orthopedic and Spine Surgery of Hayatabad Medical Complex Peshawar. Study Design: Prospective Study Patients and Methods: Seventy three consecutive patients of either sex, having distal radius fracture were included in the study while patients younger than 18 years, those with polytrauma and those who sustained concomitant head injuries were excluded. Data collected included age, income level, type of treatment, level of education, gender, severity of fracture, mechanism of injury, and marital and employment status. The Frykmen classification system was used to grade the degree of severity and joint involvement on initial injury radiographs. Results: There were total 73 patients. Minimum age was 40 year and maximum was 81 year while average age was 54 years. There were 39 (53.4%) female and 34(46.6%) male. Income level of the patients was; 31(42.5%) poor, 31 (42.5%) satisfactory and 11 (15%) rich. There were 26 (35.6%) uneducated patients, 11 (15.1%) middle pass, 16(21.9%) matric pass, 9(12.3%) HSSC, 7(9.6%) bachelor, 4(5.5%) master. Fracture was classified according to Frykmen classification. There were 14(19.2%) type 1, 17(23.3%) type2, 13(17.8%) type 3, 11(15.1%) type 4, 5(6.8%) type5, 7(9.6%) type 6, 3(4.1%) type7and 3(4.1%) type 8. mechanism of injury was fall in 46 (63%) and road traffic accident in 27(37%) patients. There were 62 (84.9%) married patients and 11(15.1%) unmarried. Thirty two (43.8%) patients were employed while 41(56.2%) were unemployed. Close reduction and Cast Splintage were applied in 54(74%) patients, Close reduction and External Fixation in 14 (19.2%) while Open Reduction and internal Fixation was done in 5 (6.8%) patients. Nineteen (26%) patients came on first follow up at 2 weeks, 27 (37%) patients came on second follow up at 3 months, 18 (24.7%) patients came on third follow up at 6 months and 9(12.3%%) patients came on fourth follow up at 1 year. Conclusion: Multiple factors should be born in mind while labeling a patient as non respondent or not follow the proper protocol for follow up. Most of our patient population is poor and came from far flung areas for treatment and they do not know the importance of follow up in orthopedic.

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