PhD defence C.L.E. (Charlotte) Laane

Below is a brief summary of the dissertation:

This thesis evaluates the aetiology, diagnostics, prevention and treatment of complications that occur after distal radius fracture. As the incidence of this fracture increases due to an aging population, prevention and managing complications becomes more important, since they can delay recovery and lead to long-term functional problems.
First, a novel iPad-based drawing test was evaluated to measure hand function. While drawings did not visually reveal differences, digital features like pressure and speed successfully distinguished patients from healthy individuals. This tool shows promise for early monitoring during rehabilitation and may potentially help detect complications in the future.
Second, surgical techniques were optimized. Current single-use implant sets often lack the correct screw sizes, leading to inefficiencies. This research suggests tailoring screw selection based on patient anatomy and preoperative imaging. It also identifies specific screw positions that carry a higher risk of tendon damage, recommending safer placement strategies.
Third, the causes of tendon injuries were investigated. While protruding screws are a known risk, they account for only half of tendon ruptures. Other factors, such as tendon entrapment in fracture fragments, also play a significant role and should be carefully assessed on imaging.
Finally, treatment of long-term complications was reviewed. In malunion ulnar shortening osteotomy can restore function, although complications like implant irritation remain common. Therefore a buried implant may be preferred. Additionally, surgery for nonunion carries a notable risk of reoperation, highlighting the importance of informed decision-making.
Overall, this work provides practical insights to improve patient outcomes after distal radius fracture.