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Distal radius fractures (DRF) are the most common fracture in adults. A tool is needed to identify patients who may need extra attention from the physical therapist during the rehabilitation process. The purpose of the study was to examine if pulp-to-palm distance (PTP) 4 weeks postoperatively is associated with wrist function 3 months postoperatively in patients undergoing combined plating for a complex DRF. This prospective study involved 53 patients. PTP was assessed by a physical therapist at the second visit, 4 weeks postoperatively. The 3-month follow-up visit consisted of evaluating the following outcomes: PRWE (Patient-Rated Wrist Evaluation), QuickDASH (Disabilities of the Arm, Shoulder and Hand), VAS pain scores, hand grip strength and wrist range of motion. All patients received the same amount of hand therapy. Patients with zero PTP at 4 weeks postoperative had a significantly better range of motion in wrist extension, flexion, radial deviation, ulnar deviation, hand grip strength and QuickDASH scores compared to patients with a PTP>0cm. VAS pain scores did not differ between the two groups. Patients with zero PTP at 4 weeks postoperative were more likely to have a better wrist function at 3 months postoperative compared to patients with measurable PTP. Based on this study's findings, measuring the PTP distance at 4 weeks postoperative could be useful for identifying patients in need of support during the rehabilitation process after DRF surgery. This could potentially improve the allocation of hand rehabilitation resources; screening patients postoperatively could help to begin relevant interventions.

During hemodialysis blood - membrane interaction causes complement activation. During dialysis there may be an electrical current leakage to the dialyzer, especially if there is a broken ground or a defect in another electrical device coupled to the patient.This study investigated whether an electric current of 1.5 mA DC could alter blood membrane interaction as measured by changes in C3d in the blood. Such a high current leakage could occur because there is no protection in the dialysis machine (Class 1B) against auxiliary current leakage. Such a current could come from a defective external device in contact with the patient during hemodialysis.Materials A dialysis machine (Fresenius 2008C) with a filled blood-line system containing about 350 ml whole blood from each of 8 different donors was used in vitro. Each of the eight test-runs also contained 1000 U added heparin. The dialysis procedure was performed using hemophan membranes (GFS +12, Gambro) with bicarbonate and potassium 3.0 (D210, Gambro) as dialysate. Two electric poles were placed in the blood line, before and after the dialyzer (connected in parallel) and the ground was placed at entry and exit of the dialysate fluid coming from the machine to the dialysis filter. C3d was measured before the start of “dialysis” and at 15, 30, 45 and 60 min, during dialysis. Thereafter the 1.5 mA current was switched on and additional samples were drawn at 75 and 90 min. The mean C3d values were calculated. Paired non-parametric statistical analyses were performed.Results There was a significant and continuous increase in C3d as compared to the “predialysis” level. The increase during 0 to 30 minutes was greater than that from 30 to 60 minutes (p=0.018); the increase in C3d during 60 to 90 min, was greater than that from 30 to 60 min (p=0.018) and there was no difference between the 0 to 30 and the 60 to 90 min increases.Conclusions A current, used in this study, was able to induce a blood membrane interaction during in vitro dialysis. Even a weaker current leakage might have such adverse effects and similar interactions seem possible during regular dialysis depending on the extent of the leakage.