Predictors of chronic pain and disability in patients treated conservatively after distal radius fracture: a prospective cohort study

May Lai Mei Luk, Andy Chi Ming Chan, Jocelyn Sau Yee Cho, Daisy Mei Ting Ng, Isa Chui Yi Lam, Edmund Leung Kai Yau, Tiev Miller, Marco Yiu Chung Pang (Corresponding Author)

Research output: Journal article publicationJournal articleAcademic researchpeer-review

1 Citation (Scopus)

Abstract

Purpose: To determine predictors of chronic pain and disability among patients with distal radius fractures (DRF) treated conservatively with closed reduction and cast immobilization. Methods: This was a prospective cohort study. Information on patient characteristics, post-reduction radiographic parameters, finger and wrist range of motion, psychological status (Hospital Anxiety and Depression Scale or HADS), pain (Numeric Rating Scale or NRS), and self-perceived disability (Disabilities of the Arm, Should, and Hand or DASH) were taken at baseline, cast removal, and 24 weeks. Differences in outcomes between time points were determined using analysis of variance. Multiple linear regressions were used to determine predictors of pain and disability at 24 weeks. Results: One hundred forty patients with DRF (70% women, age: 67.0 ± 17.9) completed 24 weeks of follow-up and were included in the analysis. NRS (off-cast), range of ulnar deviation (off-cast), and greater occupational demands were significant predictors of pain at week 24 (adjusted R2 = 0.331, p < 0.001). Significant predictors of perceived disability at week 24 were HADS (off cast), sex (female), dominant-hand injury, and range of ulnar deviation (off cast) (adjusted R2 = 0.265, p < 0.001). Conclusions: Off-cast NRS and HADS scores are important modifiable predictors of patient-reported pain and disability at 24 weeks in patients with DRF. These factors should be targeted in the prevention of chronic pain and disability post-DRF.

Original languageEnglish
Pages (from-to)1535-1543
Number of pages9
JournalInternational Orthopaedics
Volume47
Issue number6
DOIs
Publication statusPublished - Jun 2023

Keywords

  • Conservative treatment
  • Disability evaluation
  • Pain
  • Radius
  • Wrist fractures

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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