Scientific articleEffect of Anxiety and Catastrophic Pain Ideation on Early Recovery After Surgery for Distal Radius Fractures
Section snippets
Materials and Methods
In this prospective cohort study, a total of 143 consecutive patients 20 years and older with a DRF treated by volar plate fixation between January 2013 and October 2013 were invited to participate. These patients were recruited from a tertiary care university hospital serving as a regional emergency trauma center, and the institutional review board of the university approved this study. All patients were recruited by a research assistant (trained nurse) when they attended the orthopedic
Results
All ROMs, grip strength, and MHQ scores showed a trend toward continued improvements up to 24 weeks (Table 2).
There was a significant decrease in grip strength in patients with increasing patient age, PCS score, PASS score, or severe fracture type at week 4, whereas an increase in patient age or PASS score was associated with a decrease in grip strength at week 12. At week 24, only an increase in age was associated with grip strength (Table 3). A severe fracture type and an increased PCS or
Discussion
Pain is a dominant predictor of upper extremity–specific health status after the operative treatment of DRFs.10 In addition, psychological factors, not pain per se, cause disability in patients with chronic musculoskeletal pain.22 Although psychological mechanisms underlying pain are reportedly to be associated with chronic pain, the effects of these mechanisms on outcomes of acute fractures have not been well demonstrated. Results of this study suggest that preoperative pain coping (PCS and
References (26)
- et al.
A comparison of the long-term outcome of partial articular (AO Type B) and complete articular (AO Type C) distal radius fractures
J Hand Surg Am
(2013) - et al.
The Pain Anxiety Symptoms Scale: development and validation of a scale to measure fear of pain
Pain
(1992) - et al.
Reliability and validity testing of the Michigan Hand Outcomes Questionnaire
J Hand Surg Am
(1998) - et al.
Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment
J Hand Surg Am
(2007) - et al.
Comparative responsiveness of the Michigan Hand Outcomes Questionnaire and the Carpal Tunnel Questionnaire after carpal tunnel release
J Hand Surg Am
(2009) - et al.
Cross-cultural adaptation and validation of the Korean version of the Michigan hand questionnaire
J Hand Surg Am
(2011) - et al.
Predicting pain and disability in patients with hand fractures: comparing pain anxiety, anxiety sensitivity and pain catastrophizing
Eur J Pain
(2010) - et al.
Determinants of grip strength in healthy subjects compared to that in patients recovering from a distal radius fracture
J Hand Surg Am
(2012) - et al.
What are the radiological predictors of functional outcome following fractures of the distal radius?
J Bone Joint Surg Br
(2011) - et al.
Trends in the United States in the treatment of distal radial fractures in the elderly
J Bone Joint Surg Am
(2009)
Treatment of osteoporotic distal radius fractures
Osteoporos Int
Significant change in the surgical treatment of distal radius fractures: a nationwide study between 1998 and 2008 in Finland
J Trauma
Rate of improvement following volar plate open reduction and internal fixation of distal radius fractures
Adv Orthop
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2022, Musculoskeletal Science and PracticeCitation Excerpt :However, administering them along with traditional physical impairments measures for assessing wrist/hand pain and disability in patients with DRF can significantly increase the administrative burden of assessment. Considering the association between the presence of psychological factors with worse pain and disability after DRF (Hiraga et al., 2019; Jayakumar et al., 2020; Lövgren and Hellström 2012; Roh et al., 2014; Steven et al., 2010; Yeoh et al., 2016), it is logical to consider worse scores on the measures of pain and disability as yellow flags indicative of the possible presence of psychological factors after DRF. The aim of this study was to explore the psychological factors associated with pain intensity and disability six months after DRF.
The Association Between Psychological Factors and Outcomes After Distal Radius Fracture
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The relationship between depression, anxiety, and pain interference with therapy referral and utilization among patients with hand conditions
2022, Journal of Hand TherapyCitation Excerpt :Depression is associated with greater pain at discharge after orthopedic procedures3 and greater perceived impairment in hand function among clinical populations.1,4 Comorbid anxiety in patients treated for hand conditions results in poorer clinical outcomes including delayed recovery in the wrist range of motion, decreases in grip strength, increased perceived disability,5,6 and increased postoperative pain.7,8 Depression and anxiety have been linked to decreased functional ability due to pain intensity and perceived disability.8-12
This work was supported by a grant from Gachon University, Gil Medical Center, Incheon, South Korea (to Y.H.R.).
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.