George Washington University, Washington, DC, USA; Washington Orthopaedics and Sports Medicine, Washington, DC, USA.
Jacksonville University, Jacksonville, FL, USA.
J Hand Ther. 2023 Jan-Mar;36(1):33-44. doi: 10.1016/j.jht.2021.09.002. Epub 2021 Oct 28.
Shoulder pathology can occur concurrently with a distal radius fracture (DRF) but few studies have examined this population.
The purpose of this study was to expand the understanding of the impact of shoulder pathology on individuals with DRF.
Mixed Methods Design.
A total of 45 participants with a DRF were categorized into a DRF only (n = 29) and shoulder pathology concurrent with DRF (SPCDRF) (n = 16) groups. Quantitative data gathered included demographics, Quick Disabilities of the Arm, Shoulder, and Hand, Tampa Scale of Kinesiophobia-11, Visual Analog Scale, and Compensatory Mechanism Checklist. Qualitative interviews were performed with 7 participants in the SPCDRF group. Within group correlations were analyzed via the Spearman Rank. The Mann Whitney U test was used to compare the two groups. Qualitative analysis was performed to describe the experience of participants in the SPCDRF group. A mixed methods analysis compared quantitative and qualitative data.
Sixteen participants (35.6%) in the sample presented with shoulder pathology; 6 participants (37.5%) presented at initial evaluation due to the fall; 10 participants (62.5%) developed shoulder pathology due to compensation or disuse. Average number of days to develop shoulder pathology after the DRF was 43 days. SPCDRF participants had significantly greater pain levels (p = .02) and more activity avoidance (p = .03) than the DRF only group. Four qualitative themes emerged: It's difficult to perform occupations and changes had to be made; There is fear and uncertainty; The impact of pain; Tried to be normal but could not Mixed methods analysis found that qualitative data further illuminated quantitative findings.
Individuals with shoulder pathology concurrent with a DRF may present with higher pain levels and avoid activity more. In addition, they may describe fearfulness in using their injured upper extremity especially if they have high levels of pain.
Mixed Methods Design.
肩部病变可与桡骨远端骨折（DRF）同时发生，但很少有研究对此人群进行研究。
本研究的目的是扩大对患有 DRF 的个体肩部病变影响的认识。
混合方法设计。
共有 45 名桡骨远端骨折患者分为仅桡骨远端骨折（n=29）和桡骨远端骨折并发肩部病变（SPCDRF）（n=16）两组。收集的定量数据包括人口统计学、快速上肢、肩和手残疾问卷、坦帕运动恐惧量表-11、视觉模拟评分和代偿机制检查表。对 SPCDRF 组的 7 名参与者进行了定性访谈。通过 Spearman 秩进行组内相关性分析。 Mann Whitney U 检验用于比较两组。定性分析用于描述 SPCDRF 组参与者的体验。混合方法分析比较了定量和定性数据。
样本中 16 名参与者（35.6%）存在肩部病变；6 名参与者（37.5%）因跌倒而在初次评估时出现；10 名参与者（62.5%）因代偿或失用而出现肩部病变。DRF 后出现肩部病变的平均天数为 43 天。SPCDRF 参与者的疼痛水平显著更高（p=0.02），活动回避程度更高（p=0.03），与仅 DRF 组相比。出现了四个定性主题：执行职业困难，必须做出改变；存在恐惧和不确定性；疼痛的影响；试图正常但不能。混合方法分析发现，定性数据进一步阐明了定量发现。
同时患有桡骨远端骨折和肩部病变的个体可能表现出更高的疼痛水平和更多的活动回避。此外，他们可能会描述在使用受伤的上肢时的恐惧，特别是如果他们有较高的疼痛水平。
混合方法设计。
