Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands.
J Hand Ther. 2023 Oct-Dec;36(4):903-912. doi: 10.1016/j.jht.2022.11.002. Epub 2023 Mar 11.
PROMs are increasingly used by clinicians to evaluate recovery after distal radius fractures, but can also be used as benchmark data to help patients managing their expectations about recovery after DRF.
The study aimed to determine the general course of patient-reported functional recovery and complaints during 1 year after a DRF, depending on fracture type and age. The study aimed to determine the general course of patient-reported functional recovery and complaints during one year after a DRF, depending on fracture type and age.
Retrospectively analyzed PROMs of 326 patients with DRF from a prospective cohort at baseline and at 6, 12, 26 and 52 weeks included PRWHE questionnaire for measuring functional outcome, VAS for pain during movement, and items of the DASH for measuring complaints (tingling, weakness, stiffness) and limitations in work and daily activities. The effect of age and fracture type on outcomes were assessed using repeated measures analysis.
PRWHE scores after one year were on average 5.4 points higher compared to the patients' pre-fracture scores. Patients with type B DRF had significantly better function and less pain than those with types A or C at every time point. After six months, more than 80% of the patients reported mild or no pain. Tingling, weakness or stiffness were reported by 55-60% of the overall cohort after six weeks, while 10-15% had persisting complaints at one year. Older patients reported worse function and more pain, complaints and limitations.
Functional recovery after a DRF is predictable in time with functional outcome scores after one-year follow-up that are similar to pre-fracture values. Some outcomes after DRF differ between age and fracture type groups.
患者报告的结局(PROMs)越来越多地被临床医生用于评估桡骨远端骨折(DRF)后的恢复情况,但也可作为基准数据,帮助患者管理对 DRF 后恢复的预期。
本研究旨在根据骨折类型和年龄,确定 DRF 后 1 年内患者报告的功能恢复和抱怨的一般过程。
回顾性分析了来自前瞻性队列的 326 例 DRF 患者的 PROMs,基线时和 6、12、26 和 52 周时分别使用 PRWHE 问卷测量功能结局、VAS 测量运动时疼痛以及 DASH 的项目测量抱怨(刺痛、无力、僵硬)和工作及日常活动受限。使用重复测量分析评估年龄和骨折类型对结局的影响。
与患者骨折前的评分相比,一年后 PRWHE 评分平均高出 5.4 分。B 型 DRF 患者在每个时间点的功能和疼痛均明显优于 A 型或 C 型患者。6 个月后,超过 80%的患者报告轻度或无疼痛。6 周后,整体队列中有 55-60%的患者报告有刺痛、无力或僵硬,而 10-15%的患者在 1 年后仍有持续的抱怨。年龄较大的患者报告功能更差、疼痛更严重、抱怨和受限更多。
DRF 后功能恢复具有时间预测性,一年后功能结局评分与骨折前相似。DRF 后某些结局在年龄和骨折类型组之间存在差异。