Schmidt Viktor, Tervaniemi Cecilia, Wadsten Mats
Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden.
J Hand Surg Glob Online. 2024 Jul 2;6(5):650-653. doi: 10.1016/j.jhsg.2024.06.004. eCollection 2024 Sep.
The outcome after a distal radius fracture (DRF) is often evaluated with radiography, clinical examination, and patient-reported outcome measures. However, research has identified associations between psychological factors and outcomes after a DRF. A knowledge gap exists about psychological factors and their potential implications for long-term outcomes after a DRF. The aim of this study was to examine the long-term association between psychological factors and patient-reported outcomes.
This multicenter investigation included patients aged 15-75 years with closed physes presenting with an acute DRF. Patients who completed a long-term follow-up (after 11-13 years) with patient-reported outcome measures were invited to participate in the study, and surveys measuring psychological factors were sent to the patients.
Two hundred and four patients (70%) completed the follow-up (mean [range] age at injury, 56 [18-75] years; 154 were females [75%]). Multivariable analysis showed that higher age, injury to the dominant hand, and greater pain catastrophizing were associated with an increase in scores on the Disabilities of the Arm, Shoulder, and Hand questionnaire.
A decade after sustaining a DRF, patients with higher scores on the Pain Catastrophizing Scale reported inferior outcomes as measured by the Disabilities of the Arm, Shoulder, and Hand. The Pain Catastrophizing Scale accounts for 13% of the observed variance in Disabilities of the Arm, Shoulder, and Hand.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic level IIb.
桡骨远端骨折(DRF)后的结局通常通过放射学检查、临床检查以及患者报告的结局指标来评估。然而,研究已发现心理因素与DRF后的结局之间存在关联。关于心理因素及其对DRF后长期结局的潜在影响,目前存在知识空白。本研究的目的是探讨心理因素与患者报告的结局之间的长期关联。
这项多中心调查纳入了年龄在15 - 75岁、闭合骨骺且患有急性DRF的患者。邀请完成长期随访(11 - 13年后)且有患者报告结局指标的患者参与研究,并向患者发送测量心理因素的调查问卷。
204名患者(70%)完成了随访(受伤时的平均[范围]年龄为56[18 - 75]岁;154名女性[75%])。多变量分析显示,年龄较大、优势手受伤以及疼痛灾难化程度较高与上肢、肩部和手部功能障碍问卷得分增加相关。
在发生DRF十年后,疼痛灾难化量表得分较高的患者,以上肢、肩部和手部功能障碍衡量的结局较差。疼痛灾难化量表解释了上肢、肩部和手部功能障碍观察到的变异的13%。
研究类型/证据水平:治疗性IIb级。