Baseline Predictors of Pain and Disability One Year Following Extra-Articular Distal Radius Fractures

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• 作者：Ruby Grewal (1)
  Joy C. MacDermid (1)
  Janet Pope (2)
  Bert M. Chesworth (3)
  
• 关键词：Wrist ; Fracture ; Outcome ; Pain ; Disability
• 刊名：HAND
• 出版年：2007
• 出版时间：September 2007
• 年：2007
• 卷：2
• 期：3
• 页码：104-111
• 全文大小：138KB
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• 作者单位：Ruby Grewal (1)
  Joy C. MacDermid (1)
  Janet Pope (2)
  Bert M. Chesworth (3)
  
  1. Division of Orthopedic Surgery, Hand and Upper Limb Center, St Joseph’s Health Care, University of Western Ontario, 268 Grosvenor St, London, Ontario, N6A 4L6, Canada
  2. Division of Rheumatology and Department of Epidemiology & Biostatistics, St Joseph’s Health Care, 268 Grosvenor St, London, Ontario, N6A 4L6, Canada
  3. Ontario Joint Replacement Registry, 100 Collip Circle, Suite 225, London, Ontario, N6C 2G5, Canada
  

文摘

Distal radius fractures are common injuries; however, identifying which factors are responsible for predicting outcomes remains an area of controversy. The purpose of this study was to define factors predictive of patient-reported pain and disability at 1?year in a prospective cohort of extra-articular distal radius fractures (n--22). Data were collected at the initial visit and after 3, 6, and 12?months. The primary outcome was the 1-year patient-rated wrist evaluation (PRWE) score. The effect of baseline patient and injury characteristics on the 1-year PRWE score was assessed. Univariate and forward stepwise regression analyses both agreed that the most influential predictor of pain and disability at 1?year was injury compensation. The 1-year PRWE score was significantly higher for subjects involved with third-party claims (35.48) compared to those that were not involved in any claims (14.97), p--.006. The regression model found that three baseline factors -injury compensation, education, and other medical comorbidities -explained 16.4% of the variance in PRWE scores at 1?year. No injury characteristic, including the degree of initial fracture displacement, was found to significantly influence the 1-year PRWE score. This study has shown that baseline patient and injury characteristics play a small role in predicting 1-year patient-reported pain and disability in extra-articular distal radius fractures. Conceptual factors outside of this biomedical model should be investigated.