期刊
JOURNAL OF ORTHOPAEDIC TRAUMA
卷 29, 期 10, 页码 e414-e420出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOT.0000000000000342
关键词
catastrophic thinking; distal radius; finger stiffness; fracture; predictors; trauma
资金
- Wright Medical (US) (Memphis, TN)
- Skeletal Dynamics (US) (Miami, FL)
- Biomet (US) (Warsaw, IN)
- AO North America (US) (Paoli, PA)
- AO International (US) (Dubendorf, Switzerland)
Objectives:To identify demographic, injury-related, or psychologic factors associated with finger stiffness at suture removal and 6 weeks after distal radius fracture surgery. We hypothesize that there are no factors associated with distance to palmar crease at suture removal.Design:Prospective cohort study.Setting:Level I Academic Urban Trauma Center.Patients:One hundred sixteen adult patients underwent open reduction and internal fixation of their distal radius fractures; 96 of whom were also available 6 weeks after surgery.Intervention:None.Main Outcome Measurements:At suture removal, we recorded patients' demographics, AO fracture type, carpal tunnel release at the time of surgery, pain catastrophizing scale, Whiteley Index, Patient Health Questionnaire-9, and disabilities of the arm, shoulder, and hand questionnaire, 11-point ordinal measure of pain intensity, distance to palmar crease, and active flexion of the thumb through the small finger. At 6 weeks after surgery, we measured motion, disabilities of the arm, shoulder, and hand, and pain intensity. Prereduction and postsurgery radiographic fracture characteristics were assessed.Results:Female sex, being married, specific surgeons, carpal tunnel release, AO type C fractures, and greater catastrophic thinking were associated with increased distance to palmar crease at suture removal. At 6 weeks, greater catastrophic thinking was the only factor associated with increased distance to palmar crease.Conclusions:Catastrophic thinking was a consistent and major determinant of finger stiffness at suture removal and 6 weeks after injury. Future research should assess if treatments that ameliorate catastrophic thinking can facilitate recovery of finger motion after operative treatment of a distal radius fracture.Level of Evidence:Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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