Managing patient expectations about recovery after a distal radius fracture based on patient reported outcomes

• Published in: Journal of hand therapy Vol. 36; no. 4; pp. 903 - 912
• Main Authors: Quax, M L J, Krijnen, P, Schipper, I B, Termaat, M F
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01.10.2023
• Subjects: Activities of daily living; Age; Age factors; Fractures; Humans; Motivation; Pain; Patient Reported Outcome Measures; Patients; Prospective Studies; Questionnaires; Radius Fractures; Range of motion; Recovery of function; Retrospective Studies; Stiffness; Wrist Fractures; Patient reported outcome measures; Expectation management; Distal radius fracture; Functional outcome
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2022.11.002

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.