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

J Hand Ther. 2023 Oct-Dec;36(4):903-912. doi: 10.1016/j.jht.2022.11.002. Epub 2023 Mar 11.

Abstract

Introduction: 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.

Purpose of the study: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Distal radius fracture; Expectation management; Functional outcome; Patient reported outcome measures.

MeSH terms

  • Humans
  • Motivation
  • Pain
  • Patient Reported Outcome Measures
  • Prospective Studies
  • Radius Fractures*
  • Retrospective Studies
  • Wrist Fractures*