Early Psychological and Social Factors Explain the Recovery Trajectory After Distal Radial Fracture

Area of Science:

• Orthopedics
• Psychology
• Rehabilitation Medicine

Background:

• Distal radial fractures are common injuries impacting upper-extremity function.
• Early recovery factors influencing long-term outcomes require identification.
• Patient-reported outcomes are crucial for assessing functional limitations.

Purpose of the Study:

• To identify demographic, injury, psychological, and social variables associated with functional limitations 6-9 months post-distal radial fracture.
• To assess predictors of Patient-Reported Outcomes Measurement Information System Upper Extremity Physical Function Computer Adaptive Test (PROMIS UE) scores over time.
• To evaluate variables influencing QuickDASH, PRWE, and EQ-5D-3L scores longitudinally.

Main Methods:

• Prospective study of 364 adult patients with distal radial fractures.
• Data collected within 1 week, 2-4 weeks, and 6-9 months post-injury.
• Multivariable regression and generalized least squares random effects models used for analysis.

Main Results:

• Early predictors of 6-9 month PROMIS UE limitations included being retired, opioid/antidepressant use, pain interference, and pain catastrophization.
• Longitudinal analysis revealed pain interference, fear of movement, low self-efficacy, older age, and female sex as significant predictors.
• These factors explained significant unique variance in upper-extremity function.

Conclusions:

• Distal radial fracture recovery is influenced by demographic, psychological, and social factors.
• Early identification of predictors like retirement status, medication use, and psychological distress is key.
• Interventions targeting pain, fear of movement, and self-efficacy can optimize functional recovery.