整形外科外傷後の定量的感覚検査：多施設共同縦断的実現可能性調査

Orthopedic trauma is a major cause of disability worldwide; around half of people who sustain orthopedic trauma develop chronic pain. Quantitative sensory testing (QST) is a standardized method of assessing pain sensitivity, which may be useful in characterizing pain after injury and predicting chronic pain. This primary aim of this project was to test the feasibility of a portable QST battery, administered to adults 6-weeks post major orthopedic trauma and surgery.

29 participants (62% male; 52% black) who sustained major orthopedic trauma and surgery completed QST testing (including static measures, conditioned pain modulation, mechanical temporal summation) at their 6-week post-operative visit and were invited to complete a 6-month follow-up survey. We examined feasibility and acceptability indices and explored associations between QST and clinical pain ratings.

Of all eligible patients, 77% were recruited. QST procedures were feasible and tolerable. No participant declined participation, withdrew for reasons related to study procedures, or discontinued QST due to discomfort. No patient experienced increased clinical pain after QST. Exploratory analyses identified a positive association between static QST and pain interference at T1. Feasibility challenges included poor 6-month retention (57%), and difficulty administering QST to patients with upper extremity injuries. High rates of analgesic use prior to testing (38%) poses an additional barrier for future QST studies in this population.

QST was acceptable and partially feasible; challenges included poor retention, high rates of analgesic use, and logistical barriers to accessing injury sites for testing. We pose several potential solutions for future research.