Format

Send to

Choose Destination
J Orthop Trauma. 2015 Oct;29(10):e414-20. doi: 10.1097/BOT.0000000000000342.

Catastrophic Thinking Is Associated With Finger Stiffness After Distal Radius Fracture Surgery.

Author information

1
*Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA; and †Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Abstract

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.

PMID:
25866942
DOI:
10.1097/BOT.0000000000000342
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center