Recovery patterns over 4 years after distal radius fracture: Descriptive changes in fracture-specific pain/disability, fall risk factors, bone mineral density, and general health status

Dewan, Neha; MacDermid, Joy C.; Grewal, Ruby; Beattie, Karen A.

doi:10.1016/j.jht.2017.06.009

Cited by 16 publications

(7 citation statements)

References 92 publications

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“…In a definitive trial with two intervention groups and with the PRWE as primary outcome, a sample size of 486 participants would be needed, based on a standardised effect size of 0.33, power of 90%, an alpha error of 0.05 (2-sided) and inflating for 20% loss to follow-up. The effect size equates to a clinically meaningful difference of 6 points in the PRWE, and a standard deviation of 18 which is consistent with evidence from other cohorts [ 20 – 22 ]. Currently, we do not know whether it is feasible to conduct a definitive trial.…”

Section: Methodssupporting

confidence: 83%

Flexibility and resistance exercises versus usual care for improving pain and function after distal radius fracture in adults aged 50 years or over: protocol for the WISE randomised multicentre feasibility trial

Keene

Srikesavan

Achten

et al. 2022

Pilot Feasibility Stud

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Background Distal radius fractures represent about 1 in 5 of all fractures treated in UK hospitals. Most distal radius fractures occur in women aged 50 years or over after a fall. Distal radius fractures are managed using splints or casting, some are also treated with surgical fixation. Patients often experience long-term muscle weakness of the hand and arm that may impact their ability to do daily activities such as personal hygiene, routine household chores and food preparation. We propose a structured and tailored flexibility and resistance exercise programme for the hand and arm supplemented with behaviour change strategies to help perform daily exercise. The main aim of our study is to assess the feasibility of conducting a definitive randomised controlled trial. Methods This study is a multicentre, parallel-group individually randomised feasibility trial. We will recruit a minimum of 72 adults aged 50 years or over with distal radius fracture treated surgically or non-surgically from at least three UK National Health Service (NHS) hospitals. They will be randomised 1:1:1 to receive usual care, usual care and independent exercise with a single therapy session or usual care and supervised exercise with three therapy sessions over 12 weeks. Our primary feasibility objectives are (1) patient engagement assessed by recruitment, (2) acceptability of the interventions assessed by adherence and patient and clinician experience and (3) retention of participants in the trial. Outcome measures will be assessed at baseline, 3 months and at 6 months after randomisation. A qualitative sub-study will explore the experiences of the trial participants and therapists delivering the exercises. Discussion A definitive trial will be considered feasible without major modifications if our progression criteria are met. If successful, the findings will inform the design of a future definitive RCT to evaluate the clinical and cost-effectiveness of the WISE exercise programme. Trial registration ISRCTN12290145.

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Section: Methodssupporting

confidence: 83%

Flexibility and resistance exercises versus usual care for improving pain and function after distal radius fracture in adults aged 50 years or over: protocol for the WISE randomised multicentre feasibility trial

Keene

Srikesavan

Achten

et al. 2022

Pilot Feasibility Stud

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“…A recent study found that the majority of the improvement in fracture-specific pain/ disability was completed at 6 months. 33 The patients were not screened for depression; this is a limitation. Depression is associated with a low SE and is known to be associated with an inferior outcome after surgery.…”

Section: Discussionmentioning

confidence: 99%

Self-efficacy corresponds to wrist function after combined plating of distal radius fractures

Björk

Niklasson

Westerdahl

et al. 2020

Journal of Hand Therapy

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a b s t r a c tStudy Design: A prospective cohort single-center study. Introduction: Self-efficacy (SE) refers to beliefs in ones capabilities to organize and execute the courses of action required to produce given goals. High SE is an important factor for recovery from injury/illness; people who believe in their capability will more likely reach a good outcome.Purpose of the Study: The aim of this study was to examine if SE has an effect to physical functioning, pain and patient-rated wrist function three months postoperatively in patients undergoing plating due to a distal radius fracture. Methods: Sixty-seven patients undergoing plating for a distal radius fracture rated SE at the first appointment with the physiotherapist. At the three-month follow-up, the following assessments were administered: Patient-Rated Wrist Evaluation (PRWE), pain-scores, hand grip strength, and range of motion. Results: The group with a high SE showed significantly better range of motion for flexion (P ¼ .046) and supination (P ¼ .045), hand grip strength (P ¼ .001) and PRWE scores (P ¼ .04). The NRS pain during activity was lower, although not significantly lower (P ¼ .09). Using Spearman's rank correlation coefficient, there was a moderate correlation between SE and pain during activity, wrist flexion, and PRWE score. Discussion: SE corresponds to wrist function after combined plating of distal radius fractures. Conclusion: Measurement of SE could possibly be useful to identify patients in special need of support during the postoperative rehabilitation.

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“…Contrary to our results, Aparicio et al [ 22 ] found a significant increase in upper limb disability one year after the acquisition of conservatively treated DRF measured using the qDASH score. Dewan et al [ 23 ] report that improvement in fracture-specific disability was completed after six months. This is in line with our results.…”

Section: Discussionmentioning

confidence: 99%

Objective Outcome Measures Continue to Improve from 6 to 12 Months after Conservatively Treated Distal Radius Fractures in the Elderly—A Prospective Evaluation of 50 Patients

Thorninger

Wæver

Maibom

et al. 2021

JCM

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Distal radius fractures (DRF) in the elderly population above 65 years represent 18% of all fractures and are thereby the second most frequent fracture in the elderly. Fracture dislocation and comminution are often used to determine whether non-operative or operative treatment is indicated. The purpose of this prospective case series of minimally displaced DRF treated with a dorsal cast was to assess the complication rate and patient-reported outcome measures. This single-centre, single-blinded, prospective case series followed 50 conservatively treated DRF patients for one year. Primary outcomes were complications and Quick Disability of Arm Shoulder and Hand (qDASH) score. Secondary outcomes were range of motion (ROM), grip strength and pain, and Patient-Rated Wrist/Hand Evaluation (PRWHE). Results showed only minor complications with a return to prior ROM, qDASH, and pain after 12 months and improvement in outcomes after 6–12 months. In conclusion, the majority of DRF patients who were treated non-operatively with five-week dorsal casting recover fully after minimally displaced DRF. This standard approach is thus considered safe, and the present results provide a reference for other studies.

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Recovery patterns over 4 years after distal radius fracture: Descriptive changes in fracture-specific pain/disability, fall risk factors, bone mineral density, and general health status

Cited by 16 publications

References 92 publications

Flexibility and resistance exercises versus usual care for improving pain and function after distal radius fracture in adults aged 50 years or over: protocol for the WISE randomised multicentre feasibility trial

Flexibility and resistance exercises versus usual care for improving pain and function after distal radius fracture in adults aged 50 years or over: protocol for the WISE randomised multicentre feasibility trial

Self-efficacy corresponds to wrist function after combined plating of distal radius fractures

Objective Outcome Measures Continue to Improve from 6 to 12 Months after Conservatively Treated Distal Radius Fractures in the Elderly—A Prospective Evaluation of 50 Patients

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