October 23, 2015
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Catastrophic thinking indicative of finger stiffness after distal radius fracture surgery

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Recently published data demonstrated that 6 weeks after distal radius fracture surgery and at suture removal, catastrophic thinking was the most consistent indicator of finger stiffness.

Researchers identified 116 patients (mean age 55 years) who underwent open reduction and internal fixation of their distal radius fractures between December 2009 and April 2014. Data collected included demographics, BMI, smoking, pain conditions, marital status, employment, education years, AO fracture type, release of carpal tunnel at time of procedure and whether the dominant hand was the one injured.

The pain catastrophizing scale was used to measure catastrophic thinking and researchers also assessed heightened illness using the Whiteley Index. The Patient Health Questionnaire-9 was used to measure depression symptoms. Patients reported their pain intensity on an 11-point ordinal scale and DASH scores were recorded at 6 weeks.

Results showed that after 6 weeks, the only indicator independently correlated with a greater distance to palmar crease was greater catastrophic thinking. Less finger range of motion at suture removal was also associated with greater catastrophic thinking, with each one-point increase in such thinking leading to an average of 4.7° less finger motion. At 6 weeks postoperatively, less thumb range of motion correlated with older age, less education, unreduced fractures and greater catastrophic thinking.

During suture removal, less thumb motion correlated with female sex, pain condition, treatment by a surgeon, AO type C fracture and greater catastrophic thinking. Older age, being married and no treatment by a surgeon were all indicative of less thumb motion 6 weeks after surgery, according to researchers. by Monica Jaramillo

Disclosures: Teunis reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.