![]() 5 As many as 63% of patients with DRF who receive appropriate treatment report some degree of persistent wrist pain 1 year after injury. Trial Registration Identifier: NCT01589692ĭistal radius fracture (DRF) is a common injury, accounting for one-sixth of all fractures managed in the emergency department, 1 - 4 with a lifetime risk of 33% in elderly women. Internal fixation may decrease the risk of chronic pain after DRF surgery, compared with percutaneous pinning or external fixation. ![]() Adequate pain control in patients with acute DRFs even before definitive surgical management and earlier fixation for patients requiring surgery may decrease the risk of developing chronic pain. Internal fixation was associated with decreased odds of developing chronic pain compared with the other 2 procedures (OR, 0.29 95% CI, 0.10-0.90).Ĭonclusions and Relevance In this study, preoperative pain, time to surgery, and procedure type were modifiable factors associated with chronic pain 1 year after DRF treated with surgery. A 1-week delay in surgery was associated with more than triple the odds of developing chronic pain (odds ratio, 3.65 95% CI, 1.48-9.00), and each 10-point increase in preoperative pain was associated with a 17% increase in the odds of experiencing chronic pain (OR, 1.17 95% CI, 1.02-1.34). Chronic pain was present in 87 patients (59.6%) and absent in 59 patients (40.4%) at 1-year follow-up. Results A total of 146 patients with DRF who were treated operatively and had 12-month MHQ scores met inclusion criteria. Inverse probability weighted logistic regression was used to identify factors associated with of chronic pain. Main Outcomes and Measures 12-month MHQ pain domain score. Interventions Volar locking plate internal fixation, external fixation, or percutaneous pinning. Analysis was conducted from September to December 2019. Adults older than 60 years who sustained closed extra-articular DRFs, were treated operatively, and completed 12-month Michigan Hand Outcomes Questionnaires (MHQs) were included in this study. Objective To identify modifiable preoperative factors that are significantly associated with developing chronic pain.ĭesign, Setting, and Participants This is a secondary analysis of the Wrist and Radius Injury Surgical Trial (WRIST), a randomized multicenter clinical trial of 24 study sites in the United States, Canada, and Singapore that enrolled patients from April 10, 2012, to December 31, 2016. Chronic musculoskeletal pain is among the leading health problems in the elderly population associated with significant personal and societal burden. Importance Despite appropriate treatment, many patients who sustain distal radius fractures (DRFs) report persistent wrist pain. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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