Effect of anxiety and catastrophic pain ideation on early recovery after surgery for distal radius fractures

Young Hak Roh, Beom Koo Lee, Jung Ho Noh, Joo Han Oh, Hyun Sik Gong, Goo Hyun Baek

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Purpose To evaluate the effects of preoperative anxiety and catastrophic pain ideation on perceived disability and objective measures after distal radius fracture surgery.

Methods A total of 121 patients with distal radius fractures treated with volar plate fixation were enrolled. The wrist range of motion (ROM), grip strength, and perceived disability as measured by the Michigan Hand Questionnaire (MHQ) score were assessed 4, 12, and 24 weeks after surgery. To evaluate psychological factors related to pain, catastrophic pain ideation was measured using the Pain Catastrophizing Scale (PCS) and pain anxiety was measured using the Pain Anxiety Symptom Scale (PASS). Then relative contributions of pain anxiety and catastrophic pain ideation and other clinical parameters to functional recovery in terms of grip strength, ROM, and MHQ score were assessed.

Results An increase in the PCS score was associated with the wrist ROM and grip strength only at week 4, whereas an increase in the PASS score was associated with the wrist ROM at week 4 and grip strength at weeks 4 and 12. According to a multivariate regression analysis, an increase in the PCS score was associated with a decrease in grip strength, ROM, and MHQ score at week 4; and an increase in the PASS score was associated with a decrease in grip strength, ROM, and MHQ score at week 4 and grip strength and MHQ score at week 12. At week 24, only age and fracture severity were associated with the MHQ score. In addition, age was associated with grip strength and fracture type was associated with ROM.

Conclusions Preoperative PCS and PASS were significantly associated with delayed recovery as evidenced by scores on both objective and subjective measures of function. Given these relationships, it becomes important to assess preoperative PCS and PASS and address issues for patients at risk with brief psychosocial intervention early in the recovery process. Type of study/level of evidence Prognostic II.

Original languageEnglish
Pages (from-to)2258-2264.e2
JournalJournal of Hand Surgery
Volume39
Issue number11
DOIs
StatePublished - 1 Nov 2014

Keywords

  • Distal radius fractures
  • catastrophic pain ideation
  • functional recovery
  • pain anxiety
  • surgical treatment

Fingerprint

Dive into the research topics of 'Effect of anxiety and catastrophic pain ideation on early recovery after surgery for distal radius fractures'. Together they form a unique fingerprint.

Cite this