Background

The evidence indicating presence of psychological factors concerns in individuals who report persistent residual pain and disability over a longer term after distal radius fractures (DRF) is emerging but requires further inquiry.

Objectives

To examine the associations of persistent wrist pain and disability at 6-months after DRF with the presence of psychological factors.

Methods

Eighty-five patients with DRF were evaluated for wrist pain and disability with subscales of Patient-rated wrist evaluation (PRWE), 6-months after the fracture. The associations of wrist pain and disability with these psychological factors at 6-months after DRF were examined using multivariable logistic regression models. The ability of PRWE scores at 6-months after DRF to accurately classify individuals with and without these psychological factors was examined using the area under the receiver operating characteristic curve (AUC).

Results

Higher PRWE-P scores were significantly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. In addition, higher PRWE-F scores were also highly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. The PRWE-P or PRWE-F Scores of ≥18/50 showed the best combination of sensitivity and specificity in identifying individuals with pain catastrophizing, emotional distress, and fear of performing wrist movements at 6-months after DRF (AUC values of ≥0.88).

Conclusion

The novel finding of this study is that scores of ≥18/50 PRWE-P or PRWEF can be used to screen for the presence of these psychological factors.

中文翻译：

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持续性疼痛和残疾的严重程度可以准确筛查桡骨远端骨折患者是否存在灾难性疼痛和害怕进行手腕运动

背景

越来越多的证据表明，在桡骨远端骨折 (DRF) 后报告长期持续残留疼痛和残疾的个体存在心理因素问题，但需要进一步调查。

目标

研究 DRF 后 6 个月持续腕部疼痛和残疾与心理因素的关系。

方法

骨折后 6 个月，85 名 DRF 患者通过患者评定的腕部评估 (PRWE) 子量表评估了腕部疼痛和残疾。使用多变量逻辑回归模型检查 DRF 后 6 个月时手腕疼痛和残疾与这些心理因素的关联。使用受试者工作特征曲线下面积 (AUC) 检查 DRF 后 6 个月 PRWE 评分对有和没有这些心理因素的个体进行准确分类的能力。

结果

较高的 PRWE-P 评分与更严重的灾难性疼痛、情绪困扰和害怕进行手腕运动显着相关。此外，较高的 PRWE-F 分数也与更严重的灾难性疼痛、情绪困扰和害怕进行手腕运动密切相关。PRWE-P 或 PRWE-F 评分≥18/50 显示出在识别 DRF 后 6 个月时出现灾难性疼痛、情绪困扰和害怕手腕运动的个体方面的敏感性和特异性的最佳组合（AUC 值≥0.88 ）。

结论

本研究的新发现是，≥18/50 PRWE-P 或 PRWEF 的分数可用于筛​​查这些心理因素的存在。