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Cited by 22Orthopedic Surgery and RehabilitationBone fractures and treatmentsMusculoskeletal pain and rehabilitation

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

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Roh, Young Hak, Noh, Jung Ho, Oh, Joo Han, Gong, Hyun Sik, Baek, Goo Hyun·2015·Clinical Orthopaedics & Related Research
DOI 10.1007/s11999-015-4269-yPMC PMC4586215
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Abstract

BACKGROUND: Patients with hand fractures often have pain, swelling, and stiffness in the joints of the hand, which may lead them to protect their hands, resulting in more stiffness and in delayed recovery. However, the effects of pain-coping strategies and catastrophization (the tendency to expect the worst to occur when pain is present, an approach that can be thought of as the opposite of "coping") on functional recovery after hand fractures have not been investigated in depth. QUESTIONS/PURPOSES: Are preoperative catastrophization and anxiety in patients with hand fractures associated with (1) decreased grip strength; (2) decreased range of motion; and (3) increased disability at 3 and 6 months after surgical treatment for a hand fracture? Secondarily, we asked if there are other patient and injury factors that are associated with these outcomes at 3 and 6 months. METHODS: A total of 93 patients with surgically treated hand fractures were enrolled in this prospective study. Preoperative assessments measured coping strategies evaluated by measuring catastrophic thinking with the Pain Catastrophizing Scale and pain anxiety with the Pain Anxiety Symptom Scale. At 3 and 6 months postoperatively, grip strength, total active range of motion, and disability (Quick Disabilities of the Arm, Shoulder, and Hand score) were assessed. Bivariate and multivariate analyses were performed to identify patient demographic, injury, and coping skills factors that accounted for outcomes of strength, motion, and disability. RESULTS: Decreased grip strength was associated with catastrophic thinking (beta = -1.29 [95% confidence interval, -1.67 to -0.89], partial R(2) = 11%, p < 0.001) and anxiety (beta = -0.83 [-1.16 to -0.50], partial R(2) = 7%, p = 0.007) at 3 months, but by 6 months, only anxiety (beta = -0.74 [-1.04 to -0.44], partial R(2) = 7%, p = 0.010) remained an important factor. Decreased total active range of motion was associated with pain catastrophizing (beta = -0.63 [-0.90 to -0.36], partial R(2) = 6 %, p = 0.024) and anxiety (beta = -0.28 [-0.42 to -0.14], partial R(2) = 3%, p = 0.035) at 3 months but not at 6 months. Similarly, increased disability was associated with pain catastrophizing (beta = 1.09 [1.39-0.79], partial R(2) = 12%, p < 0.001) and anxiety (beta = 0.93 [1.21-0.65], partial R(2) = 11%, p = 0.001) at 3 months; these factors failed to be associated for 6-month outcomes. CONCLUSIONS: Preoperative poor coping skills as measured by high catastrophization and anxiety were associated with a weaker grip strength, decreased range of motion, and increased disability after surgical treatment for a hand fracture at 3 months. However, poor coping skills did not show persistent effects beyond 6 months. More research may be needed to show interventions to improve coping skills will enhance treatment outcome in patients after acute hand fractures. LEVEL OF EVIDENCE: Level III, prognostic study.

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  • Several studies have established the mediating effect of psychological distress on hand and upper limb pain and disability.

    “Several studies have established the mediating effect of psychological distress on hand and upper limb pain and disability [21-24]”

    From Development and usability testing of a web-based and therapist-assisted coping skills program for managing psychosocial problems in individuals with hand and upper limb injuries: Mixed methods study (2020) · cites this paper as [24]

    The Results report that pain catastrophizing and anxiety were associated with disability three months after hand-fracture surgery, but not at six months. The paper supports a relationship between psychological factors and hand disability; it does not establish that psychological distress mediates the relationship between pain and disability across hand and upper-limb conditions. Page numbers are unavailable in our copy. (LLM, conf=0.87)

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Authors
Roh, Y. H., Noh, J. H., Oh, J. H., Gong, H. S., & Baek, G. H.
Affiliations
  • Gachon University (KR)
  • Kangwon National University Hospital (KR)
  • Seoul National University (KR)
ORCID
Venue
Clinical Orthopaedics & Related Research
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-11
Volume
473
Issue
11
Pages
3484-3490
ISSN
0009-921X (ISSN-L)
DOI
10.1007/s11999-015-4269-y
PMC
PMC4586215
OpenAlex
W2034288969
Cited by
22
References
28
Citations by year
2025: 1 · 2023: 1 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 2
FWCI
3.02
Type
journal article
Language
en
Status
Retracted
Update notices
retraction (2020-10-09)
Open access
Locations
  • Clinical Orthopaedics and Related Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
  • Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
hand fractures, pain coping, pain catastrophizing, pain-related anxiety, joint stiffness, grip strength, range of motion, functional recovery, disability, surgical outcomes, QuickDASH score, Pain Catastrophizing Scale, postoperative rehabilitation, patient education
MeSH terms
Adaptation, Psychological, Adult, Anxiety, Biomechanical Phenomena, Disability Evaluation, Female, Hand Injuries, Humans, Male, Middle Aged, Pain Measurement, Prospective Studies, Risk Factors, Time Factors, Multivariate Analysis, Linear Models, Range of Motion, Articular, Treatment Outcome, Hand Strength, Arthralgia, Recovery of Function, Fractures, Bone, Hand Joints, Catastrophization

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