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Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults.

Publication ,  Journal Article
Chung, KC; Kim, HM; Malay, S; Shauver, MJ; WRIST Group,
Published in: J Hand Surg Am
September 2019

PURPOSE: Current evidence on predictors of outcomes after distal radius fracture is often based on retrospective analyses or may be confounded by fracture type. Using data from the Wrist and Radius Injury Surgical Trial (WRIST), a 24-site randomized study of distal radius fracture treatment, in which all fractures are severe enough to warrant surgery, we set out to perform a secondary data analysis to explore predictors of better or worse hand outcomes. METHODS: The primary outcome measure was the Michigan Hand Outcomes Questionnaire (MHQ) summary score 12 months after treatment. We used a regression tree analysis with recursive partitioning to identify subgroups of participants who experienced similar outcomes (ie, MHQ score) and to determine which baseline or treatment factors they had in common. RESULTS: Factors most predictive of 12-month MHQ score were pain at enrollment, education, age, and number of comorbidities. Specifically, participants who had a high school education or less and also reported severe pain had the lowest MHQ scores. Conversely, participants with less pain and more education and who were age 87 years or younger with one or no comorbid condition had the highest MHQ scores. Treatment type or radiographic measurements assessed on post-reduction films did not affect 12-month outcomes. CONCLUSIONS: These results identified patient characteristics that can be used by surgeons to identify subgroups of patients who may experience similar hand outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.

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Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

September 2019

Volume

44

Issue

9

Start / End Page

762 / 771

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Radius Fractures
  • Prognosis
  • Pain Measurement
  • Outcome Assessment, Health Care
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Fracture Fixation, Internal
 

Citation

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Chung, K. C., Kim, H. M., Malay, S., Shauver, M. J., & WRIST Group, . (2019). Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults. J Hand Surg Am, 44(9), 762–771. https://doi.org/10.1016/j.jhsa.2019.05.016
Chung, Kevin C., H Myra Kim, Sunitha Malay, Melissa J. Shauver, and Melissa J. WRIST Group. “Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults.J Hand Surg Am 44, no. 9 (September 2019): 762–71. https://doi.org/10.1016/j.jhsa.2019.05.016.
Chung KC, Kim HM, Malay S, Shauver MJ, WRIST Group. Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults. J Hand Surg Am. 2019 Sep;44(9):762–71.
Chung, Kevin C., et al. “Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults.J Hand Surg Am, vol. 44, no. 9, Sept. 2019, pp. 762–71. Pubmed, doi:10.1016/j.jhsa.2019.05.016.
Chung KC, Kim HM, Malay S, Shauver MJ, WRIST Group. Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults. J Hand Surg Am. 2019 Sep;44(9):762–771.
Journal cover image

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

September 2019

Volume

44

Issue

9

Start / End Page

762 / 771

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Radius Fractures
  • Prognosis
  • Pain Measurement
  • Outcome Assessment, Health Care
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Fracture Fixation, Internal