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Erschienen in: HAND 1/2014

01.03.2014 | Original Paper

The association of education level on outcome after distal radius fracture

verfasst von: Nader Paksima, Brian Pahk, Santiago Romo, Kenneth A. Egol

Erschienen in: HAND | Ausgabe 1/2014

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Abstract

Background

Socioeconomic factors have been found to be predictors of outcome for other ailments. The purpose of this study was to evaluate the association of patient education level on pain and disability after distal radius fracture.

Methods

A series of patients with distal radius fractures (n = 335) were enrolled into a prospective research registry. Standard demographic information was obtained from patients, including a five-value categorical education variable. After treatment with closed reduction, external fixation, or internal fixation patients were evaluated for pain, function (Disability of the Arm, Shoulder, and Hand score [DASH]), range of motion (ROM), and grip strength at standard intervals until 12 months post-injury. A series of linear mixed effects models were developed to evaluate the relationship between time from injury and education level with each of the outcomes measured.

Results

Complete demographic and 12-month follow-up data were available on 227 patients (75 %). There were neither group differences in mode of injury, severity, nor treatment modality after stratification by education level. Mixed effects model analyses revealed a significant linear association between level of education and measured outcomes at each follow-up point. Overall, each increase in education level demonstrated a doubling of improvement in pain, ROM, grip strength, and DASH score.

Conclusions

Outcome of distal radius fracture depends on acute care and follow-up rehabilitation; however, patient-related factors indicative of socioeconomic status are becoming increasingly relevant as predictors of outcome and should be considered by the orthopaedist.
Literatur
1.
Zurück zum Zitat Aaronson NK, Acquadro C, Alonso J, et al. International Quality of Life Assessment (IQOLA) Project. Qual Life Res. 1992;1(5):349–51.PubMedCrossRef Aaronson NK, Acquadro C, Alonso J, et al. International Quality of Life Assessment (IQOLA) Project. Qual Life Res. 1992;1(5):349–51.PubMedCrossRef
2.
Zurück zum Zitat Beaton DE, Katz JN, Fossel AH, et al. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001;14(2):128–46.PubMedCrossRef Beaton DE, Katz JN, Fossel AH, et al. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001;14(2):128–46.PubMedCrossRef
3.
Zurück zum Zitat Blumenthal SJ, Kagen JMSJAMA. The effects of socioeconomic status on health in rural and urban America. JAMA. 2002;287(1):109.PubMedCrossRef Blumenthal SJ, Kagen JMSJAMA. The effects of socioeconomic status on health in rural and urban America. JAMA. 2002;287(1):109.PubMedCrossRef
4.
Zurück zum Zitat Catalano 3rd LW, Cole RJ, Gelberman RH, et al. Displaced intra-articular fractures of the distal aspect of the radius. Long-term results in young adults after open reduction and internal fixation. J Bone Joint Surg Am. 1997;79(9):1290–302.PubMed Catalano 3rd LW, Cole RJ, Gelberman RH, et al. Displaced intra-articular fractures of the distal aspect of the radius. Long-term results in young adults after open reduction and internal fixation. J Bone Joint Surg Am. 1997;79(9):1290–302.PubMed
5.
Zurück zum Zitat Chen NC, Jupiter JB. Management of distal radial fractures. J Bone Joint Surg Am. 2007;89(9):2051–62.PubMedCrossRef Chen NC, Jupiter JB. Management of distal radial fractures. J Bone Joint Surg Am. 2007;89(9):2051–62.PubMedCrossRef
6.
Zurück zum Zitat Chung KC, Kotsis SV, Kim HM. Predictors of functional outcomes after surgical treatment of distal radius fractures. J Hand Surg Am. 2007;32(1):76–83.PubMedCrossRef Chung KC, Kotsis SV, Kim HM. Predictors of functional outcomes after surgical treatment of distal radius fractures. J Hand Surg Am. 2007;32(1):76–83.PubMedCrossRef
7.
Zurück zum Zitat Clarke SO, Schellenbaum GD, Rea TD. Socioeconomic status and survival from out-of-hospital cardiac arrest. Acad Emerg Med. 2005;12(10):941–7.PubMedCrossRef Clarke SO, Schellenbaum GD, Rea TD. Socioeconomic status and survival from out-of-hospital cardiac arrest. Acad Emerg Med. 2005;12(10):941–7.PubMedCrossRef
8.
Zurück zum Zitat Egol K, Walsh M, Tejwani N, et al. Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospectivetrial. J Bone Joint Surg Br. 2008;90(9):1214–21.PubMedCrossRef Egol K, Walsh M, Tejwani N, et al. Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospectivetrial. J Bone Joint Surg Br. 2008;90(9):1214–21.PubMedCrossRef
9.
Zurück zum Zitat Fanuele J, Koval KJ, Lurie J, et al. Distal radial fracture treatment: what you get may depend on your age and address. J Bone Joint Surg Am. 2009;91(6):1313–9.PubMedCrossRef Fanuele J, Koval KJ, Lurie J, et al. Distal radial fracture treatment: what you get may depend on your age and address. J Bone Joint Surg Am. 2009;91(6):1313–9.PubMedCrossRef
10.
Zurück zum Zitat Grewal R, MacDermid JC, Pope J, et al. Baseline predictors of pain and disability one year following extra-articular distal radius fractures. Hand (N Y). 2007;2(3):104–11.PubMedCentralCrossRef Grewal R, MacDermid JC, Pope J, et al. Baseline predictors of pain and disability one year following extra-articular distal radius fractures. Hand (N Y). 2007;2(3):104–11.PubMedCentralCrossRef
11.
Zurück zum Zitat Grewal R, Perey B, Wilmink M, et al. A randomized prospective study on the treatment of intra-articular distal radius fractures: open reduction and internal fixation with dorsal plating versus mini openreduction, percutaneous fixation, and external fixation. J Hand Surg Am. 2005;30(4):764–72.PubMedCrossRef Grewal R, Perey B, Wilmink M, et al. A randomized prospective study on the treatment of intra-articular distal radius fractures: open reduction and internal fixation with dorsal plating versus mini openreduction, percutaneous fixation, and external fixation. J Hand Surg Am. 2005;30(4):764–72.PubMedCrossRef
12.
Zurück zum Zitat Jupiter JB, Fernandez DL, Toh CL, et al. Operative treatment of volar intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am. 1996;78(12):1817–28.PubMed Jupiter JB, Fernandez DL, Toh CL, et al. Operative treatment of volar intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am. 1996;78(12):1817–28.PubMed
13.
Zurück zum Zitat Keegan TH, McClure LA, Foran JM, et al. Improvements in survival after follicular lymphoma by race/ethnicity and socioeconomic status: a population-based study. J Clin Oncol. 2009;27(18):3044–51.PubMedCrossRef Keegan TH, McClure LA, Foran JM, et al. Improvements in survival after follicular lymphoma by race/ethnicity and socioeconomic status: a population-based study. J Clin Oncol. 2009;27(18):3044–51.PubMedCrossRef
14.
Zurück zum Zitat Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68(5):647–59.PubMed Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68(5):647–59.PubMed
15.
Zurück zum Zitat Lozano Calderon SA, Paiva A, Ring D. Patient satisfaction after open carpal tunnel release correlates with depression. J Hand Surg Am. 2008;33(3):303–7.PubMedCrossRef Lozano Calderon SA, Paiva A, Ring D. Patient satisfaction after open carpal tunnel release correlates with depression. J Hand Surg Am. 2008;33(3):303–7.PubMedCrossRef
16.
Zurück zum Zitat Lozano-Calderon SA, Souer JS, Jupiter JB, et al. Psychological differences between patients that elect operative or nonoperative treatment for trapeziometacarpal joint arthrosis. Hand (N Y). 2008;3(3):271–5.PubMedCentralCrossRef Lozano-Calderon SA, Souer JS, Jupiter JB, et al. Psychological differences between patients that elect operative or nonoperative treatment for trapeziometacarpal joint arthrosis. Hand (N Y). 2008;3(3):271–5.PubMedCentralCrossRef
17.
Zurück zum Zitat MacDermid JC, Donner A, Richards RS, et al. Patient versus injury factors as predictors of pain and disability six months after a distal radius fracture. J Clin Epidemiol. 2002;55(9):849–54.PubMedCrossRef MacDermid JC, Donner A, Richards RS, et al. Patient versus injury factors as predictors of pain and disability six months after a distal radius fracture. J Clin Epidemiol. 2002;55(9):849–54.PubMedCrossRef
18.
Zurück zum Zitat Mitchell MJ, Stubbs BA, Eisenberg MS. Socioeconomic status is associated with provision of bystander cardiopulmonary resuscitation. Prehosp Emerg Care. 2009;13(4):478–86.PubMedCentralPubMedCrossRef Mitchell MJ, Stubbs BA, Eisenberg MS. Socioeconomic status is associated with provision of bystander cardiopulmonary resuscitation. Prehosp Emerg Care. 2009;13(4):478–86.PubMedCentralPubMedCrossRef
19.
Zurück zum Zitat Owolabi MO. What are the consistent predictors of generic and specific post-stroke health-related quality of life? Cerebrovasc Dis. 2009;29(2):105–10.PubMedCrossRef Owolabi MO. What are the consistent predictors of generic and specific post-stroke health-related quality of life? Cerebrovasc Dis. 2009;29(2):105–10.PubMedCrossRef
20.
Zurück zum Zitat Pickett KE, Pearl M. Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health. 2001;55(2):111–22.PubMedCrossRef Pickett KE, Pearl M. Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health. 2001;55(2):111–22.PubMedCrossRef
21.
Zurück zum Zitat Ponsford J, Hill B, Karamitsios M, et al. Factors influencing outcome after orthopedic trauma. J Trauma. 2008;64(4):1001–9.PubMedCrossRef Ponsford J, Hill B, Karamitsios M, et al. Factors influencing outcome after orthopedic trauma. J Trauma. 2008;64(4):1001–9.PubMedCrossRef
22.
Zurück zum Zitat Reinier K, Stecker EC, Vickers C, et al. Incidence of sudden cardiac arrest is higher in areas of low socioeconomic status: a prospective two year study in a large United States community. Resuscitation. 2006;70(2):186–92.PubMedCrossRef Reinier K, Stecker EC, Vickers C, et al. Incidence of sudden cardiac arrest is higher in areas of low socioeconomic status: a prospective two year study in a large United States community. Resuscitation. 2006;70(2):186–92.PubMedCrossRef
23.
Zurück zum Zitat Ring D, Kadzielski J, Fabian L, et al. Self-reported upper extremity health status correlates with depression. J Bone Joint Surg Am. 2006;88(9):1983–8.PubMedCrossRef Ring D, Kadzielski J, Fabian L, et al. Self-reported upper extremity health status correlates with depression. J Bone Joint Surg Am. 2006;88(9):1983–8.PubMedCrossRef
24.
Zurück zum Zitat Rozental TD, Blazar PE, Franko OI, et al. Functional outcomes for unstable distal radial fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation. A prospective randomized trial. J Bone Joint Surg Am. 2009;91(8):1837–46.PubMedCrossRef Rozental TD, Blazar PE, Franko OI, et al. Functional outcomes for unstable distal radial fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation. A prospective randomized trial. J Bone Joint Surg Am. 2009;91(8):1837–46.PubMedCrossRef
25.
Zurück zum Zitat Vaillancourt C, Lui A, De Maio VJ, et al. Socioeconomic status influences bystander CPR and survival rates for out-of-hospital cardiac arrest victims. Resuscitation. 2008;79(3):417–23.PubMedCrossRef Vaillancourt C, Lui A, De Maio VJ, et al. Socioeconomic status influences bystander CPR and survival rates for out-of-hospital cardiac arrest victims. Resuscitation. 2008;79(3):417–23.PubMedCrossRef
26.
Zurück zum Zitat Vandenplas O, Toren K, Blanc PD. Health and socioeconomic impact of work-related asthma. Eur Respir J. 2003;22(4):689–97.PubMedCrossRef Vandenplas O, Toren K, Blanc PD. Health and socioeconomic impact of work-related asthma. Eur Respir J. 2003;22(4):689–97.PubMedCrossRef
27.
Zurück zum Zitat Williamson OD, Epi GD, Gabbe BJ, et al. Predictors of moderate or severe pain 6 months after orthopaedic injury: a prospective cohort study. J Orthop Trauma. 2009;23(2):139–44.PubMedCrossRef Williamson OD, Epi GD, Gabbe BJ, et al. Predictors of moderate or severe pain 6 months after orthopaedic injury: a prospective cohort study. J Orthop Trauma. 2009;23(2):139–44.PubMedCrossRef
28.
Zurück zum Zitat Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg Am. 2005;30(2):289–99.PubMedCrossRef Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg Am. 2005;30(2):289–99.PubMedCrossRef
Metadaten
Titel
The association of education level on outcome after distal radius fracture
verfasst von
Nader Paksima
Brian Pahk
Santiago Romo
Kenneth A. Egol
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
HAND / Ausgabe 1/2014
Print ISSN: 1558-9447
Elektronische ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-013-9557-y

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