Association of wrist and forearm range of motion measures with self-reported functional scores amongst patients with distal radius fractures: a longitudinal study

Zixian Yang,Sing Hwee Teo,Huaying Qiu,Huiwen Chen,Yong Hao Pua,Peggy Poh Hoon Lim

doi:10.1186/s12891-018-2065-z

Abstract

BackgroundPatients with distal radius fractures (DRF) often have limited range-of-motion (ROM) in multiple planes of movement. No studies have comprehensively examined the impact of various ROM limitations on physical function.MethodsWe performed a multi-center, longitudinal study of 138 patients with conservatively managed DRF. ROM measures were taken at initial evaluation, and at 4 and 8 weeks later. Self-reported physical function was indexed by the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH).ResultsWrist extension, active thumb opposition and a full composite grip were amongst the strongest ROM measures associated with functional scores over time. However, wrist radial deviation and forearm pronation were non-significantly associated with functional scores.ConclusionGiven that ROM is potentially modifiable, the identification of important ROM measures associated with QuickDASH scores can potentially facilitate patient education and refine interventions to optimize functional recovery. Well-designed randomized intervention studies are however needed to confirm these association findings.

Highlights

Patients with distal radius fractures (DRF) often have limited range-of-motion (ROM) in multiple planes of movement
We modeled the time course of the QuickDASH scores using a generalized least-squares model that included all available observations from all time points, and we accounted for within-patient correlation over time using a first order autoregressive covariance structure [19, 20]
Adjusting for covariates, we found that wrist extension, active thumb opposition and the ability to make a full composite grip were among the strongest range of motion (ROM) measures associated with QuickDASH scores

Summary

Introduction

Patients with distal radius fractures (DRF) often have limited range-of-motion (ROM) in multiple planes of movement. Due to the involvement of the wrist joint, patients often have limited range of motion (ROM) in multiple planes of movement - namely, wrist flexion and extension, wrist radial and ulnar deviation, forearm supination and pronation. As the wrist joint is imperative for proper function of the hand, fundamental hand functions such as making a full composite grip and thumb opposition are often affected [3] despite not being injured These can adversely impact on one’s ability to perform activities of daily living (ADLs), work or leisure, which causes loss of productive work hours, school in-attendance, loss of independence, and even lasting disability – extending beyond the direct healthcare costs [4,5,6].

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