PMID- 35415533
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220614
IS  - 2589-5141 (Electronic)
IS  - 2589-5141 (Linking)
VI  - 3
IP  - 1
DP  - 2021 Jan
TI  - Using the QuickDASH to Model Clinical Recovery Trajectory After Operative 
      Management of Distal Radius Fracture.
PG  - 1-6
LID - 10.1016/j.jhsg.2020.10.001 [doi]
AB  - PURPOSE: There is a paucity of literature examining the trajectory of meaningful 
      clinical improvement after distal radius fracture (DRF) fixation. We sought to 
      answer the following questions: (1) When do patients meet the minimum clinically 
      important difference (MCID) in the Quick-Disabilities in Arm, Shoulder, and Hand 
      questionnaire (QuickDASH) score change after DRF fixation? (2) What gains in 
      terms of number of MCIDs achieved (as measured by QuickDASH) do patients make as 
      they recover from DRF fixation? (3) What patient and injury factors are 
      characteristic of patients who meet or do not meet the average recovery 
      trajectory? METHODS: We performed a retrospective review of an institutional 
      database of DRF patients treated with operative fixation. The change in QuickDASH 
      scores from before surgery to approximate follow-up intervals of 0 to 2 months, 3 
      to 6 months, and a minimum of 9 of 12 months was assessed, in which a delta of 14 
      reflected the MCID. The change in QuickDASH score from before surgery to each 
      follow-up interval was divided by 14 to determine the number of MCIDs, 
      representing appreciable clinical improvement. Patient characteristics were 
      compared between those who did and did not reach average levels of clinical 
      improvement. RESULTS: The study included 173 patients. Mean QuickDASH score 
      before surgery was 74 (SD, 19; range, 0-100). After surgery, this improved to 50 
      (SD, 24; range, 0-100) by 0 to 2 months, 22 (SD, 22; range, 0-98) by 3 to 6 
      months, and 9.8 (SD, 15; range, 0-75) by a minimum of 9 to 12 months. Overall, 
      96% of patients reached the MCID by 1 year. Mean cumulative number of MCIDs 
      achieved (ie, number of 14-point decreases in QuickDASH score) at each interval 
      was 1.57, 3.64, and 4.43, respectively. Assuming 4.43 represents maximum average 
      improvement at 1 year, patients achieved 35% (1.57 of 4.43) of recovery from 0 to 
      2 months after surgery and 82% (3.64 of 4.43) of recovery by 3 to 6 months after 
      surgery. There appeared to be no difference in terms of age, sex, or body mass 
      index with respect to these findings. CONCLUSIONS: Overall, 96% of patients 
      undergoing DRF fixation will achieve one QuickDASH MCID by 1 year after surgery. 
      Patients achieved over 80% of total expected functional improvement by 3 to 6 
      months after surgery, which appeared to be irrespective of age, sex, or body mass 
      index. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
CI  - (c) 2020 The Authors.
FAU - Ingall, Eitan M
AU  - Ingall EM
AD  - Harvard Combined Orthopaedic Residency Program, Boston, MA.
FAU - Bernstein, David N
AU  - Bernstein DN
AD  - Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, 
      MA.
FAU - Shoji, Monica M
AU  - Shoji MM
AD  - Harvard Combined Orthopaedic Residency Program, Boston, MA.
FAU - Merchan, Nelson
AU  - Merchan N
AD  - Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, 
      MA.
FAU - Harper, Carl M
AU  - Harper CM
AD  - Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, 
      MA.
FAU - Rozental, Tamara D
AU  - Rozental TD
AD  - Harvard Combined Orthopaedic Residency Program, Boston, MA.
LA  - eng
PT  - Journal Article
DEP - 20201105
PL  - United States
TA  - J Hand Surg Glob Online
JT  - Journal of hand surgery global online
JID - 101759126
EIN - J Hand Surg Glob Online. 2021 Sep 17;3(5):316. PMID: 35420762
PMC - PMC8991532
OTO - NOTNLM
OT  - Distal radius fracture
OT  - Minimum clinically important difference
OT  - Patient-reported outcome measures
OT  - QuickDASH
EDAT- 2020/11/05 00:00
MHDA- 2020/11/05 00:01
PMCR- 2020/11/05
CRDT- 2022/04/13 05:37
PHST- 2020/08/01 00:00 [received]
PHST- 2020/10/04 00:00 [accepted]
PHST- 2022/04/13 05:37 [entrez]
PHST- 2020/11/05 00:00 [pubmed]
PHST- 2020/11/05 00:01 [medline]
PHST- 2020/11/05 00:00 [pmc-release]
AID - S2589-5141(20)30109-2 [pii]
AID - 10.1016/j.jhsg.2020.10.001 [doi]
PST - epublish
SO  - J Hand Surg Glob Online. 2020 Nov 5;3(1):1-6. doi: 10.1016/j.jhsg.2020.10.001. 
      eCollection 2021 Jan.