PMID- 37507254
OWN - NLM
STAT- MEDLINE
DCOM- 20230918
LR  - 20230918
IS  - 1879-0267 (Electronic)
IS  - 0020-1383 (Linking)
VI  - 54
IP  - 10
DP  - 2023 Oct
TI  - The Minimum Clinically Important Difference for the Patient-Rated Wrist 
      Evaluation in Surgical Fixation of Distal Radius Fractures: Does Hand Dominance 
      Make a Difference?
PG  - 110959
LID - S0020-1383(23)00645-9 [pii]
LID - 10.1016/j.injury.2023.110959 [doi]
AB  - BACKGROUND: Distal radius fractures (DRFs) are common orthopaedic injuries. They 
      can be treated in many ways, but the volar locking plate (VLP) is more frequent. 
      Currently, there is limited information regarding the minimum clinically 
      important difference (MCID) in surgically treated DRFs. The purpose of this study 
      was to calculate MCID values for the Patient-Reported Wrist Evaluation (PRWE) in 
      the setting of VLP-treated DRFs. METHODS: A retrospective review was conducted 
      for patients with isolated, surgically-treated DRFs with a VLP. Exclusions 
      included any concomitant procedure other than a carpal tunnel release, skeletal 
      immaturity, polytrauma, open fracture, or missing PRWE data. MCID was calculated 
      using PRWE, an overall health question, and the anchor-based method. RESULTS: A 
      total of 131 patients were identified. Approximately 54.2% injured their dominant 
      hand. AO/OTA classification 23C was the most common (n=89, 67.9%). Average 
      baseline, 6-week, and 12-week PRWE were 71.8 +/- 19.6, 34.3 +/- 20.1, and 21.2 +/- 18.0 
      respectively. This corresponds to an average change from baseline PRWE at 6 weeks 
      and 12 weeks of -37.5 +/- 23.4 and -50.6 +/- 22.3, respectively. Average MCID values 
      for 6 weeks and 12 weeks were 43.1 +/- 18 and 56.0 +/- 20.0, respectively (p<0.001). 
      Hand dominance did not correlate with MCID value (r(s) = 0.084 at six weeks, 
      r(s) = 0.099 at 12 weeks). MCID value additionally did not correlate with sex, 
      AO/OTA classification, smoking status, ASA score, or BMI. Treatment at a level 1 
      trauma center and diagnosis of anxiety and/or depression correlated with a higher 
      6-week MCID value (r(s) = 0.308 and r(s) = 0.410, respectively). Increasing age 
      weakly correlated with higher 12-week MCID value (r(s) = 0.352). CONCLUSIONS: 
      This study demonstrated an MCID calculation using an overall health anchor. MCID 
      value varied with follow-up time and correlated weakly with age, diagnosis of 
      anxiety and/or depression, and treatment facility, but it did not correlate with 
      injury of the dominant hand. Future research should analyze how to apply MCID and 
      identify successful treatment in the setting of DRF care.
CI  - Copyright (c) 2023 Elsevier Ltd. All rights reserved.
FAU - Huyke-Hernandez, Fernando A
AU  - Huyke-Hernandez FA
AD  - Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis 
      Park, MN, USA; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, 
      Bloomington, MN, USA.
FAU - Doxey, Stephen A
AU  - Doxey SA
AD  - Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis 
      Park, MN, USA; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, 
      Bloomington, MN, USA.
FAU - Robb, Jennifer L
AU  - Robb JL
AD  - Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, 
      USA.
FAU - Bohn, Deborah C
AU  - Bohn DC
AD  - Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, 
      USA; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, 
      USA.
FAU - Cunningham, Brian P
AU  - Cunningham BP
AD  - Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis 
      Park, MN, USA; Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, 
      Bloomington, MN, USA. Electronic address: brian.cunningham@parknicollet.com.
LA  - eng
PT  - Journal Article
DEP - 20230723
PL  - Netherlands
TA  - Injury
JT  - Injury
JID - 0226040
SB  - IM
MH  - Humans
MH  - Infant
MH  - Wrist
MH  - *Wrist Fractures
MH  - *Radius Fractures/surgery
MH  - Treatment Outcome
MH  - Wrist Joint
MH  - Fracture Fixation, Internal/methods
MH  - Bone Plates
MH  - Range of Motion, Articular
OTO - NOTNLM
OT  - Anchor-based MCID Calculation
OT  - Distal Radius Fracture
OT  - Hand Dominance
OT  - Minimum Clinically Important Difference
OT  - Patient-Reported Wrist Evaluation
OT  - Patient-reported Outcomes
OT  - Volar Locking Plate
COIS- Declaration of Competing Interest None
EDAT- 2023/07/29 06:42
MHDA- 2023/09/18 12:42
CRDT- 2023/07/28 21:54
PHST- 2023/04/05 00:00 [received]
PHST- 2023/06/22 00:00 [revised]
PHST- 2023/07/22 00:00 [accepted]
PHST- 2023/09/18 12:42 [medline]
PHST- 2023/07/29 06:42 [pubmed]
PHST- 2023/07/28 21:54 [entrez]
AID - S0020-1383(23)00645-9 [pii]
AID - 10.1016/j.injury.2023.110959 [doi]
PST - ppublish
SO  - Injury. 2023 Oct;54(10):110959. doi: 10.1016/j.injury.2023.110959. Epub 2023 Jul 
      23.