title: Effect of anxiety and catastrophic pain ideation on early recovery after surgery for distal radius fractures.
abstract: OBJECTIVE
  To evaluate the effects of preoperative anxiety and catastrophic pain ideation on perceived disability and objective measures after distal radius fracture surgery.
  
  
  METHODS
  A total of 121 patients with distal radius fractures treated with volar plate fixation were enrolled. The wrist range of motion (ROM), grip strength, and perceived disability as measured by the Michigan Hand Questionnaire (MHQ) score were assessed 4, 12, and 24 weeks after surgery. To evaluate psychological factors related to pain, catastrophic pain ideation was measured using the Pain Catastrophizing Scale (PCS) and pain anxiety was measured using the Pain Anxiety Symptom Scale (PASS). Then relative contributions of pain anxiety and catastrophic pain ideation and other clinical parameters to functional recovery in terms of grip strength, ROM, and MHQ score were assessed.
  
  
  RESULTS
  An increase in the PCS score was associated with the wrist ROM and grip strength only at week 4, whereas an increase in the PASS score was associated with the wrist ROM at week 4 and grip strength at weeks 4 and 12. According to a multivariate regression analysis, an increase in the PCS score was associated with a decrease in grip strength, ROM, and MHQ score at week 4; and an increase in the PASS score was associated with a decrease in grip strength, ROM, and MHQ score at week 4 and grip strength and MHQ score at week 12. At week 24, only age and fracture severity were associated with the MHQ score. In addition, age was associated with grip strength and fracture type was associated with ROM.
  
  
  CONCLUSIONS
  Preoperative PCS and PASS were significantly associated with delayed recovery as evidenced by scores on both objective and subjective measures of function. Given these relationships, it becomes important to assess preoperative PCS and PASS and address issues for patients at risk with brief psychosocial intervention early in the recovery process.
  
  
  METHODS
  Prognostic II.
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, South Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, South Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Beom Koo
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, South Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: bestknee@hotmail.com.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Noh
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, South Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, South Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea; Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do, South Korea; Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001860:Bone Plates; D058443:Catastrophization / Q000503:physiopathology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000601:surgery; D011885:Radius Fractures / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Distal radius fractures; catastrophic pain ideation; functional recovery; pain anxiety; surgical treatment