Contribution of functional parameters to patient-rated outcomes after surgical treatment of distal radius fractures.

PURPOSE: Outcomes of distal radius fractures can be measured radiographically, functionally, or via patient-rated questionnaires, but previous studies report conflicting results regarding the relationship between these outcomes. Our specific aim was to explore the role that functional outcomes have in the score of the Michigan Hand Outcomes Questionnaire (MHQ), a patient-rated hand instrument.

METHODS

We obtained data for 207 patients. Demographic information was collected as part of the MHQ. Function (wrist motion and grip and pinch strength) was assessed 3 and 6 months after fracture fixation. We applied linear regression analysis to determine each item's contribution to the total MHQ score.

RESULTS

After we applied linear regression analysis, we determined that 3 months after fixation, all included factors contributed 37% of the MHQ score. Only the grip strength difference between the injured and uninjured hands was significantly associated, contributing 22% of the MHQ score. Six weeks and 6 months after fixation, all included factors contributed 43% and 34%, respectively, of the MHQ score. No individual factors were significant contributors.

CONCLUSIONS

Measured functional outcomes variables account for less than 40% of the total MHQ score. Identifying the unmeasured factors that make up the additional 60% of the total MHQ score would be beneficial in the continued examination of patient-rated outcomes. Furthermore, the use of multiple outcomes assessment modalities should be considered in any study measuring patient-rated outcomes.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.