Prakash Jayakumar1, Teun Teunis2, Ana-Maria Vranceanu3, Meredith Grogan Moore4, Mark Williams5, Sarah Lamb6, David Ring3, Stephen Gwilym6. 1. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. Electronic address: pjx007@gmail.com. 2. University Medical Center Utrecht, Utrecht, The Netherlands. 3. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 4. Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX, USA. 5. Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Headington Campus, Oxford, UK. 6. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Abstract
BACKGROUND: The purpose of this study was to identify factors associated with limitations in function measured by patient-reported outcome measures (PROMs) 6-9 months after elbow fractures in adults from a range of demographic, injury, psychological, and social variables measured within a week and 2-4 weeks after injury. METHODS: We enrolled 191 adult patients sustaining an isolated elbow fracture and invited them to complete PROMs at their initial visit to the orthopedic outpatient clinic (within a maximum of 1 week after fracture), between 2 and 4 weeks, and between 6 and 9 months after injury; 183 patients completed the final assessment. Bivariate analysis was performed, followed by multivariable regression analysis accounting for multicollinearity. This was evaluated using partial R2, correlation matrices, and variable inflation factor assessment. RESULTS: There was a correlation between multiple variables within a week of injury and 2-4 weeks after injury with PROMs 6-9 months after injury in bivariate analysis. Kinesiophobia measured within a week of injury and self-efficacy measured at 2-4 weeks were the strongest predictors of limitations 6-9 months after injury in multivariable regression. Regression models accounted for substantial variance in all PROMs at both time points. CONCLUSIONS: Developing effective coping strategies to overcome fears related to movement and reinjury and finding ways of persevering with activity despite pain within a month of injury may enhance recovery after elbow fractures. Heightened fears around movement and suboptimal coping ability are modifiable using evidence-based behavioral treatments.
BACKGROUND: The purpose of this study was to identify factors associated with limitations in function measured by patient-reported outcome measures (PROMs) 6-9 months after elbow fractures in adults from a range of demographic, injury, psychological, and social variables measured within a week and 2-4 weeks after injury. METHODS: We enrolled 191 adult patients sustaining an isolated elbow fracture and invited them to complete PROMs at their initial visit to the orthopedic outpatient clinic (within a maximum of 1 week after fracture), between 2 and 4 weeks, and between 6 and 9 months after injury; 183 patients completed the final assessment. Bivariate analysis was performed, followed by multivariable regression analysis accounting for multicollinearity. This was evaluated using partial R2, correlation matrices, and variable inflation factor assessment. RESULTS: There was a correlation between multiple variables within a week of injury and 2-4 weeks after injury with PROMs 6-9 months after injury in bivariate analysis. Kinesiophobia measured within a week of injury and self-efficacy measured at 2-4 weeks were the strongest predictors of limitations 6-9 months after injury in multivariable regression. Regression models accounted for substantial variance in all PROMs at both time points. CONCLUSIONS: Developing effective coping strategies to overcome fears related to movement and reinjury and finding ways of persevering with activity despite pain within a month of injury may enhance recovery after elbow fractures. Heightened fears around movement and suboptimal coping ability are modifiable using evidence-based behavioral treatments.
Authors: Aresh Al Salman; Michael Z Khatiri; Teun Cremers; David Ring; Jacob E Thomas; Amirreza Fatehi Journal: Arch Orthop Trauma Surg Date: 2020-11-20 Impact factor: 3.067
Authors: Tom J Crijns; Niels Brinkman; Sina Ramtin; David Ring; Job Doornberg; Paul Jutte; Karl Koenig Journal: Clin Orthop Relat Res Date: 2022-02-01 Impact factor: 4.755
Authors: Cindy Nguyen; Joost T P Kortlever; Amanda I Gonzalez; Tom J Crijns; David Ring; Gregg A Vagner; Lee M Reichel Journal: Arch Bone Jt Surg Date: 2021-11