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Prognostic factors for persistent pain after a distal radius fracture: A systematic review

Rolls, Catherine; Van der Windt, Danielle A; McCabe, Candy; Babatunde, Opeyemi O; Bradshaw, Elizabeth

Prognostic factors for persistent pain after a distal radius fracture: A systematic review Thumbnail


Authors

Catherine Rolls

Candy McCabe

Elizabeth Bradshaw



Abstract

Introduction The aim of this systematic review was to synthesize the evidence regarding prognostic factors for persistent pain, including Complex Regional Pain Syndrome (CRPS), after a distal radius fracture (DRF), a common condition after which persistent pain can develop. Methods Medline, Pubmed, Embase, Psychinfo, CINAHL, BNI, AMED and the Cochrane Register of Clinical Trials were searched from inception to May 2021 for prospective longitudinal prognostic factor studies investigating persistent pain in adults who had sustained a DRF. The Quality in Prognostic Studies (QUIPS) tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework were used to assess the strength of evidence. Results A search yielded 440 studies of which 7 studies met full eligibility criteria. From five studies we found low evidence for high baseline pain or an ulnar styloid fracture as prognostic factors for persistent pain, and very low evidence for diabetes or older age. From two studies, investigating an outcome of CRPS, there was low evidence for high baseline pain, slow reaction time, dysynchiria, swelling and catastrophising as prognostic factors, and very low evidence for depression. Sex was found not to be a prognostic factor for CRPS or persistent pain. Conclusions The associations between prognostic factors and persistent pain following a DRF are unclear. The small number of factors investigated in more than one study, along with poor reporting and methodological limitations contributed to an assessment of low to very low strength of evidence. Further prospective studies, investigating psychosocial factors as candidate predictors of multidimensional pain outcomes are recommended.

Journal Article Type Review
Acceptance Date Oct 3, 2022
Online Publication Date Oct 3, 2022
Publication Date Oct 3, 2022
Publicly Available Date Mar 29, 2024
Journal Hand Therapy
Print ISSN 1758-9983
Electronic ISSN 1758-9991
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 27
Issue 4
Pages 123-136
DOI https://doi.org/10.1177/17589983221124973
Keywords wrist fracture, Prognosis, chronic pain
Publisher URL https://journals.sagepub.com/doi/abs/10.1177/17589983221124973?journalCode=hthb