Severity of persistent pain and disability can accurately screen for presence of pain catastrophizing and fear of performing wrist movements in individuals with distal radius fracture

Abstract Background The evidence indicating presence of psychological factors concerns in individuals who report persistent residual pain and disability over a longer term after distal radius fractures (DRF) is emerging but requires further inquiry. Objectives To examine the associations of persistent wrist pain and disability at 6-months after DRF with the presence of psychological factors. Methods Eighty-five patients with DRF were evaluated for wrist pain and disability with subscales of Patient-rated wrist evaluation (PRWE), 6-months after the fracture. The associations of wrist pain and disability with these psychological factors at 6-months after DRF were examined using multivariable logistic regression models. The ability of PRWE scores at 6-months after DRF to accurately classify individuals with and without these psychological factors was examined using the area under the receiver operating characteristic curve (AUC). Results Higher PRWE-P scores were significantly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. In addition, higher PRWE-F scores were also highly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. The PRWE-P or PRWE-F Scores of ≥18/50 showed the best combination of sensitivity and specificity in identifying individuals with pain catastrophizing, emotional distress, and fear of performing wrist movements at 6-months after DRF (AUC values of ≥0.88). Conclusion The novel finding of this study is that scores of ≥18/50 PRWE-P or PRWEF can be used to screen for the presence of these psychological factors.