Prognosis: Pain and Disability after Distal Radius Fracture

Delayed union, nonunion, malunion, chronic pain, disability, and sustained work loss are potential adverse outcomes that can occur following a distal radius fracture (DRF). Nonunion is rare; while malunion is more common. Malunion increases the probability of disability to a great extent in young individuals, and to a small extent in older individuals. For those working at the time of their injury, median work loss following DRF is 8 weeks; but 20% avoid any work loss. Greater use of the hand at work and higher baseline self‐reported disability are related to longer time off work. Lower physical activity, smoking, malunion, and patient‐related factors (education level, smoking, physical activity, comorbidity) contribute to disability following fracture and risk of recurrent falls and fracture. Wrist guards are protective against wrist fracture/injury in snowboarding and rollerblading. DRF causes clinically relevant disability extending beyond one year in 5‐15% of patients; and is associated with increased mortality in older patients. Limited studies of long‐term disability suggest that once present, chronic pain symptoms persist and arthrosis progresses.