A retrospective analysis of quality of life domains impacted by distal radius fracture and ulnar neuropathy

BACKGROUND: Distal radius fractures (DRF) and ulnar neuropathy (UNE) present with reduced motor function, restricted range of motion, pain, and reduced grip strength that may lead to similar treatment approaches. With rapid and insidious onset for DRF and UNE, respectively, the contextual factors impacting an individuals' experience with the condition can vary. PURPOSE: The aim of this secondary analysis is to compare ratings of quality of life (QoL) domains prior to treatment and 3 months post treatment for DRF and UNE. STUDY DESIGN: This is a retrospective cohort study conducted at the Roth McFarlane Hand and Upper Limb Centre. METHODS: 36-Item Short Form Survey (SF-36) data from 781 patients treated nonoperatively for DRF, operatively for DRF, or operatively for UNE was extracted from the Hand and Upper Limb Centre database. Group differences for the eight SF-36 domains were calculated using analysis of covariance (ANCOVA) with sex as a covariate. Differences from prior to treatment to 3 months post were assessed using separate repeated measures ANCOVA (RM-ANCOVA) with sex as a covariate. RESULTS: Nonoperative DRF, operative DRF, and operative UNE groups reported 8%-11% improvements in QoL domains at 3 months follow-up despite some persisting impairments for physical domains. Prior to treatment, the DRF patients report greater impairments for physical domains, while the UNE patients managed operatively reported greater impairments to psychosocial domains. Operatively managed DRF patients report greater physical and psychosocial impairments than those conservatively treated. Males report less severe impairments for physical and psychosocial domains than females. CONCLUSIONS: Assessing QoL domains for two upper extremity conditions with different contextual factors provides insight into the implications of those factors on QoL. Incorporating early screening and continual monitoring of QoL domains impacted by upper extremity conditions like DRF and UNE could help identify factors impacting prognosis and direct the focus of treatment to improve outcomes at 3 months.