gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Self-efficacy corresponds to wrist function after combined plating of distal radius fractures

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  • presenting/speaker Marie Björk - Dep of Hand Surgery, Örebro University Hospital, Örebro, Sweden
  • Johan Niklasson - Dep of Hand Surgery, Örebro University Hospital, Örebro, Sweden
  • Elisabeth Westerdahl - Dep of Physiotherapy, Örebro University Hospital, Örebro, Sweden
  • Marcus Sagerfors - Dep of Hand Surgery, Örebro University Hospital, Örebro, Sweden

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1054

doi: 10.3205/19ifssh1570, urn:nbn:de:0183-19ifssh15708

Published: February 6, 2020

© 2020 Björk et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Clinical issue/s: Self-efficacy (SE) refers to beliefs in ones capabilities to organize and execute the courses of action required to produce given goals. High SE is an important factor for recovery from injury/illness; people who believe in their capability will more likely reach a good outcome. The distal radius fracture (DRF) is the most common fracture in adults constituting 18% of all fractures in an orthopedic trauma unit.

To our knowledge there are no reports investigating the role of patient-reported self-efficacy in the rehabilitation of surgically treated DRFs. A tool that could identify patients in need of increased postoperative rehabilitation could potentially improve the allocation of rehabilitation resources.

Clinical reasoning: The aim of this study was to examine if SE has an effect on physical functioning, pain and patient-rated wrist function three months postoperatively in patients who underwent combined plating with a volar and dorsal plate due to a distal radius fracture (DRF).

Methods: This prospective study involved 67 patients. Follow-up results were available for 55 of them. The patients rated SE at the first appointment with the physiotherapist. The three months follow-up contained the outcome values: Patient-Rated Wrist Evaluation (PRWE), pain-scores, hand grip-strength and range of motion. The study was approved by the regional ethical committee.

Results: Three months after surgery the average wrist motion was 62-93 percent and hand grip-strength was 58 percent compared to the uninjured hand. Patients who rated high SE showed significantly better ROM for flexion and supination, hand grip-strength and PRWE-scores.

Discussion: Patients with a high SE are more likely to have a better wrist function three months postoperatively compared to patients with a low SE.

Conclusion: SE can be a tool to assist the hand therapist in the allocation of rehabilitation resources.