Purpose
Depression has been linked to inferior clinical outcomes among upper extremity patients.
It often is challenging to distinguish the symptoms of depression, symptoms of injury,
and the interaction between these 2 entities after a patient has been injured. We
aimed to study the differences in clinical outcomes after surgical fixation of distal
radius fractures between patients with and without a documented history and treatment
for depression.
Methods
All subjects with an isolated, acute distal radius fracture undergoing operative fixation
in a 10-year period at a level 1 academic trauma center were screened. Baseline demographic
data were collected, and psychiatric history and antidepressant use were recorded
and verified with a pharmacy database. Quick Disability of the Arm, Shoulder and Hand
(QuickDASH), range of motion, and grip strength were assessed at 12 months after surgery.
Multivariable linear regression analysis was used to assess the association of depression
with QuickDASH scores at 1 year after surgery.
Results
A total of 211 patients were available for 1-year follow-up, 50 of whom were being
treated actively for depression with medication at the time of injury and 161 were
without a known diagnosis of, or treatment for, depression. Demographic and injury
characteristics were similar between both groups. In a multivariable linear regression
model controlling for age, sex, and a history of osteoporosis, active treatment for
depression was associated with a slight mean increase in QuickDASH scores, 6.5 (1.3–11.8),
1 year after surgery.
Conclusions
This study demonstrates a small increase in QuickDASH scores between subjects with
a confirmed diagnoses of depression compared with all others after surgical fixation
of distal radius fracture at 1-year follow-up. We suggest that a history of depression
may portend worse clinical outcomes, although other factors, such as underreporting
of depression may influence results.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: October 29, 2022
Accepted:
August 17,
2022
Received:
June 1,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
