Introduction: Postoperative pain after distal radius fracture (DRF) surgery may negatively impact treatment outcomes.
Objectives: This study investigates the association between pain intensity on postoperative day 1 and at 1 and 3 weeks with treatment outcomes.
Methods: A retrospective observational study was conducted on 131 patients (mean age: 65 ± 15 years, 101 females) who underwent volar plate fixation for DRF between August 2020 and August 2022. Pain intensity was assessed using the Visual Analog Scale (VAS) at rest on postoperative day 1 and at 1 and 3 weeks. Treatment outcomes were evaluated at 6 weeks using the Patient-Rated Wrist Evaluation (PRWE). Patients with PRWE scores ≥21.5 were classified as the poor outcome group (n=66), and those <21.5 as the good outcome group (n=65). VAS cut-off values were determined using the Youden Index from Receiver Operating Characteristic (ROC) analysis.
Results: Median VAS scores and the proportion of patients with pain (%) were:
- Day 1: 24 mm (99%)
- Week 1: 4 mm (57%)
- Week 3: 0 mm (42%)
VAS cut-off values (AUC, sensitivity, specificity):
- Day 1: 33 mm (62%, 53%, 69%)
- Week 1: 1.5 mm (72%, 75%, 62%)
- Week 3: 5.5 mm (68%, 50%, 85%)
Conclusion: Pain persisted in nearly half of the patients beyond 1 week and influenced treatment outcomes. Patients experiencing pain at week 1 may benefit from personalized rehabilitation and pain management strategies. Furthermore, the identified VAS cut-off values, particularly at week 1 (1.5 mm) and week 3 (5.5 mm), could serve as clinical indicators for identifying patients at risk of poor outcomes, enabling early intervention and targeted treatment adjustments.