Recovery of Function
Conditions
Keywords
Upper limb surgery, Functional recovery, Postoperative recovery, General anesthesia, Brachial plexus, Nerve block, Regional anesthesia, Peripheral anesthesia
Brief summary
This study aims at determining if there is an association between locoregional anesthesia and postoperative functional recovery for orthopedic surgery to repair a distal radial fracture, as compared to general anesthesia.
Detailed description
All patients undergoing orthopedic wrist surgery under locoregional or general anesthesia at the CIUSSS de l'Estrie-CHUS who meet the selection criteria will be approach to participate in this prospective single-center observational study. Using the visual analog scale and anesthesia scale, the pain and the satisfaction of the patient will be evaluated respectively 2 weeks postoperatively. At the second visit, 6 to 8 weeks postoperatively, the participant will complete the QuickDASH questionnaire to evaluate his functional recovery and the participant's pain will be reassessed with the visual analogue scale. Finally, 12 weeks postoperatively, the wrist-joint range of motion and grip-strength test results will be recorded. The participant will also be asked to complete the QuickDASH and PRWE (Patient-Rated Wrist Evaluation) questionnaires to reevaluate his functional recovery.
Interventions
None listed
Sponsors
Université de Sherbrooke
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 18 years old and more * American Society of Anesthesiologists (ASA) score I, II, or III * Single distal radial fracture with or without ulna involvement * Orthopedic surgery by open reduction of the wrist for a distal radial fracture with or without ulnar involvement
Exclusion criteria
* Active pregnancy * Surgery with combined anesthesia (locoregional and general) * Locoregional anesthesia with catheter insertion for postoperative analgesia * Individuals with chronic pain as defined by preexisting neuropathy of the operated arm, preexisting radiculopathy of the operated limb, complex regional pain syndrome, or fibromyalgia * Polytrauma * Inability to consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional recovery using the grip strenght | 12 weeks post-surgery | We evaluate the grip strength with JAMAR hydraulic hand dynamometer. The participant squeezes the device as hard as they can. We averaged three values on both sides. |
| Functional recovery using the QuickDASH (Quick Disabilities of Arm, Shoulder and Hand) questionnaire | 12 weeks post-surgery | The QuickDASH assess the functional recovery. It consists of 11 questions scored from 1 to 5 (1 = no difficulty to 5 = unable). Higher scores indicate a greater level of disability. |
| Functional recovery using the PRWE (Patient Rated Wrist Evaluation) Questionnaire | 12 weeks post-surgery | The PRWE (Patient Rated Wrist Evaluation) Questionnaire assess the pain and the persistence of functional difficulty in activities of daily living following wrist surgery. It consists of 15 questions, each rated on a scale from 0 to 10. Five questions deal specifically with pain and are rated as 0 (no pain) to 10 (worse pain); 10 questions are on functional recovery, rated from 0 (no difficulty) to 10 (unable to do). Higher scores on the subscales represent greater pain or functional disability. |
| Functional recovery using the range of motion of all movement of the wrist | 12 weeks post-surgery | We evaluate the range of motion of all movement of the wrist with a goniometer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain- 2 weeks | 2 weeks post-operative | Post-operative pain score on the visual analogue scale. It is a 10 cm line on which the patient indicate their level of pain between 0 cm (no pain) and 10 cm (worst pain of their life). |
| Pain - 6 weeks | 6 weeks post-operative | Post-operative pain score on the visual analogue scale. It is a 10 cm line on which the patient indicate their level of pain between 0 cm (no pain) and 10 cm (worst pain of their life). |
| Functional recovery at 6 weeks | 6 weeks post-operative | Functional recovery following an orthopedic surgery under peripheral nerve block versus general anesthesia using the QuickDASH (The Quick Disabilities of Arm, Shoulder and Hand). The questionnaire consists of 11 questions scored from 1 to 5 (1 = no difficulty to 5 = unable). When all the questions are answered, the questionnaire calculate a percentage of disability. Higher scores indicate a greater level of disability. |
| Patient satisfaction | 2 weeks post-operative | Satisfaction score on the visual analogue scale. It is a 10 cm line on which the patient indicate their level of satisfaction between 0 cm (not satisfied) and 10 (fully satisfied). |
Countries
Canada
Outcome results
None listed