Relationship between Patient Satisfaction and Objective Functional Outcome after Surgical Treatment for Distal Radius Fractures

Study Design: Prospective cohort. Introduction: Patient satisfaction is increasingly used as a metric of health care outcomes. The relationship between patient satisfaction and functional outcomes metrics is understudied. Purpose: To determine the minimum recovery needed in grip strength, key pinch strength, and arc of motion needed for patient satisfaction after treatment of distal radius fracture (DRF) with volar locking plating system placement. Methods: A prospective cohort of 125 DRF patients was evaluated three months after surgery for grip strength, key pinch strength, wrist arc of motion, and satisfaction with hand strength and wrist arc of motion. Receiver operating characteristic curves were constructed using patient satisfaction items as the "gold standard" and each functional measure of outcome as a predictor. Results: We found that the optimal cutpoints to distinguish satisfaction from dissatisfaction occurred when patients had recovered 65% of their grip strength, 87% of their key grip strength, and 95% of the wrist arc of motion, as measured as percents of their uninjured wrists. Conclusions: A much greater wrist range of motion must be recovered for patients to be satisfied than what is needed to perform activities of daily living.