This prospective cohort asked what actually predicts stiff fingers after volar plate fixation of a distal radius fracture. The authors screened demographic, injury-related, and psychologic factors against finger motion at suture removal and 6 weeks. The central question: does the fracture or the patient's mindset drive stiffness?
When a patient returns with a stiff hand after a well-fixed distal radius fracture, the reflex is to blame the fracture or the surgery. This paper argues the opposite: at 6 weeks, catastrophic thinking was the only independent predictor of stiffness, while displacement and fracture type washed out.
That matters because catastrophic thinking is measurable and potentially modifiable, unlike a healed fracture. A patient who overinterprets pain avoids moving the hand, and disuse produces the stiffness and skin changes we often label vaguely as CRPS.
The authors push back on that labeling. Rather than sorting patients into diseased versus not, treat disproportionate pain and disability as a continuum driven partly by mindset. Practically: screen for catastrophic thinking early, set clear expectations, and get the fingers moving. Reduced catastrophizing improves recovery in low back pain, and the authors suggest the same lever may work here.
This prospective cohort asked what actually predicts stiff fingers after volar plate fixation of a distal radius fracture. The authors screened demographic, injury-related, and psychologic factors against finger motion at suture removal and 6 weeks. The central question: does the fracture or the patient's mindset drive stiffness?
When a patient returns with a stiff hand after a well-fixed distal radius fracture, the reflex is to blame the fracture or the surgery. This paper argues the opposite: at 6 weeks, catastrophic thinking was the only independent predictor of stiffness, while displacement and fracture type washed out.
That matters because catastrophic thinking is measurable and potentially modifiable, unlike a healed fracture. A patient who overinterprets pain avoids moving the hand, and disuse produces the stiffness and skin changes we often label vaguely as CRPS.
The authors push back on that labeling. Rather than sorting patients into diseased versus not, treat disproportionate pain and disability as a continuum driven partly by mindset. Practically: screen for catastrophic thinking early, set clear expectations, and get the fingers moving. Reduced catastrophizing improves recovery in low back pain, and the authors suggest the same lever may work here.