Functional Recovery Following Orthopedic Wrist Surgery Under Peripheral Nerve Block Versus General Anesthesia

Study Overview
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Brief Summary
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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
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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.

Official Title
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Prospective Cohort Study Comparing Functional Recovery Following Orthopedic Wrist Surgery Under Peripheral Nerve Block Versus General Anesthesia

Conditions
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Recovery of Function

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional recovery using the QuickDASH (Quick Disabilities of Arm, Shoulder and Hand) questionnaire | 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. | 12 weeks post-surgery | 
| Functional recovery using the PRWE (Patient Rated Wrist Evaluation) Questionnaire | 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. | 12 weeks post-surgery | 
| Functional recovery using the range of motion of all movement of the wrist | We evaluate the range of motion of all movement of the wrist with a goniometer | 12 weeks post-surgery | 
| Functional recovery using the grip strenght | 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. | 12 weeks post-surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain- 2 weeks | 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). | 2 weeks post-operative | 
| Pain - 6 weeks | 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). | 6 weeks post-operative | 
| Functional recovery at 6 weeks | 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. | 6 weeks post-operative | 
| Patient satisfaction | 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). | 2 weeks post-operative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Upper limb surgery, Functional recovery, Postoperative recovery, General anesthesia, Brachial plexus, Nerve block, Regional anesthesia, Peripheral anesthesia