Striving to recover - wrist splint or plaster cast : a qualitative study of patients' experience of recovery after a distal radius fracture.
Phelps EE., Tutton E., Gould J., Baird L., Achten J., Costa ML.
AIMS: We sought to explore patients' experience of early recovery from a fracture of the wrist (distal radius). This study was nested in the DRAFT-CASP randomized controlled trial (RCT), which explores the effectiveness of two treatment pathways for patients with a fracture of the distal radius that does not require manipulation: a plaster cast which is removed in fracture clinic, versus a wrist splint that patients remove themselves without returning to hospital. METHODS: Qualitative interviews were undertaken with 21 adults (mean age 58.2 years (SD 13.96), six male), from eight NHS hospitals, four to ten weeks post injury. Interviews were informed by phenomenology and analyzed using reflexive thematic analysis. RESULTS: We identified the overarching theme 'striving to recover', which conveys patients' determination to get back to normal after a wrist fracture. To recover, patients needed to be comfortable, to adapt, and to be certain that their wrist was healing. Early in their recovery, they were unable to complete their daily activities, experienced pain, loss of strength, worry, and were cautious about using their wrist. Overall, both treatments were considered acceptable. The splint was advantageous for the freedom and control it provided. The cast was valued for the protection and safety it provided. Both groups required more information and reassurance, but had varied views on the need for follow-up appointments. CONCLUSION: The splint made life easier for patients and was an acceptable treatment. Patients wanted reassurance that their wrist was healing, but they felt this could be achieved in a variety of ways. Most patients coped without a follow-up appointment. Innovative ways to maximize recovery are required. These include support for patients to, manage their pain and provide comfort, be able to adapt, and feel certain of healing. Sharing patients' experiences may help future patients to make informed treatment and recovery decisions.