Abstract
Background Finger stiffness varies substantially in patients with hand and upper extremity
illness and can be notably more than expected for a given pathophysiology. In prior
studies, pain intensity and magnitude of disability consistently correlate with coping
strategies such as catastrophic thinking and kinesiophobia, which can be characterized
as overprotectiveness. In this retrospective study we address the primary research
question whether patients with finger stiffness are more often overprotective when
the primary pathology is outside the hand (e.g. distal radius fracture) than when
it is located within the hand. Methods In an orthopaedic hand surgery department 160
patients diagnosed with more finger stiffness than expected for a given pathophysiology
or time point of recovery between December 2006 and September 2012 were analyzed to
compare the proportion of patients characterized as overprotective for differences
by site of pathology: (1) inside the hand, (2) outside the hand, and (3) psychiatric
etiology (e.g. clenched fist). Results Among 160 subjects with more finger stiffness
than expected, 132 (82 %) were characterized as overprotective including 88 of 108
(81 %) with pathology in the hand, 39 of 44 (89 %) with pathology outside the hand,
and 5 of 8 (63 %) with psychiatric etiology. These differences were not significant.
Conclusions Overprotectiveness is common in patients with more finger stiffness than
expected regardless the site and type of primary pathology. It seems worthwhile to
recognize and treat maladaptive coping strategies early during recovery to limit impairment,
symptoms, and disability.
Keywords
Finger stiffness - Pain catastrophizing - Kinesiophobia - Pain - Disability - Overprotectiveness
