Priority 17 from the Broken Bones of the Upper Limb in People over 50

UNCERTAINTY: Can we predict who will do well with rehabilitation after an upper limb fracture in people over 50? (JLA PSP Priority 17)
Overall ranking	17
JLA question ID	0093/17
Explanatory note	Rehabilitation is important to ensure a patient achieves their best possible outcome following an upper limb fracture. However, is it absolutely necessary for all patients? This question looks to determine if we can tell who will and won't benefit from physiotherapy following their fracture? This could depend on a large number of factors, such as the type of fracture they have.
Evidence	Truong JL, Doherty C & Suh N; The Effect of Socioeconomic Factors on Outcomes of Distal Radius Fractures: A Systematic Review. Hand (New York, N.Y.); Sep 2018; vol. 13 (no. 5); p. 509-515 Jack K, et al; Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review. Manual Therapy Volume 15, Issue 3, June 2010, Pages 220-228
Health Research Classification System category	Injuries and Accidents

Extra information provided by this PSP
Original uncertainty examples	What are the outcomes ROM/strength exercises vs. not? ~ Patient adherence re instructions - what helps/hinders patients following advice? ~ Who is filtering / triaging the patients for physio - are patients who need physio input all being triaged appropriately or is it down to surgeon preference. ~ What is the recommended access to physiotherapy, and OT for functional recovery?
Submitted by	24 x Healthcare Professionals, 62 x Patients, 5 x Carers/Relatives, 2 x Not stated, 1 x Research Nurse

PSP information
PSP unique ID	0093
PSP name	Broken Bones of the Upper Limb in People over 50 PSP
Total number of uncertainties identified by this PSP.	50 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	3 December 2018