The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius

Citation
Ae. Wakefield et Mm. Mcqueen, The role of physiotherapy and clinical predictors of outcome after fracture of the distal radius, J BONE-BR V, 82B(7), 2000, pp. 972-976
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME
ISSN journal
0301-620X → ACNP
Volume
82B
Issue
7
Year of publication
2000
Pages
972 - 976
Database
ISI
SICI code
0301-620X(200009)82B:7<972:TROPAC>2.0.ZU;2-P
Abstract
The capacity for physiotherapy to improve the outcome after fracture of the distal radius is unproven. We carried out a randomised controlled trial on 96 patients, comparing conventional physiotherapy with a regime of home ex ercises. The function of the upper limb was assessed at the time of removal of the plaster cast and at three and six months after injury. Factors whic h may predict poor outcome in these patients were sought. Grip strength and hand function did not significantly differ between the tw o groups. Flexion and extension of the wrist were the only movements to imp rove with physiotherapy at six months (p = 0.001). Predictors of poor funct ional outcome were malunion and impaired function before the fracture. Thes e patients presented with pain, decreased rotation of the forearm and low f unctional scores at six weeks. Our study has shown that home exercises are adequate rehabilitation after u ncomplicated fracture of the distal radius, and routine referral for a cour se of physiotherapy should be discouraged. The role of physiotherapy in pat ients at high risk of a poor outcome requires further investigation.