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.