Uršej E1,2
1Faculty of Health Care Angela Boškin, Physiotherapy, Jesenice, Slovenia, 2SMILE-E, Eva Uršej, s.p., Jesenice, Slovenia
Background: In the later years recovery time after trauma surgeries is shortening due to improved materials, different technologies and approaches used by surgeons. Nevertheless, physiotherapy in early rehabilitation plays very important role in improving functionality and range of motion.
Purpose: The main purpose of this case report was to compare the early postoperative results of range of motion and functionality between intensive, accelerated, fully supported physiotherapy, and standard rehabilitation protocols, described in the literature and other previous researches.
Methods: A patient with an isolated distal radius fracture was treated by internal fixation using a volar plate excluding bone graft after three weeks of immobilization and began with intensive physiotherapy, consisting of manual therapy, passive stretching, and active mobilization two days postoperatively. At two weeks, strengthening exercises, hydrotherapy in salt water, and swimming were added to therapy sessions. The physiotherapy was performed twice a day, each session lasting for 60 minutes. Range of motion in all wrist movements was assessed every day for 6 weeks. Additionally, Quick Disability of the Arm, Shoulder and Hand (QuickDASH) questionnaire, Patient-Rated Wrist Evaluation (PRWE), and pain according to the Visual Analog Scale score were analysed once a week.
Results: The range of motion of patient´s wrist was increasing faster compared to patients from researches found in literature. Also, QuickDASH, PRWE and VAS scores were better up to 6 weeks postsurgery. There were no complications noted during the early rehabilitation phase.
Conclusion(s): Intensive, fully supported physiotherapy after surgically treated distal radius fracture leads to very good outcomes (better range of motion, better functional results and less pain) and seems to be a safe treatment for postoperative aftercare in early rehabilitation of 6 weeks. A randomized controlled study with sample size big enough needs to be done to confirm differences between intensive therapy group and control group undergoing standard rehabilitation protocol. Also, follow-up assessment of the same patient for at least 6 months needs to be done to discover the time to full recovery.
Implications: The results of this study report suggest that intensive physiotherapy in early rehabilitation after surgically treated distal radius fracture can lead to better and faster recovery. Everyday therapy with combination of manual therapy, active and passive mobilization, strengthening exercises and hydrotherapy could be used more often if possible in order to shorten the time to full recovery.
Keywords: Early rehabilitation, distal radius fracture, volar fixation
Funding acknowledgements: The work was unfunded.
Purpose: The main purpose of this case report was to compare the early postoperative results of range of motion and functionality between intensive, accelerated, fully supported physiotherapy, and standard rehabilitation protocols, described in the literature and other previous researches.
Methods: A patient with an isolated distal radius fracture was treated by internal fixation using a volar plate excluding bone graft after three weeks of immobilization and began with intensive physiotherapy, consisting of manual therapy, passive stretching, and active mobilization two days postoperatively. At two weeks, strengthening exercises, hydrotherapy in salt water, and swimming were added to therapy sessions. The physiotherapy was performed twice a day, each session lasting for 60 minutes. Range of motion in all wrist movements was assessed every day for 6 weeks. Additionally, Quick Disability of the Arm, Shoulder and Hand (QuickDASH) questionnaire, Patient-Rated Wrist Evaluation (PRWE), and pain according to the Visual Analog Scale score were analysed once a week.
Results: The range of motion of patient´s wrist was increasing faster compared to patients from researches found in literature. Also, QuickDASH, PRWE and VAS scores were better up to 6 weeks postsurgery. There were no complications noted during the early rehabilitation phase.
Conclusion(s): Intensive, fully supported physiotherapy after surgically treated distal radius fracture leads to very good outcomes (better range of motion, better functional results and less pain) and seems to be a safe treatment for postoperative aftercare in early rehabilitation of 6 weeks. A randomized controlled study with sample size big enough needs to be done to confirm differences between intensive therapy group and control group undergoing standard rehabilitation protocol. Also, follow-up assessment of the same patient for at least 6 months needs to be done to discover the time to full recovery.
Implications: The results of this study report suggest that intensive physiotherapy in early rehabilitation after surgically treated distal radius fracture can lead to better and faster recovery. Everyday therapy with combination of manual therapy, active and passive mobilization, strengthening exercises and hydrotherapy could be used more often if possible in order to shorten the time to full recovery.
Keywords: Early rehabilitation, distal radius fracture, volar fixation
Funding acknowledgements: The work was unfunded.
Topic: Orthopaedics; Musculoskeletal: upper limb; Sport & sports injuries
Ethics approval required: No
Institution: Ministry of Health, Republic of Slovenia
Ethics committee: National Medical Ethics Committee
Reason not required: Ethics approval was not required because National Medical Ethics committee (Ministry of Health, Republic of Slovenia) gives oppinion only for research project work (case report is not considered as research project). The patient consent form was signed.
All authors, affiliations and abstracts have been published as submitted.
