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Earlier return to function experienced with accelerated rehabilitation after ORIF
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Compared with patients with an unstable distal radial fracture who followed a more standard rehabilitation protocol, patients who followed an accelerated rehabilitation protocol after treatment with open reduction and internal fixation had an earlier return to function, according to study results.
From November 2007 to November 2010, researchers randomly assigned 81 patients with an unstable distal radial fracture to follow either an accelerated or standard rehabilitation protocol after undergoing open reduction and internal fixation (ORIF) with a volar plate for a distal radial fracture. At 3 to 5 days postoperatively, both groups began with gentle active range of motion. However, the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises at 2 weeks, whereas the standard group initiated at 6 weeks postoperatively.
The researchers assessed patients at 3 to 5 days, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 weeks, 12 weeks and 6 months postoperatively. Outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) scores and measurement of wrist flexion/extension, supination, pronation, grip strength and palmar pinch.
Lower DASH scores were observed among patients in the accelerated group compared with patients in the standard group from the 3-to-5-day to 8-week postoperative time points. From 2 to 8 weeks postoperatively, the researchers found the accelerated group experienced a better range of motion and strength. However, 12-week and 6-month follow-up data showed fewer differences between the two groups, with better wrist flexion and grip strength in the accelerated group as the only statistically significant differences in range of motion and strength.
Disclosures: Brehmer and Husband received grants from DePuy.
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