Is progressive early digit mobilization intervention beneficial for patients with external fixation of distal radius fracture? A pilot randomized controlled trial

Clin Rehabil. 2013 Nov;27(11):983-93. doi: 10.1177/0269215513487391. Epub 2013 Jun 20.

Abstract

Objective: To investigate whether progressive early digit mobilization resulted in better outcomes for hand stiffness and related functional results, as well as the effects on the bone healing process.

Design: Prospective, pilot randomized controlled trial.

Setting: A university hospital in southern Taiwan.

Participants: Twenty-two patients with distal radius fracture randomized into two groups: early digit mobilization or control.

Interventions: The intervention group received 45 minutes per treatment session and three sessions per week until the external fixator was removed 6 weeks after fracture. The control group received usual home programmes. After removing fixators, both groups received regular rehabilitation programmes until 12 weeks after surgery.

Main measures: Hand strength, dexterity and functional outcomes were obtained using a dynamometer, Purdue pegboard and self-report assessment, respectively, and X-rays of the distal radius were taken to reveal bone healing 1, 3, 6 and 12 weeks after surgery. A motion tracking system measured various kinematic parameters.

Results: The recovery rates between the groups showed statistically significant differences in both thumb workspace (81.55% vs. 69.54%, P = 0.04) and finger workspace (89.22% vs. 59.97%, P = 0.03) 12 weeks after injury. However, no statistical differences were found in finger dexterity, strength and self-reported outcomes. The radiographic assessment showed no significant differences between the groups for radial inclination, radial height and volar tilt throughout the examinations.

Conclusions: The findings suggest that early rehabilitative intervention for digits is applicable for distal radius fracture treatment, and does not produce additional bone deformities.

Keywords: Distal radius fracture; bone healing; early digit mobilization; finger kinematics; hand function.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Early Ambulation*
  • External Fixators
  • Female
  • Fracture Fixation*
  • Fracture Healing
  • Hand Strength
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Radius Fractures / physiopathology
  • Radius Fractures / rehabilitation*
  • Radius Fractures / surgery*
  • Range of Motion, Articular
  • Recovery of Function
  • Time Factors
  • Treatment Outcome