Functional Outcomes in Early Rehabilitation of 202 Distal Radius Fractures After Volar Fixation

Abstract

Introduction: The incorporation of stable fixation techniques over the past 10 years has allowed the early mobilization of distal radius fractures (DRFs), maximizing the chances of achieving optimal functional outcomes in rehabilitation. Purpose: The purpose of this study was to describe the functional outcomes after early rehabilitation for DRFs treated with volar plate fixation. Materials and Methods: A descriptive cross-sectional study was carried out on 202 patients with a DRF based on the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification system. They were treated with open reduction over the 2006-2015 period. Baseline and final therapy evaluations were carried out to collect demographic data—gender, age, and occupation (Swanson)—and functional information—pain using the visual analogue scale (VAS), range of movement (ROM) with a goniometer, grip strength tested with a standard Jamar hydraulic hand dynamometer, and self-report outcomes with the Patient-Rated Wrist Evaluation (PREW). Results: Sample mean age was 56.2 years (SD, ±16.4); 73% of the group were women, 43% of whom performed manual labor. Fifteen percent of the group had associated injuries. On average, therapy started 4 weeks after surgery. Mean treatment period was 68 days and 93 days in the case of those with associated lesions. The median VAS score at the onset was 4 (minimum: 0, maximum: 10) and at the end of treatment was 0 (minimum: 0, maximum: 9) ( P < .0001). Mean ROM was 52.7° for flexion, 57.9° for extension, 78.4° for pronation, and 67° for supination. Mean grip strength was 19.85 kg. Mean PREW score was 13.4. Conclusion: The study results indicate that early therapy after DRF surgery optimizes ROM and grip strength with good functional recovery and a quick return to daily activities and work.