Physiotherapy after volar plating of wrist fractures is effective using a home exercise program.
OBJECTIVE
To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures: treatment by a physical therapist with 12 sessions and an unassisted home exercise program.


METHODS
Randomized controlled cohort study.


METHODS
Hospital-based care, primary center of orthopedic surgery.


METHODS
Volunteers (N=48) with fractures of the distal radius after internal fixation with locking plates. There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol.


METHODS
Not applicable.


METHODS
Evaluation of grip strength using a Jamar dynamometer, range of motion (ROM), and Patient Related Wrist Evaluation (PRWE).


RESULTS
After a 6-week period of postoperative treatment, the patients (n=23) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist. Grip strength reached 54% (P=.003), and ROM in extension and flexion 79% (P<.001) of the uninjured side. Ulnar and radial abduction was also higher in this group. In contrast, patients who were treated by a physical therapist achieved grip strength equal to 32%, and ROM in extension and flexion of 52% of the uninjured side. Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50% lower value (P<.001) in the PRWE score.


CONCLUSIONS
In the postoperative rehabilitation of wrist fractures, instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment.
Center of Surgery, Clinic for Traumatology, Hand, Plastic, and Reconstructive Surgery, University of Ulm, Ulm, Germany.
Gert D
GD
Krischak
Anna
A
Krasteva
Florian
F
Schneider
Daniel
D
Gulkin
Florian
F
Gebhard
Michael
M
Kramer
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001860:Bone Plates; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006225:Hand / Q000503:physiopathology; D018737:Hand Strength; D006701:Home Nursing / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000534:rehabilitation* / Q000601:surgery; D016059:Range of Motion, Articular; D012648:Self Care / Q000379:methods*; D014955:Wrist Joint / Q000503:physiopathology