title: Early functional postoperative therapy of distal radius fracture with a dynamic orthosis: results of a prospective randomized cross-over comparative study.
abstract: BACKGROUND
  This study was conducted according to GCP criteria as a prospective randomized cross-over study. The primary goal of the study was to determine clinical findings and patient satisfaction with postoperative treatment. 29 patients with a distal radius fracture that was surgically stabilized from volar and who met the inclusion criteria were enrolled over a 12-month period. Each patient randomly received either a dorsal plaster splint or a vacuum-fit flexible but blocked orthosis applied postoperatively in the operating theatre to achieve postoperative immobilization. After one week all patients were crossed over to the complementary device maintaining the immobilization until end of week 2. After week 2 both groups were allowed to exercise wrist mobility with a physiotherapist, in the orthosis group the device was deblocked, thus allowing limited wrist mobility. After week 4 the devices were removed in both groups. Follow-up exams were performed after postoperative weeks 1, 2, 4 and 12.
  
  
  CONCLUSIONS
  Results were determined after week 1 and 2 using SF 36 and a personally compiled questionnaire; after weeks 4 and 12 with a clinical check-up, calculation of ROM and the DASH Score. Comparison of the two groups showed a significant difference in ROM for volar flexion after 4 weeks, but no significant differences in DASH Score, duration of disability or x-ray findings. With regard to satisfaction with comfort and hygiene, patients were significantly more satisfied with the dynamic orthosis, and 23 of the 29 patients would prefer the flexible vacuum orthosis in future.
  
  
  BACKGROUND
  German Clinical Trials Register (DRKS) DRKS00006097.
authors.affiliation: BG Trauma Center, University of Tuebingen, Schnarrenbergstrasse 95, D-72076, Tuebingen, Germany.
authors.forename: Fabian M
authors.initials: FM
authors.lastname: Stuby
authors.affiliation: BG Trauma Center, University of Tuebingen, Schnarrenbergstrasse 95, D-72076, Tuebingen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Döbele
authors.affiliation: BG Trauma Center, University of Tuebingen, Schnarrenbergstrasse 95, D-72076, Tuebingen, Germany.
authors.forename: Susanne-Dorothea
authors.initials: SD
authors.lastname: Schäffer
authors.affiliation: Muon-Stat Statistical Services, Klugestrasse 28, D-70197, Stuttgart, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Mueller
authors.affiliation: BG Trauma Center, University of Tuebingen, Schnarrenbergstrasse 95, D-72076, Tuebingen, Germany.
authors.forename: Atesch
authors.initials: A
authors.lastname: Ateschrang
authors.affiliation: Paracelsus Hospital Ruit, Hedelfinger Strasse 166, D-73760, Ostfildern, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Baumann
authors.affiliation: Department of General Surgery, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany.
authors.forename: Derek
authors.initials: D
authors.lastname: Zieker
mesh_terms: D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D011885:Radius Fractures / Q000534:rehabilitation* / Q000601:surgery*; D057566:Self Report; D016896:Treatment Outcome
references.citation: Acta Orthop. 2008 Aug;79(4):540-7
references.pmid: 18766489
references.citation: Injury. 2012 Jul;43(7):1006-13
references.pmid: 22178307
references.citation: J Orthop Sci. 2004;9(6):560-5
references.pmid: 16228671
references.citation: Handchir Mikrochir Plast Chir. 2012 Oct;44(5):300-5
references.pmid: 23027335
references.citation: J Physiother. 2012;58(3):173-80
references.pmid: 22884184
references.citation: J Orthop Trauma. 2004 Sep;18(8):488-93
references.pmid: 15475843
references.citation: Hand Surg. 2013;18(2):159-67
references.pmid: 24164118
references.citation: Gesundheitswesen. 1999 Dec;61 Spec No:S184-90
references.pmid: 10726419
references.citation: Unfallchirurg. 2000 Mar;103(3):215-9
references.pmid: 10800385
references.citation: J Orthop Trauma. 2007 Jul;21(6):355-61
references.pmid: 17620992
references.citation: J Orthop Surg Res. 2010 Aug 06;5:53
references.pmid: 20691093
references.citation: Orthopedics. 2012 Nov;35(11):e1613-7
references.pmid: 23127452
references.citation: Acta Orthop. 2006 Jun;77(3):445-53
references.pmid: 16819684
references.citation: J Orthop Surg Res. 2012;7(1):8
references.pmid: 22340861
references.citation: J Bone Joint Surg Am. 2013 Oct 2;95(19):1737-44
references.pmid: 24088965
references.citation: J Hand Surg Am. 2001 Sep;26(5):908-15
references.pmid: 11561245
references.citation: Injury. 2013 Apr;44(4):421-6
references.pmid: 23199760
references.citation: J Hand Surg Br. 2003 Feb;28(1):50-3
references.pmid: 12531669
references.citation: BMC Musculoskelet Disord. 2003 Jun 16;4:11
references.pmid: 12809562
references.citation: J Bone Joint Surg Br. 1996 May;78(3):404-9
references.pmid: 8636175
references.citation: J Bone Joint Surg Am. 2011 Dec 7;93(23):2146-53
references.pmid: 22159849
references.citation: J Hand Surg Br. 2003 Oct;28(5):417-21
references.pmid: 12954249
references.citation: Eur J Orthop Surg Traumatol. 2013 Aug;23(6):647-50
references.pmid: 23412175
references.citation: J Hand Surg Am. 2013 Nov;38(11):2198-203
references.pmid: 24206983
references.citation: J Bone Joint Surg Am. 2010 Jul 21;92(8):1687-96
references.pmid: 20660231
references.citation: J Hand Surg Am. 2008 May-Jun;33(5):691-700
references.pmid: 18590852
references.citation: J Bone Joint Surg Am. 1994 Aug;76(8):1149-61
references.pmid: 8056795
references.citation: J Bone Joint Surg Am. 2007 Sep;89(9):2051-62
references.pmid: 17768207
references.citation: J Bone Joint Surg Br. 1998 Jul;80(4):665-9
references.pmid: 9699834
references.citation: Acta Orthop. 2013 Jun;84(3):292-6
references.pmid: 23594225
references.citation: BMJ. 1993 May 29;306(6890):1437-40
references.pmid: 8518639
references.citation: Handchir Mikrochir Plast Chir. 2005 Oct;37(5):303-8
references.pmid: 16287014
references.citation: J Hand Surg Am. 2008 Jul-Aug;33(6):958-65
references.pmid: 18656773
references.citation: Bone Joint J. 2013 Sep;95-B(9):1285-9
references.pmid: 23997147