Rehabilitation Following Surgically Treated Distal Radius Fractures: Do Immobilization and Physiotherapy Affect the Outcome?

Abstract

Distal radius fractures (DRF) are one of the most common fractures treated by orthopaedic surgeons around the globe. It has been estimated that the National Health Services (NHS) spends an average of £1375.34 per patient for surgical fixation of DRF with a volar locking plate as a day case. This figure climbs to £1983.39 if the same patient stays at the hospital overnight. Inpatient physiotherapy costs the NHS a staggering £82.03 per day, while each outpatient session with physiotherapy is £40.70 for the NHS. This means that a substantial amount is spent by the NHS on rehabilitation and physiotherapy for each DRF, whether fixed surgically or non-surgically. Post-operative rehabilitation involving initial immobilization followed by physiotherapy/hand therapy is an indispensable part of the total management concept of DRF. Most of the conservative management protocols also advocate a five-week immobilization followed by physiotherapy/hand therapy. Due to the fact that more than 50% of the patients with DRF are still employed, the impairment caused by a restriction of range of motion, duration of the sick leave and the effects of DRF on quality of life play a very important socio-economical role in the broadest sense. Patients are routinely referred to physiotherapists/hand therapists following DRF to improve the range of motion (ROM), manage pain, strengthen the wrist and develop full functionality to pre-injury levels. However, the real impact of supervised exercises and active physiotherapy in restoring mobility and strength to the fractured wrist is still not well understood. This article aims to review the existing literature and evidence base regarding the efficacy of immobilization and physiotherapy in improving the functional outcome of surgically treated DRFs.

Outcome Analysis of Distal Radius Fracture with Orthosis Versus Cast Immobilization after Palmar Plate Osteosynthesis: A Randomized Controlled Study

“…Immobilization in a plaster cast or splint is initially carried out after closed reduction, as well as after surgery. The period of postoperative immobilization is determined on an individual basis depending on the severity of the fracture, bone quality, and quality of care, and is usually 0–6 weeks [ 15 , 16 , 17 , 18 ]. Little changed in this approach for many years.…”

Wearable rehabilitation wristband for distal radius fractures

“…A period of rehabilitation after the removal of the cast or splint plays a major role in the recovery of joint function ( Badwaik et al, 2021 ). However, there is a common phenomenon that patients do not pay attention to rehabilitation training, have poor compliance, and have irregular training movements ( Bhan et al, 2021 ). Therefore, it is important to build a rehabilitation training assistance monitoring system so that the physician can supervise the patient promptly and increase the patient’s self-motivation for rehabilitation training.…”

Physiotherapeutic Protocol and ZnO Nanoparticles: A Combined Novel Treatment Program against Bacterial Pyomyositis

“…Physiotherapy is a field of medicine that incorporates a variety of physical disciplines to help relieve injuries, restore mobility, and improve physical function [ 9 ]. In health recruitment, management, treatment, and rehabilitation, the advantages of physiotherapeutic intervention have been thoroughly applied in muscle atrophy studies [ 9 , 10 ]. Several techniques can be employed in physiotherapy programs, such as the low-level laser treatment (LLLT), which was proven to be efficient in decreasing the latency of acute inflammation and enhancing tissue regeneration in muscle and tendon lesions [ 11 ].…”