Rehabilitation for distal radial fractures in adults

Handoll, Helen; Elliott, Joanne

doi:10.1002/14651858.cd003324.pub3

Cited by 55 publications

(58 citation statements)

References 74 publications

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“…Numerous clinical studies are demonstrating the role of hand therapy and how hand therapy impacts patients with DRFs in the short-term [5,14]. However, there is no treatment guideline that is universally agreed upon [15].…”

Section: Discussionmentioning

confidence: 99%

Defining Outcomes Following Distal Radius Fractures: Correlation of Function, Pain, and Hand Therapy Utilization

Ahmed

Cinotto

Boczar

et al. 2020

Cureus

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Background Distal radius fractures (DRF) is one of the most common fractures in clinical practice. Our objective was to study the role of early hand therapy and its impact on pain and return to daily activities. Methods The charts of patients with DRFs seen between January 2016 and November 2017 in the Hand Center of Mayo Clinic Florida were reviewed retrospectively. Forty-nine patients with DRFs who met inclusion criteria were included in the analysis. The variables collected included: age, gender, side of the fracture, surgery vs non-surgery, time to start hand therapy, number of visits, shortened disabilities of the arm, shoulder, and hand (QuickDASH) initial and discharge scores, and visual analog scale (VAS) initial and discharge. Results The patients' mean age was 67.90 years, (standard deviation (SD) 14.54), 38 (77.6%) were female, 28 (57.1%) had a right DRF, 21 (42.9%) had a left DRF, 38 (77.6%) had no surgery, 11 (22.4%) had surgery. The mean time from fracture to therapy is 32.41, (SD 24.13) days, and the mean total number of visits is 6.20 (SD 3.49). We noticed a statistically significant difference between the initial QuickDASH (59.27, SD 16.93) compared to the discharge QuickDASH (24.08, SD 12.77) (P-value <.001); and initial VAS (3.57, SD 1.71) with a discharge VAS (1.33, SD 0.97) (P-value <.001). Conclusion This retrospective study found a statistically significant reduction in the QuickDASH and VAS scores after six hand therapy visits. The results suggest that early rehabilitation interventions lead to improvements in pain and return to daily activity following DRF.

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Section: Discussionmentioning

confidence: 99%

Defining Outcomes Following Distal Radius Fractures: Correlation of Function, Pain, and Hand Therapy Utilization

Ahmed

Cinotto

Boczar

et al. 2020

Cureus

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“…Jupiter et al 19 and Zhang et al 20 state that early mobility allowed by volar locking plates would be a critical factor for significant clinical improvement. However, Handoll et al, 21 in a systematic Cochrane review, concluded that evidence from randomized trials on rehabilitation of adult distal radius fractures is insufficient to establish the effectiveness between immobilization time and different postoperative interventions. Handoll et al 21 also suggest that large centers should identify priority issues for patient rehabilitation to improve scientific evidence quality.…”

Section: Discussionmentioning

confidence: 99%

“…Jupiter et al 19 e Zhang et al 20 discutem que a mobilidade precoce que a placa de bloqueio volar permite seria um dos principais fatores para uma melhora clínica significativa. Contudo, Handoll et al, 21 em revisão sistemática pelo banco de dados Cochrane, concluiu que a evidência dos estudos randomizados em reabilitação de fraturas do rádio distal em adultos é insuficiente para estabelecer a efetividade entre o tempo de imobilização e as diferentes intervenções no pós-operatório. Handoll et al 21 sugerem, ainda, que os grandes centros devem identificar questões prioritárias na reabilitação dos pacientes para melhorar a qualidade da evidência científica produzida.…”

Section: Discussionunclassified

Avaliação radiográfica dos pacientes submetidos a fixação percutânea com parafuso maciço para tratamento de fraturas da extremidade distal do radio

Gaibor

Thomaz

Borges

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Apresentar o resultado das avaliações radiográficas dos pacientes com fraturas extra-articulares do rádio distal submetidos a fixação percutânea com parafuso maciço de 3.5mm. Métodos Série de casos, analítica, descritiva e retrospectiva de 16 pacientes com avaliação dos parâmetros radiográficos da técnica utilizada. Resultados A média de idade da população estudada foi de 46,5 anos (25–60 anos), sendo 81,25% do sexo feminino. O tempo de espera até a cirurgia foi de 8,8 dias (4–14 dias). O tilt volar médio pré-procedimento foi - 7,41° (−23,48°–5,29°, desvio padrão [DP] ± 6,59°). O tilt volar imediatamente após o procedimento cirúrgico foi de 5,93° (DP ± 6,23°, p < 0,001). Sem diferença estatística nos valores de tilt volar ao final de 6 meses de evolução. A altura radial pré-procedimento foi de 4,13 mm (−7,8°–9,5°, DP ± 5,06°). Aumento estatisticamente significativo no pós-operatório imediato para 10,04 mm (p = 0,002). Redução significativa ao final de 6 meses para 9,55 mm (p = 0,012). Atingimos 100% de consolidação com a técnica utilizada, com índice mínimo de complicações. Nenhum paciente apresentou infecção ou precisou ser reoperado. Conclusão A técnica mostrou-se eficaz para o tratamento de fraturas extra-articulares da extremidade distal do rádio ao final de 6 meses, com baixo índice de complicações e parâmetros radiográficos aceitáveis e próximos dos valores anatômicos.

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“…Microdamage accumulates in bone in response to repeated, cyclic loading, also referred to as fatigue loading, and provides a powerful trigger for endogenous healing activity (Tami et al, 2003). While both PEMF and ESWT therapies show promise for the potentiation of endogenous healing mechanisms, controlled clinical trials are needed to test the efficacy and optimal dosing regimens for such treatments (Elsisi et al, 2015; Handoll et al, 2015; Hannemann et al, 2015; Rosso et al, 2015; Reilingh et al, 2016). …”

Section: Mechanotherapy Driven Mechanoadaptation At the Systemic Lengmentioning

confidence: 99%

Establishing the Basis for Mechanobiology-Based Physical Therapy Protocols to Potentiate Cellular Healing and Tissue Regeneration

Kersh

Kilbreath

et al. 2017

Front. Physiol.

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Life is mechanobiological: mechanical stimuli play a pivotal role in the formation of structurally and functionally appropriate body templates through mechanobiologically-driven cellular and tissue re/modeling. The body responds to mechanical stimuli engendered through physical movement in an integrated fashion, internalizing and transferring forces from organ, through tissue and cellular length scales. In the context of rehabilitation and therapeutic outcomes, such mechanical stimuli are referred to as mechanotherapy. Physical therapists use mechanotherapy and mechanical interventions, e.g., exercise therapy and manual mobilizations, to restore function and treat disease and/or injury. While the effect of directed movement, such as in physical therapy, is well documented at the length scale of the body and its organs, a number of recent studies implicate its integral effect in modulating cellular behavior and subsequent tissue adaptation. Yet the link between movement biomechanics, physical therapy, and subsequent cellular and tissue mechanoadaptation is not well established in the literature. Here we review mechanoadaptation in the context of physical therapy, from organ to cell scale mechanotransduction and cell to organ scale extracellular matrix genesis and re/modeling. We suggest that physical therapy can be developed to harness the mechanosensitivity of cells and tissues, enabling prescriptive definition of physical and mechanical interventions to enhance tissue genesis, healing, and rehabilitation.

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Rehabilitation for distal radial fractures in adults

Cited by 55 publications

References 74 publications

Defining Outcomes Following Distal Radius Fractures: Correlation of Function, Pain, and Hand Therapy Utilization

Defining Outcomes Following Distal Radius Fractures: Correlation of Function, Pain, and Hand Therapy Utilization

Avaliação radiográfica dos pacientes submetidos a fixação percutânea com parafuso maciço para tratamento de fraturas da extremidade distal do radio

Establishing the Basis for Mechanobiology-Based Physical Therapy Protocols to Potentiate Cellular Healing and Tissue Regeneration

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