BACKGROUND: Plate fixation of the distal part of the radius is believed to improve wrist motion by allowing earlier exercises. We performed a clinical trial comparing mobilization of the wrist joint within two weeks (early motion) or at six weeks (late motion) after volar plate fixation of a fracture of the distal part of the radius in order to test the null hypothesis that there are no differences in the flexion-extension arc three and six months after surgery. METHODS:Sixty patients with an isolated fracture of the distal part of the radius that was treated with a single, fixed-angle volar plate and screws were enrolled. Thirty patients were randomized to the early motion group, and thirty were randomized to the late motion group. Three and six months after surgery, patients underwent range of motion measurements, grip strength measurements, and radiographic evaluation. The patients also were evaluated according to the modified Gartland and Werley score and the Mayo wrist score, rated pain on a 10-point ordinal scale, and completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. RESULTS: There were no significant differences between the early motion group and the late motion group with regard to the average flexion-extension arc of the injured wrist at three months (104 degrees compared with 107 degrees; p = 0.61) or six months (124 degrees compared with 126 degrees; p = 0.65) after surgery. In secondary analyses, there were no significant differences in terms of selected other motions, grip strength, radiographic parameters, or the Gartland and Werley, Mayo, pain, or DASH scores. CONCLUSIONS: The initiation of wrist exercises six weeks after volar plate fixation of a fracture of the distal part of the radius does not lead to decreased wrist motion compared with the initiation of wrist motion within two weeks after surgery.
RCT Entities:
BACKGROUND: Plate fixation of the distal part of the radius is believed to improve wrist motion by allowing earlier exercises. We performed a clinical trial comparing mobilization of the wrist joint within two weeks (early motion) or at six weeks (late motion) after volar plate fixation of a fracture of the distal part of the radius in order to test the null hypothesis that there are no differences in the flexion-extension arc three and six months after surgery. METHODS: Sixty patients with an isolated fracture of the distal part of the radius that was treated with a single, fixed-angle volar plate and screws were enrolled. Thirty patients were randomized to the early motion group, and thirty were randomized to the late motion group. Three and six months after surgery, patients underwent range of motion measurements, grip strength measurements, and radiographic evaluation. The patients also were evaluated according to the modified Gartland and Werley score and the Mayo wrist score, rated pain on a 10-point ordinal scale, and completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. RESULTS: There were no significant differences between the early motion group and the late motion group with regard to the average flexion-extension arc of the injured wrist at three months (104 degrees compared with 107 degrees; p = 0.61) or six months (124 degrees compared with 126 degrees; p = 0.65) after surgery. In secondary analyses, there were no significant differences in terms of selected other motions, grip strength, radiographic parameters, or the Gartland and Werley, Mayo, pain, or DASH scores. CONCLUSIONS: The initiation of wrist exercises six weeks after volar plate fixation of a fracture of the distal part of the radius does not lead to decreased wrist motion compared with the initiation of wrist motion within two weeks after surgery.
Authors: Stefan Quadlbauer; Christoph Pezzei; Josef Jurkowitsch; Brigitta Kolmayr; Tina Keuchel; Daniel Simon; Thomas Hausner; Martin Leixnering Journal: J Wrist Surg Date: 2016-08-05
Authors: André Duprat; Juan José Hidalgo Diaz; Paul Vernet; Stéphanie Gouzou; Sybille Facca; Yuka Igeta; Philippe Liverneaux Journal: J Wrist Surg Date: 2018-01-16
Authors: Ara A Salibian; Karl C Bruckman; Jonathan M Bekisz; Joshua Mirrer; Vishal D Thanik; Jacques H Hacquebord Journal: J Wrist Surg Date: 2018-11-16
Authors: Robert J MacFarlane; David Miller; Lynn Wilson; Carl Meyer; Cronan Kerin; David James Ford; Graham Cheung Journal: J Hand Microsurg Date: 2015-01-27