Is progressive early digit mobilization intervention beneficial for patients with external fixation of distal radius fracture? A pilot randomized controlled trial.

OBJECTIVE

To investigate whether progressive early digit mobilization resulted in better outcomes for hand stiffness and related functional results, as well as the effects on the bone healing process.

DESIGN

Prospective, pilot randomized controlled trial.

SETTING

A university hospital in southern Taiwan.

PARTICIPANTS

Twenty-two patients with distal radius fracture randomized into two groups: early digit mobilization or control.

INTERVENTIONS: The intervention group received 45 minutes per treatment session and three sessions per week until the external fixator was removed 6 weeks after fracture. The control group received usual home programmes. After removing fixators, both groups received regular rehabilitation programmes until 12 weeks after surgery.

MAIN MEASURES: Hand strength, dexterity and functional outcomes were obtained using a dynamometer, Purdue pegboard and self-report assessment, respectively, and X-rays of the distal radius were taken to reveal bone healing 1, 3, 6 and 12 weeks after surgery. A motion tracking system measured various kinematic parameters.

RESULTS

The recovery rates between the groups showed statistically significant differences in both thumb workspace (81.55% vs. 69.54%, P = 0.04) and finger workspace (89.22% vs. 59.97%, P = 0.03) 12 weeks after injury. However, no statistical differences were found in finger dexterity, strength and self-reported outcomes. The radiographic assessment showed no significant differences between the groups for radial inclination, radial height and volar tilt throughout the examinations.

CONCLUSIONS

The findings suggest that early rehabilitative intervention for digits is applicable for distal radius fracture treatment, and does not produce additional bone deformities.