Portal de Periódicos da CAPES

Physiotherapy After Volar Plating of Wrist Fractures Is Effective Using a Home Exercise Program

2009; Elsevier BV; Volume: 90; Issue: 4 Linguagem: Inglês

10.1016/j.apmr.2008.09.575

1532-821X

Gert Krischak, Anna Krasteva, Florian Schneider, Daniel Gulkin, Florian Gebhard, Michael D. Kramer,

Medical Malpractice and Liability Issues

Krischak GD, Krasteva A, Schneider F, Gulkin D, Gebhard F, Kramer M. Physiotherapy after volar plating of wrist fractures is effective using a home exercise program. Objective To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures: treatment by a physical therapist with 12 sessions and an unassisted home exercise program. Design Randomized controlled cohort study. Setting Hospital-based care, primary center of orthopedic surgery. Participants Volunteers (N=48) with fractures of the distal radius after internal fixation with locking plates. There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol. Interventions Not applicable. Main Outcome Measures Evaluation of grip strength using a Jamar dynamometer, range of motion (ROM), and Patient Related Wrist Evaluation (PRWE). Results After a 6-week period of postoperative treatment, the patients (n=23) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist. Grip strength reached 54% (P=.003), and ROM in extension and flexion 79% (P<.001) of the uninjured side. Ulnar and radial abduction was also higher in this group. In contrast, patients who were treated by a physical therapist achieved grip strength equal to 32%, and ROM in extension and flexion of 52% of the uninjured side. Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50% lower value (P<.001) in the PRWE score. Conclusions In the postoperative rehabilitation of wrist fractures, instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment.