scholarly journals Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

2020 ◽  
Vol 09 (04) ◽  
pp. 345-352
Author(s):  
Nicole M. Sgromolo ◽  
Jill M. Cancio ◽  
Peter C. Rhee
Keyword(s):  
Distal Radius ◽  
Operative Management ◽  
Rehabilitation Program ◽  
Distal Radius Fractures ◽  
Controlled Study ◽  
Radius Fractures ◽  
Safety And Efficacy ◽  
Rehabilitation Protocol ◽  
Flow Restriction ◽  
Randomized Controlled

Abstract Background Blood flow restriction (BFR) therapy is an emerging addition to rehabilitative programs that allows patients to increase strength at lower loads over shorter time periods. Therefore, we conducted a study to evaluate the safety and efficacy of a rehabilitation program using BFR to a traditional rehabilitation protocol following operative fixation of distal radius fractures. Methods A randomized controlled study was conducted comparing a standardized rehabilitation protocol alone to a combined protocol with the use of BFR therapy in patients treated with volar plate fixation following a displaced distal radius fracture. The same exercises done in the control group were performed by the BFR group with a restrictive tourniquet in place. Patients were followed with serial radiographs to ensure fracture stability. Outcome measures included wrist range of motion, grip strength, pinch strength, visual analog scale (VAS) pain scores at rest and during activity, patient rated wrist evaluation scores (PRWE), and disabilities of the arm, shoulder, and hand scores. Results Nine patients were randomized and enrolled within the BFR group (n = 5) and control (n = 4) groups. Patients within the BFR group had a significantly greater reduction in pain with activity over the course of the rehabilitation program. Additionally, the BFR group had a significant improvement in PRWE scores during the 8-week rehabilitation program. There was no difference in radiographic measures after initiation of BFR, and all patients tolerated therapy without noted complications. Conclusion BFR therapy is safe and well tolerated after operatively treated distal radius fractures. The addition of BFR therapy can result in quicker reduction in pain with activity and improvement in patient disability when used early following operative management of a distal radius fracture. Level of Evidence This is a Level 1, prognostic study.

Effect of illusory kinesthesia on hand function in patients with distal radius fractures: a quasi-randomized controlled study

2017 ◽  
Vol 31 (5) ◽  
pp. 696-701 ◽  
Author(s):  
Ryota Imai ◽  
Michihiro Osumi ◽  
Tomoya Ishigaki ◽  
Shu Morioka
Keyword(s):  
Distal Radius ◽  
Pain Catastrophizing ◽  
Hand Function ◽  
Distal Radius Fractures ◽  
Controlled Study ◽  
Control Group ◽  
Radius Fractures ◽  
Randomized Controlled ◽  
The Mean ◽  
Pain At Rest

Objectives: We investigated the effects of the illusion of motion through tendon vibration on hand function in patients with distal radius fractures. Setting: Kawachi General Hospital, Japan. Subjects: A total of 22 patients with distal radius fractures were divided into either an illusory kinesthesia group ( n = 11) or a control group ( n = 11). Intervention: We performed the intervention for seven consecutive days after surgery. Evaluations were performed at one day, seven days, one month, and two months postsurgery. Main measures: Data were collected on pain at rest and pain during movement. The Patient-Rated Wrist Evaluation and Pain Catastrophizing Scale were also used. Results: The illusory kinesthesia group showed significantly better scores on Patient-Rated Wrist Evaluation ( p < 0.01) compared with the control group at seven days, one month, and two months postsurgery. The mean (SD) of the Patient-Rated Wrist Evaluation total score was 97.6 (2.2) at one day postsurgery and 9.1 (5.3) at seven days postsurgery in the illusory kinesthesia group, while the Patient-Rated Wrist Evaluation total score was 96.3 (4.4) at one day postsurgery and 20.1 (17.0) at seven days postsurgery in the control group. Conclusion: Our results indicate that illusory kinesthesia is an effective postsurgery management strategy not only for pain alleviation, but also hand function in patients with distal radius fractures. Furthermore, the significant improvements persisted for up to two months after intervention in the illusory kinesthesia group, but not in the control group. In addition, patients in the kinesthetic illusions group showed increased use of the affected limb in daily living.

Predictors of Management of Distal Radius Fractures in Patients Aged >65 Years

Hand ◽  
2021 ◽  
pp. 155894472110172
Author(s):  
Amanda Walsh ◽  
Nelson Merchan ◽  
David N. Bernstein ◽  
Bailey Ingalls ◽  
Carl M. Harper ◽  
...  
Keyword(s):  
Distal Radius ◽  
Operative Management ◽  
Nonoperative Treatment ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Total N ◽  
Fracture Characteristics ◽  
Time Period ◽  
Tertiary Center ◽  
Comorbidity Index

Background Treatment of distal radius fractures (DRFs) in patients aged >65 years is controversial. The purpose of this study was to identify what patient and fracture characteristics may influence the decision to pursue surgical versus nonsurgical treatment in patients aged >65 years sustaining a DRF. Methods We queried our institutional DRF database for patients aged >65 years who presented to a single academic, tertiary center hand clinic over a 5-year period. In all, 164 patients treated operatively were identified, and 162 patients treated nonoperatively during the same time period were selected for comparison (total N = 326). Demographic variables and fracture-specific variables were recorded. Patient and fracture characteristics between the groups were compared to determine which variables were associated with each treatment modality (operative or nonoperative). Results The average age in our cohort was 72 (SD: 11) years, and 274 patients (67%) were women. The average Charlson Comorbidity Index (CCI) was 4.1 (SD: 2.1). The CCI is a validated tool that predicts 1-year mortality based on patient age and a list of 22 weighted comorbidities. Factors associated with operative treatment in our population were largely related to the severity of the injury and included increasing dorsal tilt (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.05-1.12; P < .001) and AO Classification type C fractures (OR, 5.42; 95% CI, 2.35-11.61; P < .001). Increasing CCI was the only factor independently associated with nonoperative management (OR, 0.84; 95% CI, 0.72-0.997; P = .046). Conclusion Fracture severity is a strong driver in the decision to pursue operative management in patients aged >65 years, whereas increasing CCI predicts nonoperative treatment.

scholarly journals Manual passive rehabilitation program for geriatric distal radius fractures

Medicine ◽  
2021 ◽  
Vol 100 (3) ◽  
pp. e24074
Author(s):  
Wei Zhang ◽  
Lei Wang ◽  
Xiong Zhang ◽  
Qing Zhang ◽  
Baoli Liang ◽  
...  
Keyword(s):  
Distal Radius ◽  
Rehabilitation Program ◽  
Distal Radius Fractures ◽  
Radius Fractures

Outcomes and complications of operative versus non-operative management of distal radius fractures in adults under 65 years of age

2020 ◽  
pp. 175319342094131
Author(s):  
Brent R. DeGeorge ◽  
Holly K. Van Houten ◽  
Raphael Mwangi ◽  
Lindsey R Sangaralingham ◽  
Sanjeev Kakar
Keyword(s):  
Upper Extremity ◽  
Distal Radius ◽  
Complication Rate ◽  
Operative Management ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Radius Fractures ◽  
Specific Complication ◽  
Secondary Procedures ◽  
Non Operative Management

To compare the outcomes of non-operative versus operative treatment for distal radius fractures in patients aged from 18 to 64 years, we performed a retrospective analysis using the OptumLabs® Data Warehouse using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes of distal radius fracture. Of the 34,184 distal radius fractures analysed, 11,731 (34%) underwent operative management. Short-term complications within 90 days of fracture identified an overall complication rate of 16.6 per 1000 fractures and the 1-year upper extremity-specific complication rate was 287 per 1000 fractures. Overall, post-injury stiffness was the most common 1-year upper extremity-specific complication and was associated with operative management (202.8 vs. 123.4 per 1000 fractures, operative vs. non-operative, p < 0.01). Secondary procedures were significantly more common following non-operative management (8.7% vs. 43%, operative vs. non-operative, p < 0.01) with carpal tunnel release representing the most common secondary procedure. Operative management of distal radius fractures resulted in significantly fewer secondary procedures at the expense of increased overall 1-year complication rates, specifically stiffness. Level of evidence: III

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