No Benefit of Occupational Therapy After Wrist Fracture

Surgeon-directed independent exercises superior for volar plate fixed radial fractures

THURSDAY, Oct. 13 (HealthDay News) -- For patients with an unstable distal radial fracture treated with open reduction and volar locking plate fixation, surgeon-directed independent exercises, but not those under supervision of an occupational therapist, improve average motion and disability score of the wrist, according to a study published in the Oct. 5 issue of The Journal of Bone & Joint Surgery.

J. Sebastiaan Souer, M.D., from the Massachusetts General Hospital in Boston, and colleagues investigated whether wrist function and arm-specific disability six months after open reduction and volar plate fixation of 94 unstable distal radial fractures differed in patients who received occupational therapist-supervised exercises or surgeon-directed independent exercises. Combined wrist flexion and extension were measured six months after surgery. Wrist motion, grip strength, Gartland and Werley scores, Mayo wrist scores, and Disabilities of Arm, Shoulder and Hand (DASH) scores were measured at three and six months after surgery.

The investigators found that the mean arc of wrist flexion and extension six months after surgery was significantly improved in those patients prescribed independent exercises. A significant difference was observed in mean pinch strength, grip strength, and Gartland and Werley score at three months after surgery, and in the mean results of wrist extension, ulnar deviation, supination, grip strength, and Mayo score at six months after surgery, and favored independent exercises. No differences were found in the DASH score at any time point.

"Prescription of formal occupational therapy does not improve the average motion or disability score after volar locking plate fixation of a fracture of the distal part of the radius," the authors write.

One or more of the study authors disclosed a financial relationship with the biomedical industry.

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