Comparison of Early Rehabilitation (2 Weeks) of Distal Radius Fracture versus Late Rehabilitation (6 Weeks) in Patients Treated with Percutaneous Pinning: A prospective Randomized Study

Abstract

Background & Aims: Distal radius is the most common site of fracture in the upper extremity. To assess the clinical controversy of the duration of the immobilization period, we conducted a prospective study. The aim of this study was to compare early rehabilitation (two weeks of short-arm cast immobilization) versus the mean regular period of immobilization of 6 weeks in patients with distal radius fractures (DRF). We hypothesize that 2 weeks of immobilization lead to better or same patient-reported outcomes compared with 6 weeks of immobilization and that this treatment does not lead to more complications. Materials & Method: In this prospective study, 84 patients with an isolated DRF were treated by reduction and percutaneous fixation. 43 patients were randomly assigned to the 2-week group and 41 patients were randomly assigned to the 6-week group. The types of fractures were the same in both groups. At 6 weeks and 12 weeks after surgery, Disability of the arm, shoulder and hand (DASH) questionnaire, patient-rated wrist evaluation (PRWE), and Mayo score were analyzed. Results: The 2-week group had significantly higher Mayo scores at 6 weeks. According to Mayo score questionnaire, the 2-week group reported significantly less pain and more functional outcome than the control group at the 6-week follow-up and no significant differences in grip strength and range of motion scores were found at 6 weeks. Although patients who were treated with 2 weeks of cast immobilization showed better results based on PRWE score and DASH score, the difference between the groups was not statistically significant. There were no significant differences between groups at 12-week follow-up based on the PRWE, DASH, and Mayo score. Conclusions: There is no difference between short-term immobility and long-term immobility. However, in the rapid onset of active movements, better results are seen in short-term evaluations. As a result, it can be said that performing active movements early in patients with DRF can be safe, as long as these movements do not cause complications and treatment failure.