Rehabilitation for distal radial fractures in adults

Hdl Handle:
http://hdl.handle.net/10149/58214
Title:
Rehabilitation for distal radial fractures in adults
Authors:
Handoll, H. H. G. (Helen); Madhok, R. (Rajan); Howe, T. E. (Tracey)
Affiliation:
University of Teesside. Research Institute for Health Sciences and Social Care. Centre for Rehabilitation Sciences (CRS); University of Manchester. Cochrane Bone, Joint and Muscle Trauma Group; Glasgow Caledonian University. HealthQWest.
Citation:
Handoll, H. H. G., Madhok, R. and Howe, T. E. (2006) 'Rehabilitation for distal radial fractures in adults', Cochrane Database of Systematic Reviews, 3, pp.1-63.
Publisher:
Wiley-Blackwell
Journal:
Cochrane Database of Systematic Reviews
Issue Date:
Jul-2006
URI:
http://hdl.handle.net/10149/58214
DOI:
10.1002/14651858.CD003324.pub2
Abstract:
Background: Fracture of the distal radius is a common clinical problem, particularly in older white women with osteoporosis. Objectives: To examine the effects of rehabilitation interventions in adults with conservatively or surgically treated distal radial fractures. Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2005), MEDLINE, EMBASE, CINAHL, AMED, PEDro, OTseeker and other databases, conference proceedings and reference lists of articles. No language restrictions were applied. Selection criteria: Randomised or quasi-randomised controlled trials evaluating rehabilitation as part of the management of fractures of the distal radius sustained by adults. Rehabilitation interventions such as active and passive mobilisation exercises, and training for activities of daily living, could be used on their own or in combination, and be applied in various ways by various clinicians. Data collection and analysis: The authors independently selected and reviewed trials. Study authors were contacted for additional information. No data pooling was done. Main results: Fifteen trials, involving 746 mainly female and older patients, were included. Initial treatment was conservative, involving plaster cast immobilisation, in all but 27 participants whose fractures were fixed surgically. Though some trials were well conducted, others were methodologically compromised. For interventions started during immobilisation, there was weak evidence of improved hand function for hand therapy in the days after plaster cast removal, with some beneficial effects continuing one month later (one trial). There was weak evidence of improved hand function in the short term, but not in the longer term (three months), for early occupational therapy (one trial), and of a lack of differences in outcome between supervised and unsupervised exercises (one trial). For interventions started post-immobilisation, there was weak evidence of a lack of clinically significant differences in outcome in patients receiving formal rehabilitation therapy (four trials), passive mobilisation (two trials), ice or pulsed electromagnetic field (one trial), or whirlpool immersion (one trial) compared with no intervention. There was weak evidence of a short-term benefit of continuous passive motion (post external fixation) (one trial), intermittent pneumatic compression (one trial) and ultrasound (one trial). There was weak evidence of better short-term hand function in participants given physiotherapy than in those given instructions for home exercises by a surgeon (one trial). Authors' conclusions: The available evidence from randomised controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius.
Type:
Article
Keywords:
rehabilitation; distal radial; fractures; adults; mobilisation
ISSN:
1469-493X
Rights:
In return for the grant of the licence, the author(s) shall have the following rights: The right to post the review as an electronic file on the author's own website and/or the author's institution's website, using the PDF version of the review available in the Cochrane Database of Systematic Reviews. [Advice from CEO of The Cochrane Collaboration]
Citation Count:
5 [Scopus, 13/01/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorHandoll, H. H. G. (Helen)-
dc.contributor.authorMadhok, R. (Rajan)-
dc.contributor.authorHowe, T. E. (Tracey)-
dc.date.accessioned2009-04-01T10:46:09Z-
dc.date.available2009-04-01T10:46:09Z-
dc.date.issued2006-07-
dc.identifier.citationCochrane Database of Systematic Reviews; 3: 1-63-
dc.identifier.issn1469-493X-
dc.identifier.doi10.1002/14651858.CD003324.pub2-
dc.identifier.urihttp://hdl.handle.net/10149/58214-
dc.description.abstractBackground: Fracture of the distal radius is a common clinical problem, particularly in older white women with osteoporosis. Objectives: To examine the effects of rehabilitation interventions in adults with conservatively or surgically treated distal radial fractures. Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2005), MEDLINE, EMBASE, CINAHL, AMED, PEDro, OTseeker and other databases, conference proceedings and reference lists of articles. No language restrictions were applied. Selection criteria: Randomised or quasi-randomised controlled trials evaluating rehabilitation as part of the management of fractures of the distal radius sustained by adults. Rehabilitation interventions such as active and passive mobilisation exercises, and training for activities of daily living, could be used on their own or in combination, and be applied in various ways by various clinicians. Data collection and analysis: The authors independently selected and reviewed trials. Study authors were contacted for additional information. No data pooling was done. Main results: Fifteen trials, involving 746 mainly female and older patients, were included. Initial treatment was conservative, involving plaster cast immobilisation, in all but 27 participants whose fractures were fixed surgically. Though some trials were well conducted, others were methodologically compromised. For interventions started during immobilisation, there was weak evidence of improved hand function for hand therapy in the days after plaster cast removal, with some beneficial effects continuing one month later (one trial). There was weak evidence of improved hand function in the short term, but not in the longer term (three months), for early occupational therapy (one trial), and of a lack of differences in outcome between supervised and unsupervised exercises (one trial). For interventions started post-immobilisation, there was weak evidence of a lack of clinically significant differences in outcome in patients receiving formal rehabilitation therapy (four trials), passive mobilisation (two trials), ice or pulsed electromagnetic field (one trial), or whirlpool immersion (one trial) compared with no intervention. There was weak evidence of a short-term benefit of continuous passive motion (post external fixation) (one trial), intermittent pneumatic compression (one trial) and ultrasound (one trial). There was weak evidence of better short-term hand function in participants given physiotherapy than in those given instructions for home exercises by a surgeon (one trial). Authors' conclusions: The available evidence from randomised controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius.-
dc.publisherWiley-Blackwell-
dc.rightsIn return for the grant of the licence, the author(s) shall have the following rights: The right to post the review as an electronic file on the author's own website and/or the author's institution's website, using the PDF version of the review available in the Cochrane Database of Systematic Reviews. [Advice from CEO of The Cochrane Collaboration]-
dc.subjectrehabilitation-
dc.subjectdistal radial-
dc.subjectfractures-
dc.subjectadults-
dc.subjectmobilisation-
dc.titleRehabilitation for distal radial fractures in adults-
dc.typeArticle-
dc.contributor.departmentUniversity of Teesside. Research Institute for Health Sciences and Social Care. Centre for Rehabilitation Sciences (CRS); University of Manchester. Cochrane Bone, Joint and Muscle Trauma Group; Glasgow Caledonian University. HealthQWest.-
dc.identifier.journalCochrane Database of Systematic Reviews-
ref.assessmentRAE 2008-
ref.citationcount5 [Scopus, 13/01/2010]-
or.citation.harvardHandoll, H. H. G., Madhok, R. and Howe, T. E. (2006) 'Rehabilitation for distal radial fractures in adults', Cochrane Database of Systematic Reviews, 3, pp.1-63.-
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