Lower arm bone fractures are fairly common and are often the result of falling. When the radius, one of the forearm bones, is badly fractured it is often repaired by inserting a plate with screws to hold all of the bone fragments together. Following the surgery the wrist is placed in a cast for two weeks and strengthening and moving the wrist is not allowed until six to eight weeks after the surgery. However, this protocol for restoring a person’s normal wrist function has now been called into question with the results of a recent research study.
Authors of this study wondered whether or not it was necessary to place a wrist in the cast for two weeks and hold off on strengthening for so long or if it would lead to faster healing to start the wrist motion and strengthening immediately after surgery. They took 81 people who under went the same surgery (open reduction and internal fixation with a volar fixed-angle plate) and divided them into two groups. The first group consisted of 42 people who underwent the standard rehabilitation protocol following the surgery of waiting for two weeks before moving the wrist and another six weeks before beginning strengthening. The second group was made up of 36 people and underwent an accelerated rehabilitation program which involved beginning gentle passive motion of the wrist and forearm three to five days after surgery with gentle strengthening and active motion beginning at the two week mark. The standard protocol involved all of the same activities of the accelerated four weeks after the accelerated program.
The authors followed the patient’s recovery for six months after their surgeries. Results showed that the patients who underwent the accelerated rehabilitation program fared better initially, having less pain and an ability to do more than those undergoing the typical rehabilitation protocol. At the six month follow up there was not much of a difference. Authors concluded that for a quicker return to normal function, it is recommended to use an accelerated protocol for rehabilitation following a radial head fracture surgery that involves movement immediately after surgery and starts strengthening two weeks after surgery.