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DOS Kongressen 2016 ·
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Early Mobilization after Volar Plate Osteosynthesis of
Distal Radius Fractures - a Prospective Randomized
Study.
Thomas Juul Sørensen, Kecia Ardensø, Gunnar H. Laier, Susanne Kristensen Mallet
Department of Orthopedic Surgery, Zealand University Hospital; Department
of Occupational- and Physiotherapy, Zealand University Hospital; Production,
Research and Innovation, Region Zealand; Department of Orthopedic Surgery,
Zealand University Hospital
Background:
Distal radius fracture is one of the most common fractures in
people over 50. Volar locked plating has become the primary choice of treat-
ment. Little is known about the postoperative regime and the influence on out-
come and morbidity.
Purpose / Aim of Study:
To investigate if early mobilization improved patient
reported outcome and did not increase the risk of fracture displacement.
Materials and Methods:
The study was performed as a prospective, rand-
omized trial. 100 patients with distal radius fracture treated with volar locked
plating were randomized 1:1 to either removable wrist lacer with mobilization
from day one or cast for 14 days before mobilization. The primary outcome
measure was the DASH-score after 1, 3, 6 and 12 months. The score range
from 0 to 100 with 0 being the best possible score. Secondary outcome meas-
ure was fracture displacement at x-rays after 14 days. Statistical analysis was
done using a repeated measurement ANOVA model of the square root trans-
formed DASH scores. Overall difference between groups was assessed using a
maximum likelihood ratio test.
Findings / Results:
83 patients were eligible for analysis after 12 months. The
estimated median DASH score in the early mobilization group
⦋
n = 41
⦌
after 12
months was 7.46, 95% CI
⦋
4.74, 10.78
⦌
compared to 8.37
⦋
5.28, 12.17
⦌
in
the late mobilization group
⦋
n = 42
⦌
, p = 0.69. One fracture dislocation occurred
after 14 days in the early mobilization group, but can be explained by a wrong
use of the volar locking plate.
Conclusions:
The study did not find any statistical significant difference be-
tween groups though DASH scores at all follow ups were lower in the early mo-
bilization group. Early mobilization with removable wrist lacer is a safe and equal
postoperative treatment compared to regular casting.
No conflicts of interest reported
92.