Mobilisation with movement after distal radius fracture

...does it improve outcomes when added to usual care?

Distal radius fractures are the most common fracture seen in emergency departments. They are predicted to increase over the coming decades. Medical management is usually conservative casting, which immobilises the wrist in a flexed, pronated, and ulnar deviated position, for up to six weeks often resulting in wrist pain and stiffness especially into supination and extension.

There is limited evidence that joint mobilisation after removal of the cast can improve outcomes. One drawback of joint mobilisations is that they rely on a trained clinician to deliver them. 'Mobilisation with movement' (MWM) is a manual therapy technique that can be self-applied, thereby engaging the patient in recovering wrist and hand function.

This suggests that patients with a distal radius fracture would likely be in roughly the same spot a year later whether they do MWM or not. However, in the interim they would experience at least 3 months of less severe symptoms and enjoy greater arm function if they do undertake MWM.

Based on this study, the authors recommend that patients would benefit from a MWM intervention in addition to range of motion exercises and advice in the management of distal radius fractures.

> From: Reid et al., J Physiother 66 (2020) (Epub ahead of print). All rights reserved to Australian Physiotherapy Association. Click here for the online summary.

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