Short Term Outcomes Following Open Reduction Internal Fixation Surgery for a Distal Radius Fracture: 2 Week Versus 4 Week Immobilization. A Retrospective Analysis

Abstract

Study design: The study was a retrospective cohort analysis for a 41 month period; from January 2013 to May 2016. Introduction: It is suggested that patients following a distal radius fracture (DRF) achieve a comparable outcome at 3 and 6 months post surgery regardless of the time they begin mobilization. In previous studies there has been limited analysis of outcomes within the initial 3 months: functional return, time taken from work and use of therapy resources are key outcomes which have not formally been investigated in previous studies. Purpose of the study: To analyze short term outcomes of patients following open reduction internal fixation (ORIF) for a DRF. Methods: A retrospective cohort analysis was conducted to determine primarily if there is a difference in time from work, number of therapy appointments, cost of therapy materials, time to discharge from therapy and secondarily range of motion (ROM) and grip strength (GS); when measured in patients who begin mobilization prior to 2 weeks compared to those who begin mobilization at 4 or greater weeks post surgery. Results: Patients mobilized early were discharged from hand therapy significantly quicker (p = 0.033) and returned to work significantly faster (p = 0.019) than those mobilized later. Patients who began mobilization at 2 weeks or earlier post surgery had significantly greater wrist extension/flexion arc at 4 weeks (p < 0.001) and 6 weeks (p < 0.001) and rotation at 4 weeks (p < 0.001). Conclusions: Patients who begin mobilization at 2 weeks or earlier following ORIF for a DRF will lose less time from work and will be discharged sooner from hand therapy. They will additionally have increased ROM in the early post surgery phase.