Treatment of wrist stiffness through posture orthosis and active exercise: A case report
Introduction: Wrist fractures, particularly the distal radius, can result in significant stiffness and hand dysfunction if not mobilized early. The variable immobilization period post-fracture depends on fracture type, location, stability, and surgical intervention. Inadequate early mobilization typ...
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| Language: | English |
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Elsevier
2024-10-01
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| Series: | Trauma Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644024000918 |
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| author | Paolo Boccolari Mario Lando Lucia Zingarello Leonardo Monzani Vecchi Roberto Tedeschi Danilo Donati |
| author_facet | Paolo Boccolari Mario Lando Lucia Zingarello Leonardo Monzani Vecchi Roberto Tedeschi Danilo Donati |
| author_sort | Paolo Boccolari |
| collection | DOAJ |
| description | Introduction: Wrist fractures, particularly the distal radius, can result in significant stiffness and hand dysfunction if not mobilized early. The variable immobilization period post-fracture depends on fracture type, location, stability, and surgical intervention. Inadequate early mobilization typically leads to structured stiffness, influenced by patient health, injury mechanism, joint surface involvement, associated tissue injuries, and patient motivation. Case presentation: A 64-year-old female in good health suffered a distal radius fracture, treated with open reduction and internal fixation. A modified treatment plan, including custom orthosis and active wrist exercises, was initiated after the standard immobilization phase to enhance the range of motion while accommodating the patient's daily activities. Clinical discussion: The patient underwent 15 evaluations of active range of motion (AROM) using a goniometer, guided by the American Society of Hand Therapists. A Tissue Composition Analysis (TCA) was performed to guide the orthosis-treatment choice. Despite consistent improvement shown in AROM, it was inconclusive whether the modified treatment contributed significantly beyond the standard approach. Conclusions: While the patient's AROM improved, the treatment's effect on this single case cannot definitively confirm the efficacy of the modified approach. A more extensive study is necessary to evaluate the conservative treatment strategy's validity for such fractures in high-demand patients, considering the biomechanical complexity of the injury and the patient's professional needs. |
| format | Article |
| id | doaj-art-6482007d86954ccf8dc7b6d3442f2d02 |
| institution | OA Journals |
| issn | 2352-6440 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj-art-6482007d86954ccf8dc7b6d3442f2d022025-08-20T02:31:44ZengElsevierTrauma Case Reports2352-64402024-10-015310106810.1016/j.tcr.2024.101068Treatment of wrist stiffness through posture orthosis and active exercise: A case reportPaolo Boccolari0Mario Lando1Lucia Zingarello2Leonardo Monzani Vecchi3Roberto Tedeschi4Danilo Donati5University of Modena and Reggio Emilia, Largo del Pozzo 71, 41124 Modena, ItalyDepartment of Hand surgery and Microsurgery, University Hospital of Modena, Modena, ItalyDepartment of Hand surgery and Microsurgery, University Hospital of Modena, Modena, ItalyDepartment of Hand surgery and Microsurgery, University Hospital of Modena, Modena, ItalyDepartment of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy; Corresponding author at: Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Via Zamboni 33, 40126 Bologna, Italy.Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena, Italy; Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyIntroduction: Wrist fractures, particularly the distal radius, can result in significant stiffness and hand dysfunction if not mobilized early. The variable immobilization period post-fracture depends on fracture type, location, stability, and surgical intervention. Inadequate early mobilization typically leads to structured stiffness, influenced by patient health, injury mechanism, joint surface involvement, associated tissue injuries, and patient motivation. Case presentation: A 64-year-old female in good health suffered a distal radius fracture, treated with open reduction and internal fixation. A modified treatment plan, including custom orthosis and active wrist exercises, was initiated after the standard immobilization phase to enhance the range of motion while accommodating the patient's daily activities. Clinical discussion: The patient underwent 15 evaluations of active range of motion (AROM) using a goniometer, guided by the American Society of Hand Therapists. A Tissue Composition Analysis (TCA) was performed to guide the orthosis-treatment choice. Despite consistent improvement shown in AROM, it was inconclusive whether the modified treatment contributed significantly beyond the standard approach. Conclusions: While the patient's AROM improved, the treatment's effect on this single case cannot definitively confirm the efficacy of the modified approach. A more extensive study is necessary to evaluate the conservative treatment strategy's validity for such fractures in high-demand patients, considering the biomechanical complexity of the injury and the patient's professional needs.http://www.sciencedirect.com/science/article/pii/S2352644024000918Distal radius fractureWrist stiffnessConservative treatmentActive mobilizationRehabilitation |
| spellingShingle | Paolo Boccolari Mario Lando Lucia Zingarello Leonardo Monzani Vecchi Roberto Tedeschi Danilo Donati Treatment of wrist stiffness through posture orthosis and active exercise: A case report Trauma Case Reports Distal radius fracture Wrist stiffness Conservative treatment Active mobilization Rehabilitation |
| title | Treatment of wrist stiffness through posture orthosis and active exercise: A case report |
| title_full | Treatment of wrist stiffness through posture orthosis and active exercise: A case report |
| title_fullStr | Treatment of wrist stiffness through posture orthosis and active exercise: A case report |
| title_full_unstemmed | Treatment of wrist stiffness through posture orthosis and active exercise: A case report |
| title_short | Treatment of wrist stiffness through posture orthosis and active exercise: A case report |
| title_sort | treatment of wrist stiffness through posture orthosis and active exercise a case report |
| topic | Distal radius fracture Wrist stiffness Conservative treatment Active mobilization Rehabilitation |
| url | http://www.sciencedirect.com/science/article/pii/S2352644024000918 |
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