Physiotherapy and Physical Therapy in Comprehensive Treatment of Patients with Fractures of the Distal Radius Metaepiphysis

A.K. Rushay, F.V. Klimovitskiy, S.V. Lisunov, E.A. Solonitsin

Abstract


Background. Fracture of the distal radius metaepiphysis (fracture of the radius in a typical place) is not uncommon, especially in the elderly [2, 4]. Among all fractures, they comprise from 11 to 30 % [6, 7]. In this group of victims, there is a high proportion of postmenopausal women with decreased bone mineral density [8, 9]. Unsatisfactory results of treatment in patients over 70 years are found in 44 % of cases [6, 8]. Timely and adequate medical rehabilitation is extremely important to get good results in the treatment of patients with fractures of the distal radius metaepiphysis. The major complications in these patients are contractures and neurodystrophic syndrome of varying severity. The aim was to improve treatment outcomes in patients with fractures of the distal radius metaepiphysis based on early physiotherapy and rehabilitation treatment. Materials and methods. We observed 63 patients with fractures of the distal radius metaepiphysis. Most of them were females (43 (68.3 %)). Age of the victims was more than 55 years in 38 cases (60.4 %). In this group of patients, Colles fractures were diagnosed in 49 cases, Smith — in 14 (77.8 and 22.2 %, respectively). Exercises for the injured arm were about 25 %, with the beginning in isometric and isotonic mode, passive and active exercises for fingers. Physiotherapy was conducted separately for the first finger — its abduction together with extension of fingers 1–4, flexion in the metacarpophalangeal and interphalangeal joints. Attention was drawn to the state of the fixing bandage in this area — a hole in the splint should be sufficient, the edges — do not traumatize the skin. After removing the fixing bandage, gymnastics was performed by 2nd (postimmobilization) period. Its features were the change in the proportion of conditioning exercises up to 25 %, 75 % were special exercises for the injured arm. The objectives of therapeutic physical training were as follows: recovery of the affected arm function; elimination of muscle atrophy, stiffness in the joints. Results. After the restorative treatment, a pain in 52 (82.5 %) of patients was assessed as minor and tolerable (2.40 ± 0.24 points). In a survey of patients using DASH scale, function of the affected arm was identified as satisfactory (33.20 ± 0.41 points) in 52 (82.5 %) patients, sufficient for self-service, without strenuous exercise.


Keywords


multimodal analgesia; physiotherapy; fracture of the distal radius metaepiphysis

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DOI: https://doi.org/10.22141/1608-1706.6.17.2016.88624

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