Early rehabilitation of distal radius fractures with robotic orthosis. Case Report
DOI:
https://doi.org/10.1016/j.rccot.2021.04.007Keywords:
radius fractures, exoskeleton, robotic orthosisAbstract
Background: Robotic exoskeletons are a new alternative to complement the functional rehabilitation processes of the wrist, facilitating early passive mobilization therapy after local traumatic events, with the purpose of maintaining or restoring joint range of motion while the tissues heal. The aim of the study is to present the results of early mobilization therapy in a passive robotic wrist orthosis.
Methods: Four patients with distal radius fractures were selected, treated surgically with open reduction and internal fixation of distal radius fracture with volar plate locking system. Conventional physiotherapy and early mobilization with the PRO-Wix robotic orthosis was performed. Clinical monitoring of functionality (DASH scale), pain (VAS scale), joint mobility arches (goniometer), adherence and potential adverse events were carried out.
Results: all patients returned to their daily living activities after three weeks of rehabilitation. Recovery of normal wrist joint range of motion was achieved; decreased in pain intensity, functional recovery, adequate adherence to rehabilitation protocol and adverse events were also recorded.
Discussion: preserving the joint anatomy as much as possible in specialized surgical intervention is the basis for starting early rehabilitation, and allowing the patient to tolerate passive mobilization with robotic orthoses. Further studies including a wide number of patients have to be conducted.
Evidence Level: IV
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References
Havemann D, Busse FW. Accident mechanisms and classifications in distal radius fractures. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:639-42.
Wolfe SW. Chapter 15 Distal Radius Fractures. Green's Operative Hand Surgery. 2017;2-VolumeSet, 7th Edition.
Nellans KW, Kowalski E, Chung KC. The Epidemiology of Distal Radius Fractures. Hand Clinics. 2012;28:113-25. https://doi.org/10.1016/j.hcl.2012.02.001
Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg [Am]. 2001;26:908-15. https://doi.org/10.1053/jhsu.2001.26322
Liporace FA, Adams MR, Capo JT. Distal Radius Fractures. MD J Orthop Trauma. 2009;23:739-48. https://doi.org/10.1097/BOT.0b013e3181ba46d3
de Putter CE, Selles RW, Polinder S, et al. Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. J Bone Joint Surg Am. 2012;94:e56, https://doi.org/10.2106/JBJS.K.00561
Cherubino P, Bini A, Marcolli D. Management of distal radius fractures: Treatment protocol and functional results. International Journal of the Care of the Injury. 2010;41:1120-6. AlbaladejoF,MoraG,Chavarria-HerreraJ,Sánchez-Garre.Fracturas de la extremidad distal del radio Enfoque actualizado. Revista de Fisioterapia. 2004;26:78-97. https://doi.org/10.1016/S0211-5638(04)73087-4
Zenke Y, Sakai A, Oshige T, Moritani S, Fuse Y, Maehara T, Nakamura T. Clinical Results of Volar Locking Plate for Distal Radius Fractures: Conventional versus Minimally Invasive Plate Osteosynthesis. Orthop Trauma. 2011;25:425-31, https://doi.org/10.1097/BOT.0b013e3182008c83
Chen AC, Chou YC, Cheng CY. Distal radius fractures: Minimally invasive plate osteosynthesis with dorsal bicolumnar locking plates fixation. Indian J Orthop. 2017;51:93-8, https://doi.org/10.4103/0019-5413.197555
McKay SD, MacDermid JC, Roth JH, Richards RS. Assessment of Complications of Distal Radius Fractures and Development of a Complication Checklist. J Hand Surg Am. 2001;26:916-22, https://doi.org/10.1053/jhsu.2001.26662
Mathews AL, Chung KC. Management of Complications of Distal Radius Fractures Hand Clinic. Hand Clin. 2015;31:205-15, https://doi.org/10.1016/j.hcl.2014.12.002
Gil-Henao A, Moreno-Arango JD, Gómez-Rendón JF, Becerra-Velasquez J, Orozco-Tellez CH. Rehabilitación temprana de fracturas de mano con órtesis robóticas. Rev Col Or Trau. 2018;32:184-90, https://doi.org/10.1016/j.rccot.2017.11.004
Magnus CR, Arnold CM, Johnston G, Dal-Bello Haas V, Basran J, Krentz JR, Farthing JP. Cross-education for improving strength and mobility after distal radius fractures: a randomized controlled trial. Arch Phys Med Rehabil. 2013;94:1247-55, https://doi.org/10.1016/j.apmr.2013.03.005
Souza da Luz L 1, Maisonnave Raffone A, Kaempf de Oliveira R, Delgado Serrano PJ. Evaluación de la fisioterapia precoz en las fracturas de la extremidad distal del radio tratadas mediante placa volar de ángulo fijo. Trauma Fund MAPFRE. 2008;20(n1),
Hayes, Inc. Medical Technology Directory. Continuous Passive Motion (CPM) Following the Micro fracture Procedure. Hayes Inc.: Lansdale, PA: June 14, 2011a.
Hayes, Inc. Medical Technology Directory. Mechanical Stretching Devices for the Treatment of Joint Contractures of the Extremities. Hayes Inc.: Lansdale, PA: August 8, 2011b.
Moreno Juan A, Moreno Julian A. Robots para rehabilitación y asistencia de mano y mun ̃eca. IX Congreso Iberoamericano de Tecnologías de Apoyo a la Discapacidad (Iberdiscap). 2017:250-7.
Fernandez DL. Fractures of the distal radius: operative treatment. Instr Course Lect. 1993;42:73-88.
