The effect of early manual therapy on functional outcomes in distal radius fractures

Objective: To investigate the effects of early manual therapy on functional outcomes in patients underwent volar plating after distal radius fracture (DRF). Method: Patients were randomly divided into two groups: Routin Physiotherapy (RP) (n=17) or Early Manual Therapy (EMT) (n=15). While RP group received routine physiotherapy, EMT group received routine physiotherapy plus Mulligan's Mobilization With Movement technique. All treatments were done two sessions a week, through 12 weeks. Severity of pain, edema, ROM, hand and pinch grip strength, function, disability and quality of life of patients were assessed. Measurements were made at postoperative week 3, 6 and 12. Results: The demographic and clinical characteristics of the groups were similar except for age, and there was no statistically significant difference between groups (p>0.05). When compared to the first measurements, a significant decrease in severity of pain, edema and DASH disability values, and a significant inrease in ROM, grip strength, Patient Rated Wrist Evaluation (PRWE) function values were observed in both groups (p<0.05). Between group comparisons showed that EMT group's severity of pain and PRWE scores were lower, ROM and grip strength values were higher than RP groups' in all measurements (p<0.05). Conclusion: Manual therapy application added to the routine physiotherapy in the early period after volar plating of DRF is more effective than routine physiotherapy on severity of pain, ROM, grip strength and hand functions. Manual therapy can safely be applied in early postoperative period in those patients.