AB1436-HPR Comparison of physiotherapy gains of the patients with and without osteopenia in distal radius fractures
Authors: M Tomruk, N. Gelecek, O. Başçı, M.H. Özkan
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> It is known that osteopenia was correlated with severity of forearm fractures.<sup>1</sup> Since there is an increased risk of long-term impairment due to the involvement of wrist joint after distal radius fractures, physiotherapy is an integral component of the complete concept for the treatment.<sup>2, 3</sup> However, there are no recommendations supported by studies regarding which patients might possibly benefit more or less from physiotherapy.<sup>4</sup> <h3>Objectives</h3> The aim of this study was to compare physiotherapy gains of the patients with and without osteopenia in distal radius fractures. <h3>Methods</h3> 31 patients (13 with normal bone quality, 18 osteopenic) surgically treated with volar plating after distal radius fracture were included. Bone mineral density (BMD) was assessed by using Dual-energy X-ray absorptiometry (DEXA). A BMD T-Spine value higher than −1 were considered as normal bone quality and the value between −1 and −2.5 were considered as osteopenia. A physiotherapy program, beginning at first day postoperatively, was applied for all patients, twice a week, through 12 weeks. Wrist and forearm range of motions (wrist flexion, wrist extension, ulnar deviation, radial deviation, forearm supination, forearm pronation), severity of pain, oedema and grip strength were assessed at 3rd week and 12th week postoperatively after ending of physiotherapy program. Physiotherapy gains of patients with normal bone quality (group 1, n=13) and patients with osteopenia (group 2, n=18) were compared. <h3>Results</h3> Median (min-max) BMD-T spine value was −0.3 (−0.7–1.0) for group 1 and −1.75 (−1.3 – −2.3) for group 2. At baseline, there were no statistically significant differences between groups in terms of evaluated parameters (p&gt;0.05). In-group analyses showed that all evaluated parameters except forearm pronation were significantly improved in both groups (p&lt;0.05). Changes of the measurements in both groups were similar and no significant differences were found in between-group analyses (p&gt;0.05). <h3>Conclusions</h3> Physiotherapy gains of osteopenic patients with distal radius fractures were similar to patients with normal bone quality after 12 week treatment program. Wrist and forearm range of motions, severity of pain, oedema and grip strength of osteopenic patients can be improved like that of patients with normal bone quality after distal radius fracture by implementing physiotherapy program. <h3>References</h3> [1] Lill C, Goldhahn J, Albrecht A, Eckstein F, Gatzka C, Schneider E. Impact of bone density on distal radius fracture patterns and comparison between five different fracture classifications. Journal of orthopaedic trauma. 2003;17(4):271–8. [2] Dekkers MK, Søballe K. Activities and impairments in the early stage of rehabilitation after Colles' fracture. Disability and rehabilitation. 2004;26(11):662–8. [3] Hegeman J, Oskam J, Van der Palen J, Ten Duis H, Vierhout P. The distal radial fracture in elderly women and the bone mineral density of the lumbar spine and hip. Journal of Hand Surgery. 2004;29(5):473–6. [4] Michlovitz SL, LaStayo PC, Alzner S, Watson E. Distal radius fractures: therapy practice patterns. Journal of Hand Therapy. 2001 14(4):249–57. <h3>Disclosure of Interest</h3> None declared