Rehabilitation after wrist fracture: A narrative review of outcome measures and protocols

INTRODUCTION: Wrist fractures represent the commonest fractures of upper limb. After the orthopedic surgical or conservative management, patients usually experience decrease of mobility, strength and function of wrist and hand, with consequent reduction of independence in daily life activities. For the management of the rehabilitative phase, a multitude of therapeutic approaches have been proposed, but a consensus on the program for rehabilitation of wrist fracture still lacks. Aim of this review was to describe the current literature evidence for rehabilitation after wrist fracture. EVIDENCE ACQUISITION: A search was performed using PubMed, Pedro and Scopus electronic databases for peer-reviewed literature related to rehabilitation of wrist fractures in adults published between January 2005 and April 2020. Only studies in English with participants older than 18 years were included and all types of study design were selected, except for systematic reviews, single case reports and congress proceedings. For each publication included, we reviewed the outcome measures and the rehabilitation program. EVIDENCE SYNTHESIS: We included 49 studies, reporting different rehabilitative protocols which integrate various approaches: advice, passive and active exercises, manual therapy and instrumental physiotherapy, sensorimotor and pharmacological interventions. We observed variability in terms of application (therapist-supervised versus self-administered home protocols), rehabilitation timing and outcome measures (objective measurement, evaluator-based scales, patient-reported outcome measures). CONCLUSIONS: After a wrist fracture, numerous rehabilitative approaches may be applied to reduce pain, enhance motility, increase strength and improve function of upper limb. On the basis of the current literature, we show a possible rehabilitative protocol after wrist fracture.