Examination and Treatment for a Patient with a Distal Radius Fracture

BACKGROUND AND PURPOSE: This article describes the eight month outpatient physical therapy management of 67 year old female who had an open fracture of the left distal radius that was stabilized internally with K-wire and externally with the application of external fixator. Initially, this patient presented with a need for patient education on wound care, edema control techniques, splinting, and a maintenance program for finger and shoulder range of motion. The physical therapy intervention progressed to range of motion, strengthening, joint mobilization, and functional exercises for the wrist and hand. The purpose of this article is to describe the interventions used for this patient, the results of these interventions, and the rationale for these interventions. DESCRIPTION: This case was unique due to the addition of a splint that was worn with the external fixator. Treatment of this patient included wound care, therapeutic exercise, joint mobilization, edema control techniques, patient education, and splinting. RESULTS: Following PT intervention, this patient achieved objective improvement of range of motion and grip strength as well as improvements in functional activities of the hand. DISCUSSION: Treatment guidelines outlined by the American Society of Hand Therapists provided the framework and foundation for evaluation and treatment for this individual and were deemed appropriate for this individual. While these guidelines were useful for the evaluation and treatment of this patient, adaptations, such as the splint, were implemented