A Randomized Trial Assessing the Muscle Strength and Range of Motion in Elderly Patients following Distal Radius Fractures Treated with 4- and 6-Week Cast Immobilization

Jarosław Olech; Grzegorz Konieczny; Łukasz Tomczyk; Piotr Morasiewicz

doi:10.3390/jcm10245774

A Randomized Trial Assessing the Muscle Strength and Range of Motion in Elderly Patients following Distal Radius Fractures Treated with 4- and 6-Week Cast Immobilization

J Clin Med. 2021 Dec 9;10(24):5774. doi: 10.3390/jcm10245774.

Authors

Jarosław Olech¹, Grzegorz Konieczny², Łukasz Tomczyk³, Piotr Morasiewicz⁴

Affiliations

¹ Provincial Specialist Hospital in Legnica, Orthopedic Surgery Department, Iwaszkiewicza 5, 59-220 Legnica, Poland.
² Faculty of Health Sciences and Physical Education, Witelon State University of Applied Sciences, Sejmowa 5A Street, 59-220 Legnica, Poland.
³ Department of Food Safety and Quality Management, Poznan University of Life Sciences, 60-624 Poznan, Poland.
⁴ Department of Orthopaedic and Trauma Surgery, University Hospital in Opole, Institute of Medical Sciences, University of Opole, al. Witosa 26, 45-401 Opole, Poland.

Abstract

Background: There is no consensus among orthopedic surgeons as to the required period of cast immobilization in distal radius fractures in elderly patients. The purpose of this study was to assess muscle strength and range of motion symmetry in elderly patients after distal radius fractures with different periods of cast immobilization.

Methods: This study evaluated 50 patients (33 women and 17 men), aged over 65 years, after cast immobilization treatment for distal radius fracture. The mean age at the beginning of treatment was 71 years. The mean duration of follow-up was 1 year and 3 months. The first subgroup (n = 24) comprised the patients whose fractures had been immobilized in a cast for 6 weeks, another subgroup (n = 26) comprised the patients with 4-week cast immobilization. We assessed: (1) muscle strength, (2) range of motion.

Results: The mean grip strength in the treated limb was 71% and 81% of that in the healthy limb in the groups with 4-week and 6-week cast immobilization, respectively (p = 0.0432). The study groups showed no differences in the mean grip strength in the treated limbs or the mean grip strength in the healthy limbs. The mean treated limb flexion was 62° and 75° in the 4-week and 6-week immobilization groups, respectively (p = 0.025). The evaluated groups showed no differences in terms of any other range of motion parameters. The grip strength and range of motion values were significantly lower in the treated limb than in the healthy limb in both evaluated groups. Only the values of wrist radial deviation in the 6-week cast immobilization group showed no differences between the treated and healthy limbs.

Conclusion: Higher values of injured limb muscle strength and greater mean range of wrist flexion were achieved in the 6-week subgroup. Neither of the evaluated groups achieved a symmetry of muscle strength or range of motion after treatment. Full limb function did not return in any of the elderly distal radius fracture patients irrespective of cast immobilization duration.

Keywords: aging; distal radius; fracture; grip strength; muscle strength; range of motion.