Early postoperative rehabilitation following surgical fixation of distal radius fractures: isokinetic and functional evaluation

Abstract Study aim: To assess hand function in patients after surgical repair of distal radius fractures using the open reduction and internal fixation (ORIF) method, compared with the contralateral (non-operated) limb serving as an internal control, following six months of early rehabilitation. Material and methods: A prospective controlled study was conducted on 14 patients (8 women, 6 men; mean age 50.1 ± 9.3 years) treated surgically for distal radius fracture. The functional assessment included range of motion (ROM), grip strength, and isokinetic testing (Biodex System 4 Pro) of wrist flexion, extension, forearm pronation, and supination. Subjective outcomes were evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Statistical analysis was performed using the Wilcoxon signed-rank test, with significance set at p ≤ 0.05, and effect sizes (Cohen’s d ) were calculated. Results : No significant differences were observed between operated and non-operated limbs for most functional parameters. Wrist flexion was reduced in the operated limb (50.3 ± 12.9° vs 60.4 ± 11.0°, p = 0.008, d = 0.79), and pronation torque was significantly lower at both angular velocities (90°/s: 4.73 ± 2.49 vs 7.00 ± 5.38 Nm, p = 0.018; 210°/s: 4.82 ± 2.56 vs 6.41 ± 3.96 Nm, p = 0.028). Normalization to body weight (PT/BW) confirmed that these differences were independent of body mass. Conclusions : Early postoperative rehabilitation initiated 3–5 days after ORIF resulted in functional recovery comparable to the contralateral hand, except for reduced pronation strength. Targeted strengthening of the pronator muscles should be emphasized in early rehabilitation programs.