Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial

Questions

Does the addition of cyclic pneumatic soft-tissue compression during the 6-week immobilisation period following fracture of the distal radius result in a faster recovery of muscle strength and joint range of motion? Does it result in a larger recovery of muscle strength and joint range of motion immediately after the immobilisation period (at 6 weeks) or four weeks after the immobilisation period (at 10 weeks)?

Design

Randomised controlled trial with concealed allocation and assessor blinding.

Participants

21 patients with fracture of the distal radius.

Intervention

The experimental group received cyclic pneumatic soft-tissue compression during the 6-week immobilisation period whereas the control group received usual care. Both groups were instructed to actively make a fist 100 times per day during the 6-week immobilisation period and were given an exercise program during the 4-week post-immobilisation period.

Outcome measures

Function was measured as power grip, pinch grip, key grip, and supination strength using dynamometry from Week 1 to 10 as well as wrist flexion/extension and forearm supination/pronation range of motion using goniometry from Week 6 to 10. The outcome measures are presented as a percentage of the intact side.

Results

The experimental group improved significantly faster than the control group in muscle strength from Week 1 to 10 (p ≤ 0.001) but not in joint range of motion from Week 6 to 10 (p > 0.05). By Week 6, the experimental group was 12–26% stronger and had 8–14% more range of motion than the control group. By Week 10, the experimental group was 24–29% stronger and had 10–15% more range of motion than the control group.

Conclusion

The findings indicate that a larger clinical trial is warranted and should incorporate direct measures of fracture healing.