In 2011, a prospective randomized controlled trial conducted by J. Sebastiaan Souer, Geert Buijze, and David Ring, the efficacy of formal occupational therapy following open reduction and volar plate fixation for distal radial fractures was investigated. The study aimed to discern whether formal therapy provided any significant advantage over independent exercises in terms of wrist function and arm-specific disability six months post-surgery.

Ninety-four patients with unstable distal radial fractures underwent open reduction and volar locking plate fixation and were randomly assigned to either receive exercises supervised by an occupational therapist or undergo surgeon-directed independent exercises. The primary outcome measured was the combined wrist flexion and extension at the six-month mark post-surgery.

Results indicated a noteworthy disparity in the mean arc of wrist flexion and extension at the six-month follow-up, favoring patients who engaged in independent exercises. Moreover, three months post-surgery, there were significant differences in pinch strength, grip strength, and Gartland and Werley scores, all in favor of the independent exercise group. At the six-month mark, significant differences were observed in wrist extension, ulnar deviation, supination, grip strength, and Mayo score, again favoring the independent exercise group. However, no discrepancies were noted in arm-specific disability, as measured by the DASH score, at any evaluation point.

In conclusion, the prescription of formal occupational therapy did not yield improvements in average motion or disability scores following volar locking plate fixation for distal radius fractures. These findings underscore the potential efficacy of independent exercises as a viable postoperative rehabilitation approach.

Reference: Souer, J. S., Buijze, G., & Ring, D. (2011). A prospective randomized controlled trial comparing occupational therapy with independent exercises after volar plate fixation of a fracture of the distal part of the radius. JBJS, 93(19), 1761-1766.