Functional recovery after reduced pediatric fractures of the forearm with respect to perceived limitations, common post-traumatic symptoms, range of motion, and dexterity: a prospective study.

Autor:	Hepping AM; Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.; Roessingh Center for Rehabilitation, Enschede, The Netherlands., Barvelink B; Department of Orthopedics, Erasmus Medical Center Rotterdam, The Netherlands., Ploegmakers JJW; Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van der Palen J; Section Cognition, Data and Education, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands.; Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands., Geertzen JHB; Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, The Netherlands., Bulstra SK; Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Harbers JS; Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Stevens M; Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Disability and rehabilitation [Disabil Rehabil] 2023 Oct; Vol. 45 (21), pp. 3560-3566. Date of Electronic Publication: 2022 Oct 10.
DOI:	10.1080/09638288.2022.2131006
Abstrakt:	Purpose: Studies on functional recovery after pediatric forearm fractures are scarce. Outcome measures are usually (retrospectively) incorporated to compare treatments. How these parameters recover has only rarely fallen within the scope. Aim was to provide insight into "normal recovery" by evaluating how limitations, post-traumatic symptoms, range of motion (ROM) and dexterity recuperate. Materials and Methods: Prospective observational study regarding children 4 and 18 years with a reduced forearm fracture. Limitations, post-traumatic symptoms, ROM, and dexterity were evaluated 6 weeks, 3 and 6 months post-trauma. ROM of the unaffected side was used as a baseline. Results: Of 54 participants 25.9% and 5.9% perceived limitations after 3 respectively 6 months. Pain, swelling and hypertrichosis were common symptoms. Movements distal from the elbow were restrained 6 weeks post-trauma. Supination and palmar flexion were most affected, followed by dorsal flexion and pronation. Palmar flexion and pronation were still affected after 3 months and associated with treatment invasiveness. Dexterity was diminished at 6 weeks only. Conclusions: Mild limitations are common. Further investigation of the association between pain, reduced sensitivity and hypertrichosis with treatment invasiveness is warranted. Regarding ROM supination, pronation, palmar and dorsal flexion should be incorporated in future studies. Dexterity is an unsuitable outcome measure.IMPLICATIONS FOR REHABILITATIONThis study relates to monitoring recovery from pediatric forearm fractures.Physicians ought to realize that one in four children experience limitations preceding 3 months post-trauma, in which case involvement of a hand therapist should be considered.Pain, swelling and especially hypertrichosis are common post-traumatic symptoms in children and should on itself not immediately raise concerns for complex regional pain syndrome (CRPS).To assess recovery of range of motion measuring pronation, supination, dorsal, and palmar flexion is sufficient.
Databáze:	MEDLINE
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