Early controlled mobilization using dart-throwing motion with a twist for the conservative management of an intra-articular distal radius fracture and scapholunate ligament injury: A case report

J Hand Ther. 2016 Apr-Jun;29(2):191-8. doi: 10.1016/j.jht.2016.02.012. Epub 2016 Mar 8.

Abstract

This case describes an early controlled mobilization (ECM) approach that uses dart-throwing motion (DTM) with a twist orthoses as an alternative to immobilization for conservative management of a minimally displaced and intra-articular distal radius styloid fracture with an associated scapholunate ligament injury in a 47-year-old female health care administrator (JP). Pain-free active DTM began at day 10 (5 times/d) with a dynamic DTM with a twist orthosis worn during the day from weeks 3 to 6. At 6 weeks, JP had pain-free functional mobility and strength with minimal limitation in household and occupational activities, returning to her normal sporting activities by 3 months. ECM led to rapid return of normal functioning in the short term with no apparent impact on intermediate outcomes at 8 months. This case allows hand therapists to consider a similar ECM approach for the management of similar injuries in their patients.

Level of evidence: Level 5 and case report.

Keywords: Dart-throwing motion; Distal radius fracture; Early mobilization; Scapholunate ligament.

Publication types

  • Case Reports

MeSH terms

  • Conservative Treatment / methods*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Injury Severity Score
  • Intra-Articular Fractures / diagnosis
  • Intra-Articular Fractures / rehabilitation*
  • Ligaments, Articular / injuries*
  • Middle Aged
  • Multiple Trauma / diagnosis
  • Multiple Trauma / rehabilitation
  • Pain Measurement
  • Radius Fractures / diagnosis
  • Radius Fractures / rehabilitation*
  • Range of Motion, Articular / physiology
  • Recovery of Function
  • Risk Assessment
  • Skiing / injuries
  • Splints
  • Treatment Outcome
  • Wrist Injuries / diagnosis
  • Wrist Injuries / rehabilitation*