Distal and/or Proximal Joint Stiffness Among Post-Fracture Patients Treated in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia

Abstract

Background Stiffness, or more precisely, a restriction in the range of motion, is a potential complication following any intra- or extra-articular injury. The passive or active range of motion of the physiological joint is an important factor in determining the significance of joint stiffness. The goals of this study were to assess the incidence of joint stiffness following a fracture, using a standard goniometer, and to identify potential predictors of joint stiffness among post-fracture patients. Methods A prospective hospital-based cross-sectional study was conducted from July 1, 2021 to September 13, 2021, at University of Gondar Comprehensive Specialized Hospital. A total of 230 study participants participated in the study, and systematic sampling methods were used to recruit the study participants. Bivariate and multivariable binary logistic regression model analyses were conducted, with SPSS version 23, to identify factors associated with post-fracture joint stiffness. Results The overall prevalence of post-fracture stiffness was 25.7% (n=59). Having a left-side fracture (AOR=10.83; 95% CI 1.71–17.74), patients having no physiotherapy follow-up (AOR=6.72; 95% CI 1.79–25.13), and patients using assistive devices (AOR=11.95; 95% CI 3.63–39.35) were significantly associated with post-fracture stiffness, with p -values of less than 0.05. Conclusion The study found that one-quarter of the study participants experienced post-fracture joint stiffness. A fracture on the left side, individuals with no physiotherapy follow-up, and the use of assistive devices were found to be independent predictors of joint stiffness. Early referral of fracture patients to the rehabilitation center is recommended to prevent post-fracture complications and joint stiffness.

Overview of Cochrane Systematic Reviews for Rehabilitation Interventions in Individuals with Upper Limb Fractures: A Mapping Synthesis

“…The paucity of CSRs and the poor quality of evidence of the primary studies emphasize the need to further investigate the best rehabilitative approach post ULFs. The main outcomes of rehabilitation after ULFs are pain relief and regaining mobility, strength, and function [ 25 , 26 ]. For people with distal radius fractures, functional recovery is often fairly good after surgical or non-surgical treatment.…”

“…The interventions extracted from the CSRs and shown in our evidence map summarized evidence of rehabilitation started during plaster cast immobilisation or post-immobilization. Early occupational and hand therapy, cyclic pneumatic soft tissue compression, and cross-education, when started during immobilization, seems to improve grip strength and wrist ROM, with results maintained up to 12 weeks from the cast removal, compared to no intervention [ 26 ]. At the same time, interventions such as PEMF, ice, ultrasound, or whirlpool, compared to sham/no intervention or towel, started post-immobilization, may not improve the outcomes investigated and, in some cases, such as whirlpool versus towel, the comparison seems more beneficial than the intervention [ 27 ].…”

“…At the same time, interventions such as PEMF, ice, ultrasound, or whirlpool, compared to sham/no intervention or towel, started post-immobilization, may not improve the outcomes investigated and, in some cases, such as whirlpool versus towel, the comparison seems more beneficial than the intervention [ 27 ]. Approaches such as OT and passive mobilisation, started post-immobilization, are probably safe in terms of secondary complications (such as CRPS-1, median nerve compression, or finger stiffness) [ 26 ]. Concerning the method of delivering rehabilitative treatment after distal radius fracture, accelerated rehabilitation may be beneficial for function, ROM, and strength compared to rehabilitation provided 6 weeks post-surgery, while evidence of no effect was found for almost all other comparisons with, a certainty of evidence ranging from low to moderate [ 27 ].…”