Static vs. Dynamic Progressive Splinting for Persistent Wrist Stiffness After DRF

Al Hayah University In Cairo50 enrolled

Overview

This randomized controlled trial will compare the effectiveness of static progressive splinting versus dynamic splinting for treating persistent wrist stiffness in adults ≥18 years old at least 8 weeks post distal radius fracture (DRF) injury. Both splinting modalities are provided as an adjunct to one weekly supervised therapy session over a 6-week period. The primary outcomes are wrist active and passive range of motion (AROM/PROM) measured using goniometry, with secondary outcomes including patient-reported wrist function (PRWE), overall satisfaction, and adverse events.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Distal Radius Fractures

Interventions

Static Progressive Splinting for Persistent Wrist Stiffness

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: Adults aged 18 years or older. At least 8 weeks post distal radius fracture (operative or nonoperative) who have completed standard rehabilitation. Demonstrated persistent wrist stiffness with ≤50% of contralateral wrist extension or flexion. Capable of providing written informed consent and complying with study procedures Exclusion Criteria: Presence of complex regional pain syndrome (CRPS) or active fracture healing issues. History of significant wrist pathology unrelated to the DRF. Uncontrolled medical conditions that would interfere with splint application or therapy. Known skin conditions or allergies that preclude orthosis use. Inability or unwillingness to adhere to the intervention protocol or follow-up schedule. Pregnant or breastfeeding individuals.

Outcomes

Primary Outcomes

Wrist Active and Passive Range of Motion (AROM/PROM)

Measured using a standard goniometer, improvements in wrist flexion and extension (in degrees) are the primary indicators of treatment efficacy.

Time frame: Assessed at baseline, 6 weeks (post-intervention), and 3 months follow-up.

Secondary Outcomes

Patient-Rated Wrist Evaluation (PRWE)

The PRWE questionnaire assesses wrist pain and disability, with lower scores indicating better functional status.

Time frame: Assessed at baseline and at 6 weeks post-intervention.

Patient Satisfaction

A standardized satisfaction survey measuring patients' perceived improvement and overall satisfaction with the orthotic intervention.

Time frame: Collected at 6 weeks and 3 months post-intervention.

Incidence of Adverse Events

Incidence and severity of adverse events such as skin breakdown, discomfort, or pain (≥4/10) associated with splint usage.

Time frame: Continuously monitored from baseline to the 3-month follow-up.