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J Wrist Surg 2020; 09(04): 345-352
DOI: 10.1055/s-0040-1712504
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Safety and Efficacy of Blood Flow Restriction Therapy after Operative Management of Distal Radius Fractures: A Randomized Controlled Study

Nicole M. Sgromolo
1   Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, Texas
,
Jill M. Cancio
2   Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio Military Medical Center, JBSA Ft. Sam Houston, San Antonio, Texas
3   Extremity Trauma and Amputation Center of Excellence, JBSA Ft. Sam Houston, San Antonio, Texas
,
Peter C. Rhee
4   Division of Hand Surgery, Mayo Clinic, Rochester, Minnesota
5   Department of Orthopedic Surgery, Clinical Investigation Facility, Travis Air Force Base, California
› Author Affiliations
Further Information

Publication History

30 October 2019

07 April 2020

Publication Date:
22 June 2020 (online)

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Abstract

Background Blood flow restriction (BFR) therapy is an emerging addition to rehabilitative programs that allows patients to increase strength at lower loads over shorter time periods. Therefore, we conducted a study to evaluate the safety and efficacy of a rehabilitation program using BFR to a traditional rehabilitation protocol following operative fixation of distal radius fractures.

Methods A randomized controlled study was conducted comparing a standardized rehabilitation protocol alone to a combined protocol with the use of BFR therapy in patients treated with volar plate fixation following a displaced distal radius fracture. The same exercises done in the control group were performed by the BFR group with a restrictive tourniquet in place. Patients were followed with serial radiographs to ensure fracture stability. Outcome measures included wrist range of motion, grip strength, pinch strength, visual analog scale (VAS) pain scores at rest and during activity, patient rated wrist evaluation scores (PRWE), and disabilities of the arm, shoulder, and hand scores.

Results Nine patients were randomized and enrolled within the BFR group (n = 5) and control (n = 4) groups. Patients within the BFR group had a significantly greater reduction in pain with activity over the course of the rehabilitation program. Additionally, the BFR group had a significant improvement in PRWE scores during the 8-week rehabilitation program. There was no difference in radiographic measures after initiation of BFR, and all patients tolerated therapy without noted complications.

Conclusion BFR therapy is safe and well tolerated after operatively treated distal radius fractures. The addition of BFR therapy can result in quicker reduction in pain with activity and improvement in patient disability when used early following operative management of a distal radius fracture.

Level of Evidence This is a Level 1, prognostic study.

Keywords

blood flow restriction - distal radius fracture - occlusion pressure

Note

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army or the Department of Defense or the U.S. Government.