{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:42:39Z","timestamp":1792197759782,"version":"4.4.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,7,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimum period of immobilization following open reduction and internal fixation (ORIF) of distal radial fractures has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>One hundred and thirty-three adults with a distal radial fracture treated with ORIF (using a volar locked plate) were randomly allocated, with stratification according to age, to 1, 3, or 6 weeks of postoperative immobilization in a parallel-design, assessor-blinded, randomized controlled trial (RCT). After cast removal, a standardized education and exercise program was followed for 6 weeks. Primary outcomes were function (according to the Patient-Rated Wrist Evaluation [PRWE]), worst (visual analog scale [VAS]-W) and usual (VAS-U) pain in the past week, and active wrist extension and forearm supination range of motion. All measures were recorded at 6, 12, and 26 weeks following surgery. Secondary outcomes were wrist flexion, radial deviation, ulnar deviation, and forearm pronation active range of motion; function (Disabilities of the Arm, Shoulder and Hand [DASH]); grip strength; postoperative adverse events; return to work and\/or usual daily activities; and compliance with the home exercise program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>More than 90% of the participants received treatment as allocated, and 87% completed the 6-month follow-up. At 6 weeks, both the 1-week and 3-week groups had significantly better PRWE scores, wrist extension, and flexion active range of motion than the 6-week group. However, no treatment group was superior to another with respect to primary or secondary outcomes at 12 weeks or 6 months following surgery. Analyses considering only the main effect of the intervention group indicated a preference for the 3-week group, which performed significantly better than the 6-week group with respect to the PRWE, pain (VAS-W and VAS-U), wrist flexion, ulnar deviation, forearm pronation active range of motion, and DASH score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>For patient function, range of motion, and pain, this investigation demonstrated that immobilization periods of 1 and 3 weeks produced superior short-term outcomes compared with those after 6 weeks of immobilization. These differences were not evident at 3 and 6 months following surgery, with the immobilization period having no significant effect on long-term function, range of motion, or pain. There were no significant differences in adverse events associated with shorter immobilization periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00912","type":"journal-article","created":{"date-parts":[[2018,7,7]],"date-time":"2018-07-07T04:28:09Z","timestamp":1530937689000},"page":"1118-1125","source":"Crossref","is-referenced-by-count":44,"title":["A Comparison of the Effect of One, Three, or Six Weeks of Immobilization on Function and Pain After Open Reduction and Internal Fixation of Distal Radial Fractures in Adults"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8683-7183","authenticated-orcid":false,"given":"Narelle","family":"Watson","sequence":"first","affiliation":[{"name":"Western Health, St. Albans, Victoria, Australia"},{"name":"Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence","family":"Haines","sequence":"additional","affiliation":[{"name":"Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phong","family":"Tran","sequence":"additional","affiliation":[{"name":"Western Health, St. Albans, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Keating","sequence":"additional","affiliation":[{"name":"Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"7","key":"bib1-20230714","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s00402-003-0538-4","article-title":"Surgical treatment of fractures of the distal radius with plates: a comparison of palmar and dorsal plate position","volume":"123","author":"Letsch","year":"2003","journal-title":"Arch Orthop Trauma Surg."},{"issue":"9","key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.2106\/JBJS.K.00561","article-title":"Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study","volume":"94","author":"de Putter","year":"2012","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib3-20230714","first-page":"137","article-title":"Management of Colles\u2019 fractures","volume":"14","author":"Cooney","year":"1989","journal-title":"J Hand Surg Br."},{"issue":"4","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1302\/0301-620X.70B4.3403617","article-title":"Colles fracture: does the anatomical result affect the final function?","volume":"70","author":"McQueen","year":"1988","journal-title":"J Bone Joint Surg Br."},{"issue":"8","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.2106\/00004623-198264080-00007","article-title":"Correction of post-traumatic wrist deformity in adults by osteotomy, bone-grafting, and internal fixation","volume":"64","author":"Fernandez","year":"1982","journal-title":"J Bone Joint Surg Am."},{"key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00003086-199212000-00025","article-title":"Hand and wrist function after external fixation of unstable distal radial fractures","volume":"285","author":"McQueen","year":"1992","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1302\/0301-620X.80B4.0800665","article-title":"Redisplaced unstable fractures of the distal radius. 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Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand) [corrected]","volume":"29","author":"Hudak","year":"1996","journal-title":"Am J Ind Med."},{"key":"bib14-20230714","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1471-2474-4-24","article-title":"Pain and disability reported in the year following a distal radius fracture: a cohort study","volume":"4","author":"MacDermid","year":"2003","journal-title":"BMC Musculoskelet Disord."},{"issue":"10 Suppl","key":"bib15-20230714","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/00005131-200711101-00001","article-title":"Fracture and dislocation classification compendium \u2013 2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee","volume":"21","author":"Marsh","year":"2007","journal-title":"J Orthop Trauma."},{"issue":"2","key":"bib16-20230714","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00402-013-1767-9","article-title":"Distal Radius Working Group of the International Society for Fracture Repair (ISFR); International Osteoporosis Foundation (IOF). Recommendation for measuring clinical outcome in distal radius fractures: a core set of domains for standardized reporting in clinical practice and research","volume":"134","author":"Goldhahn","year":"2014","journal-title":"Arch Orthop Trauma Surg."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201807050-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:43:32Z","timestamp":1787751812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201807050-00006"}},"subtitle":["A Randomized Controlled Trial"],"short-title":[],"issued":{"date-parts":[[2018,7,5]]},"references-count":15,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.00912","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,5]]}}}