Recovery in the symmetry of hand use after distal radius fracture

Hand use recovery after a distal radius fracture (DRF) depends on whether the injured hand is dominant or not, which can affect laterality and influence functional outcomes. This study aimed to investigate how the injured side impacts changes in laterality and its relationship to functional outcome, aiming to contribute to the development of future hand therapy strategies.

Patients with DRF were prospectively recruited. Triaxial accelerometers were wrist-mounted to collect data at 1, 4, 8, and 12 weeks postoperatively and examine the laterality index (LI), total hand use time, and total vector magnitude. Correlations between LI and functional outcomes were assessed at each time point.

42 patients participated in this study. Among them, 19 and 23 had injured dominant (DI) and injured non-dominant (non-DI) hands, respectively. The LI showed a faster restoration of symmetry in the DI group than in the non-DI group at 8 and 12 weeks postoperatively. Moderate correlations between LI and functional outcomes were observed in wrist joints and grip strength in the DI and non-DI groups, respectively, at all time points.

The change in LI in the DI group was considered recovery, as it was identical to the symmetry observed in healthy adults. Additionally, the non-DI group was considered to have adapted to a pattern of predominant use of the dominant hand. The correlation between LI and some functional outcomes appeared to depend on hand use patterns, specifically whether the injured hand was dominant or not. These findings underscore the importance of tailoring interventions.