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[Markedly varying physiotherapeutic treatment following carpal injuries]
W Roolker1, M M Tiel-van Buul, A H Broekhuizen
1Afd. Nucleaire Geneeskunde, Academisch Medisch Centrum, Amsterdam.
Objective:
To inventory long-term symptomatic and physiotherapeutic results in patients treated conservatively for a carpal injury.
Design:
Follow-up investigation and case control study.
Setting:
University Medical Centre, Amsterdam.
Method:
A follow-up investigation was conducted in a group of 100 patients with carpal injury. In this group clinical parameters of patients treated conservatively and with physiotherapy (PT) (n = 16) were compared with 16 case controls without PT, selected for age, sex, diagnosis and duration of immobilisation.
Results:
After removal of the plaster cast, 16 patients had been referred to a physiotherapist because pain was a major complaint. PT was given 2-3 times a week for an average of 11 days after a period of immobilisation of about 9.5 weeks. Treatment varied strongly among the physiotherapists. Follow-up took place 13-50 months after injury. Patients treated with PT had significantly more complaints concerning the traumatised hand than patients without PT. In the long run only 2 patients benefited from PT.
Conclusion:
Physiotherapy after carpal injury lacks method. Applications were arbitrary added or omitted. Patients with carpal injury who were treated with physiotherapy after immobilisation had more complaints in the long run. This difference may be due to selectivity in the policy of referring for physiotherapy.
