Journal of hand therapy : official journal of the American Society of Hand Therapists
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Issues of the theory and methodology of case reports and case studies have been presented. Examples of applications of techniques used in the rehabilitation of the upper extremity conclude this report in pocket format on the theory and methodology of case reports and case studies. Case reports and studies enhance our knowledge about practice in ways that are unique to each case, which are not possible when investigations are performed through group comparison. Case inquiries help us share our practice, sharpen our theoretical reasoning, develop our good habits of applying reliable and valid measurements, and above all help us explore and discuss our treatments.
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The majority of research on distal radius fractures consists of retrospective, descriptive studies of patients with unstable fractures requiring fixation. The purpose of this investigation was to report on impairments in flexibility, grip strength, and motor control and on the presence of swelling and atrophy immediately after cast immobilization of closed reductions of simple distal radius fractures. Sixteen adult subjects from Kaiser Permanente Medical Center, San Francisco, entered the study, and 13 completed it. ⋯ These measured impairments immediately after immobilization of simple radius fractures were greater than the reported impairments in patients after reduction of radius fractures with fixation 6 to 27 months after injury. To prevent long-term disability and recover flexibility, strength, and function, patients with simple distal radius fractures should be referred to a hand, occupational, or physical therapist for evaluation, education, and treatment after immobilization. Longitudinal studies are needed to quantify long-term functional recovery with regard to the type of fracture and the degree of impairment measured immediately after casting.