The Impact of Dorsal and Volar Surgical Approaches on The Postoperative Rehabilitation Process Following Open Reduction and Internal Fixation of Distal Forearm Fractures

Abstract

This prospective comparative cohort study evaluated early rehabilitation outcomes following open reduction and internal fixation (ORIF) of distal forearm fractures using either a dorsal or volar surgical approach. 46 adult patients, mean age: 51,96±7,64, 31 females, 15 males were assessed at the initiation of rehabilitation after cast removal and again after 5 weeks. Outcome measures included active wrist range of motion arc (AROM - Flexion plus Extension of wrist), grip strength (GS), and patient-reported pain and wrist function using the PRWE questionnaire. Both groups demonstrated clinically meaningful improvements across all parameters during the study period. Although the volar fixation group showed slightly better numerical outcomes; no statistically significant differences were identified between the two groups. These findings suggest that in uncomplicated distal forearm fractures, the choice of surgical approach may not significantly influence early functional recovery. Furthermore, the standardized rehabilitation protocol was well tolerated in both groups, including dorsal fixation cases, without pain exacerbation. Therefore, the study supports the effectiveness and safety of early rehabilitation following either approach, while acknowledging limitations such as small sample size and unequal group distribution due to the prevalence of volar approaches in clinical practice.