Physiotherapy does not helps much in distal radial fractures in adults

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Hey friends following is a excerpt of a review of physiotherapy treatment of fracture around wrist joint. the review claims that physiotherapy is not very successful in rehabilitating such cases. Read it & give opinion.
Rehabilitation as part of treatment for adults with a broken wrist. Particularly in older women, a broken wrist (comprising a fracture at the lower end of one of the two forearm bones) can result from a fall onto an outstretched hand. Treatment usually includes putting the bone fragments back in place, if badly displaced, and immobilising the wrist in a plaster cast. Exercises and other physical interventions are used to help restore function and speed up recovery. HHG Handoll et al (2006) reviewed 15 randomised controlled trials including 13 comparisons in a total of 746 mainly female and older people. Initial treatment was plaster cast immobilisation in all but 27 participants who had surgery. Some trials were well conducted but others were methodologically compromised and none provided conclusive evidence. There was weak evidence that rehabilitation (hand therapy or task-orientated therapy) started during immobilisation improved hand function after plaster cast removal but not in the longer term (two trials). There was weak evidence that outcome after supervised exercises started during immobilisation did not differ from outcome after unsupervised exercises (one trial). The rest of the interventions under test were started post-immobilisation, mainly after removal of the plaster cast. There was weak evidence indicating that formal rehabilitation therapy (four trials), passive mobilisation of the wrist joint complex by the therapist while the patient remained inactive (two trials), ice or pulsed electromagnetic field (one trial), or whirlpool immersion of the injured forearm (one trial) did not improve outcome. There was weak evidence of a short-term benefit of using a continuous passive motion device (after external fixation) (one trial), intermittent pneumatic compression (one trial) and ultrasound (one trial). There was weak evidence of better short-term hand function in participants given physiotherapy than in those given instructions for home exercises by a surgeon (one trial). They concluded that there was not enough evidence available to determine the best form of rehabilitation for people with wrist fractures.

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