Scoping Review of Occupational Therapy for Distal Radius Fractures, Including Complications.

A scoping review following PRISMA-ScR guidelines. Six researchers with occupational therapy backgrounds searched PubMed, ProQuest, MEDLINE, OTseeker, and Cochrane Library (last search January 31, 2025) for prospective interventional studies or case reports on occupational therapy for adult distal radius fractures, including complications. From 1,026 articles, five met inclusion criteria. No critical appraisal of methodological quality was conducted, consistent with the scoping review purpose of mapping the literature rather than evaluating effectiveness.

The five included studies (four randomised, one non-randomised) predominantly used impairment-level outcomes: 80% measured range of motion and grip strength. The COPM appeared in only a small number of studies. Two of five articles evaluated activity and participation within the ICF framework. Intervention content was mostly range of motion training; ADL training was mentioned in two studies but not described in sufficient detail to confirm it was occupation-focused. Two articles reported complications (CRPS, tendon issues, carpal tunnel release) in their intervention groups.

This review confirms that occupational therapy research on wrist fractures is extremely thin (five studies) and that those studies measure what physical therapists measure — range of motion and grip strength — rather than the activity and participation outcomes that define OT practice. If you are treating a patient with a distal radius fracture, the evidence base for occupation-focused intervention is essentially absent. The review also flags that patients with complications (CRPS, tendon injuries) are systematically excluded from research, so the little evidence that exists may not apply to your more complex cases.

Only five studies met inclusion criteria, so the map of the literature is based on a very small sample. Limited to English-language, prospective interventional studies and case reports; no critical appraisal of study quality was performed. The review focused solely on occupational therapy–related studies, so interventions delivered by physical therapists or surgeons in the same hand therapy setting may not be captured. Narrow eligibility criteria in the included studies (excluding complications, additional injuries) limit generalisability to the full range of patients seen in practice.

No funding was received for this manuscript. The authors declare no conflicts of interest.

Do not read this review as evidence that any particular occupational therapy intervention works for distal radius fractures. It is a map of what has been studied, not a test of whether it works. The five included studies were not appraised for quality, and the review's stated purpose was to identify gaps in the literature, not to recommend a treatment.