Copyright (c) 2026 Synergía
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Traffic accidents are a leading cause of complex traumatic upper limb injuries, resulting in significant and prolonged functional disability. Modern rehabilitation has evolved from prolonged immobilization toward early mobilization protocols and multidisciplinary intervention, although clinical implementation of evidence remains heterogeneous. Objective: To analyze the current scientific evidence (2023-2025) on rehabilitation interventions in adult patients with distal radius and proximal humerus fractures after traffic accidents, evaluating their effectiveness and identifying a phase-based intervention framework. Methods: A systematic review was conducted in PubMed/MEDLINE, Cochrane Library, PEDro, and CINAHL (January 2023 - March 2025). Experimental and quasi-experimental studies in adults with post-traumatic fractures evaluating physiotherapy or occupational therapy interventions using psychometrically validated instruments were included. Evidence quality was assessed using the GRADE system. Results: Eight studies were included (7 randomized controlled trials and 1 longitudinal cohort). Early mobilization (?2 weeks) showed improvements in DASH function with SMD = -0.27 (95% CI: -0.48 to -0.07) and pain with SMD = -0.28 (95% CI: -0.52 to -0.03). Supervised occupational therapy demonstrated clinically relevant benefits in high-complexity subgroups (d = 3.46 for DASH in closed kinetic chain exercises; 95% CI: 2.43-4.49). Sensorimotor proprioceptive training showed large effect sizes for joint position sense (d = 2.05; 95% CI: 1.28-2.82). Certainty of evidence was predominantly low or very low (GRADE). Conclusions: Current evidence supports a paradigm shift toward early, personalized, and sensorimotor rehabilitation protocols. A four-phase intervention framework is proposed, from the acute stage to functional reintegration, emphasizing objective psychometric assessment and multidisciplinary management. Higher methodological quality clinical trials are required.
