Radiographic results after plaster cast fixation for 10 days versus 1 month in reduced distal radius fractures: a prospective randomised study

Abstract

BackgroundThe aim of this study was to examine whether reduced distal radius fractures can be treated with early mobilisation without affecting the radiographic results.MethodsIn a prospective randomised study, 109 patients (mean age 65.8 (range 50–92)) with moderately displaced distal radius fractures were treated with closed reduction and plaster cast fixation for about 10 days (range 8–13 days) followed by randomisation to one of two groups: early mobilisation (n = 54, active group) or continued plaster cast fixation for another 3 weeks (n = 55, control group).ResultsFor three patients in the active group (6%), treatment proved unsuccessful because of severe displacement of the fracture (n = 2) or perceived instability (n = 1). From 10 days to 1 month, i.e. the only period when the treatment differed between the two groups, the active group displaced significantly more in dorsal angulation (4.5°, p < 0.001), radial angulation (2.0°, p < 0.001) and axial compression (0.5 mm, p = 0.01) compared with the control group. However, during the entire study period (i.e. from admission to 12 months), the active group displaced significantly more than the controls only in radial angulation (3.2°, p = 0.002) and axial compression (0.7 mm, p = 0.02).ConclusionsEarly mobilisation 10 days after reduction of moderately displaced distal radius fractures resulted in both an increased number of treatment failures and increased displacement in radial angulation and axial compression as compared with the control group. Mobilisation 10 days after reduction cannot be recommended for the routine treatment of reduced distal radius fractures.Trial registrationClinicalTrail.gov, NCT02798614. Retrospectively registered 16 June 2016.

Clinical Outcome after Plaster Cast Fixation for 10 Days Versus 1 Month in Reduced Distal Radius Fractures: A Prospective Randomized Study

“…The radiographic results of this study have already been published (31). Both groups were equally reduced after admission.…”

Cast-OFF Trial: One Versus 4 to 5 Weeks of Plaster Cast Immobilization for Nonreduced Distal Radius Fractures: A Randomized Clinical Feasibility Trial

“…The studies by Davis and Buchanan, 24 Jensen, 25 and Stoffelen and Broos 26 also found no increase in secondary displacement with 1 week of plaster cast immobilization for nondisplaced and minimally displaced fractures. However, the study of Christersson and colleagues 27 shows that moderately displaced DRF, treated with closed reduction and plaster cast immobilization for 10 days, resulted in an increased number of secondary displacements. This is supported by the study of Jung and colleagues who described that greater displacement on the initial radiographs gives a higher possibility of early redisplacement (within 2 weeks after injury).…”

Radiographic prediction of Colles fracture displacement after splint fixation-a prospective study of 97 patients

“…Therefore, we believe that the greater the degree of radial displacement of Colles fractures before reduction, the more severe the injury and the easier to ignore the reduction of the radial displacement direction is the basis of its displacement. The contractile activity of soft tissues such as the muscles of the affected limb provides adverse stress for its displacement tendency [19] . The xation mechanism of the splint cannot counteract the pulling force of the muscles on the distal fragment, resulting in displacement of the fracture after xation.…”