A prospective randomized controlled trial comparing circumferential casting and splinting in displaced Colles...

Area of Science:

• Orthopedic surgery
• Traumatology
• Radiology

Background:

• Displaced distal radius fractures are common injuries requiring effective immobilization.
• Choosing the optimal immobilization technique is crucial for maintaining reduction and achieving good functional outcomes.

Purpose of the Study:

• To compare the effectiveness of circumferential casting (CC), volar-dorsal splinting (VDS), and modified sugar-tong (MST) splinting in maintaining reduction of displaced distal radius fractures.
• To assess long-term functional outcomes associated with fiberglass splinting versus standard CC.

Main Methods:

• A prospective randomized single-blind controlled trial involving patients over 18 with displaced distal radius fractures requiring closed reduction.
• Primary outcome: loss of reduction. Secondary outcomes: DASH score, return to work, activities of daily living, pain, range of motion, and grip strength at 8 weeks and 6 months.

Main Results:

• Radiographic loss of reduction occurred in 16% of VDS, 20% of CC, and 30% of MST groups (p=0.17).
• Functional outcomes, including DASH scores, at 8 weeks and 6 months were similar across all immobilization groups (p>0.25).

Conclusions:

• No statistically significant difference in maintaining anatomic position among CC, VDS, and MST splinting.
• A trend towards increased loss of reduction was observed with MST splinting.
• Clinical decisions should consider ease of application and familiarity when selecting immobilization for distal radius fractures.