Circumferential Casting of Distal Radius Fractures

Area of Science:

• Orthopedic surgery
• Trauma care
• Radiology

Background:

• Distal radius fractures (DRFs) are common injuries.
• Circumferential casting is a standard initial treatment for DRFs without immediate surgical indications.
• Early cast alterations, including splitting, trimming, or replacement, are sometimes necessary.

Purpose of the Study:

• To determine the prevalence and predictive factors for early cast alterations in DRF patients treated with circumferential casts.
• To assess whether early cast alterations affect fracture alignment.

Main Methods:

• Retrospective cohort study at a Level 1 Trauma Center.
• Analysis of 296 adult patients with DRFs treated over 3 years.
• Evaluation of patient demographics, polytrauma status, and cast alteration types.
• Radiographic assessment of fracture alignment.

Main Results:

• Approximately 20-25% of patients required cast alteration within 10 days.
• One-third of polytrauma patients underwent cast alteration.
• No cast alteration type was significantly associated with loss of fracture alignment at 2 or 6 weeks.

Conclusions:

• Early cast alteration is frequent in DRF management but does not compromise fracture alignment.
• Consideration of immediate cast splitting for polytrauma patients may be beneficial.