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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Albert Christersson, Sune Larsson, Bengt Östlund, Bengt Sandén

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2016

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Abstract

Background

The aim of this study was to examine whether reduced distal radius fractures can be treated with early mobilisation without affecting the radiographic results.

Methods

In 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).

Results

For 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).

Conclusions

Early 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 registration

ClinicalTrail.gov, NCT02798614. Retrospectively registered 16 June 2016.
Literature
1.
Abbaszadegan H, Conradi P, Jonsson U. Fixation not needed for undisplaced Colles’ fracture. Acta Orthop Scand. 1989;60(1):60–2.CrossRefPubMed
2.
Stoffelen D, Broos P. Minimally displaced distal radius fractures: do they need plaster treatment? J Trauma. 1998;44(3):503–5.CrossRefPubMed
3.
Davis TR, Buchanan JM. A controlled prospective study of early mobilization of minimally displaced fractures of the distal radial metaphysis. Injury. 1987;18(4):283–5.CrossRefPubMed
4.
McAuliffe TB, Hilliar KM, Coates CJ, Grange WJ. Early mobilisation of Colles’ fractures. A prospective trial. J Bone Joint Surg Br. 1987;69(5):727–9.PubMed
5.
Vang Hansen F, Staunstrup H, Mikkelsen S. A comparison of 3 and 5 weeks immobilization for older type 1 and 2 Colles’ fractures. J Hand Surg Am. 1998;23(3):400–1.CrossRef
6.
Millett PJ, Rushton N. Early mobilization in the treatment of Colles’ fracture: a 3 year prospective study. Injury. 1995;26(10):671–5.CrossRefPubMed
7.
Sarmiento A, Pratt GW, Berry NC, Sinclair WF. Colles’ fractures. Functional bracing in supination. J Bone Joint Surg Am. 1975;57(3):311–7.CrossRefPubMed
8.
Sarmiento A, Zagorski JB, Sinclair WF. Functional bracing of Colles’ fractures: a prospective study of immobilization in supination vs. pronation. Clin Orthop Relat Res. 1980;146:175–83.
9.
Dias JJ, Wray CC, Jones JM, Gregg PJ. The value of early mobilisation in the treatment of Colles’ fractures. J Bone Joint Surg Br. 1987;69(3):463–7.CrossRefPubMed
10.
Stewart HD, Innes AR, Burke FD. Functional cast-bracing for Colles’ fractures. A comparison between cast-bracing and conventional plaster casts. J Bone Joint Surg Br. 1984;66(5):749–53.PubMed
11.
12.
Abbaszadegan H, Jonsson U, von Sivers K. Prediction of instability of Colles’ fractures. Acta Orthop Scand. 1989;60(6):646–50.CrossRefPubMed
13.
Dias JJ, Wray CC, Jones JM. The radiological deformity of Colles’ fractures. Injury. 1987;18(5):304–8.CrossRefPubMed
14.
Hove LM, Solheim E, Skjeie R, Sorensen FK. Prediction of secondary displacement in Colles’ fracture. J Hand Surg Am. 1994;19(6):731–6.CrossRef
15.
Foldhazy Z, Tornkvist H, Elmstedt E, Andersson G, Hagsten B, Ahrengart L. Long-term outcome of nonsurgically treated distal radius fractures. J Hand Surg Am. 2007;32(9):1374–84.CrossRefPubMed
16.
Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury. 1989;20(4):208–10.CrossRefPubMed
17.
Mackenney PJ, McQueen MM, Elton R. Prediction of instability in distal radial fractures. J Bone Joint Surg Am. 2006;88(9):1944–51.PubMed
18.
Nesbitt KS, Failla JM, Les C. Assessment of instability factors in adult distal radius fractures. J Hand Surg Am. 2004;29(6):1128–38.CrossRefPubMed
19.
Makhni EC, Ewald TJ, Kelly S, Day CS. Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment. J Hand Surg Am. 2008;33(8):1301–8.CrossRefPubMed
20.
Beumer A, McQueen MM. Fractures of the distal radius in low-demand elderly patients: closed reduction of no value in 53 of 60 wrists. Acta Orthop Scand. 2003;74(1):98–100.CrossRefPubMed
21.
22.
Dixon S, Allen P, Bannister G. Which Colles’ fractures should be manipulated? Injury. 2005;36(1):81–3.CrossRefPubMed
23.
Leung F, Ozkan M, Chow SP. Conservative treatment of intra-articular fractures of the distal radius—factors affecting functional outcome. Hand Surg. 2000;5(2):145–53.CrossRefPubMed
24.
Wilcke MK, Abbaszadegan H, Adolphson PY. Patient-perceived outcome after displaced distal radius fractures. A comparison between radiological parameters, objective physical variables, and the DASH score. J Hand Ther. 2007;20(4):290–8. quiz 299.CrossRefPubMed
25.
Aro HT, Koivunen T. Minor axial shortening of the radius affects outcome of Colles’ fracture treatment. J Hand Surg Am. 1991;16(3):392–8.CrossRefPubMed
26.
Gliatis JD, Plessas SJ, Davis TR. Outcome of distal radial fractures in young adults. J Hand Surg Am. 2000;25(6):535–43.CrossRef
27.
Grewal R, MacDermid JC. The risk of adverse outcomes in extra-articular distal radius fractures is increased with malalignment in patients of all ages but mitigated in older patients. J Hand Surg Am. 2007;32(7):962–70.CrossRefPubMed
28.
Brogren E, Wagner P, Petranek M, Atroshi I. Distal radius malunion increases risk of persistent disability 2 years after fracture: a prospective cohort study. Clin Orthop Relat Res. 2013;471(5):1691–7.CrossRefPubMedPubMedCentral
29.
Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. J Hand Surg Am. 2000;25(1):19–28.CrossRefPubMed
30.
Jaremko JL, Lambert RG, Rowe BH, Johnson JA, Majumdar SR. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment? Clin Radiol. 2007;62(1):65–72.CrossRefPubMed
31.
Egol KA, Walsh M, Romo-Cardoso S, Dorsky S, Paksima N. Distal radial fractures in the elderly: operative compared with nonoperative treatment. J Bone Joint Surg Am. 2010;92(9):1851–7.CrossRefPubMed
32.
Arora R, Gabl M, Gschwentner M, Deml C, Krappinger D, Lutz M. A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma. 2009;23(4):237–42.CrossRefPubMed
33.
Arora R, Lutz M, Deml C, Krappinger D, Haug L, Gabl M. A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am. 2011;93(23):2146–53.CrossRefPubMed
34.
Clement ND, Duckworth AD, Court-Brown CM, McQueen MM. Distal radial fractures in the superelderly: does malunion affect functional outcome? ISRN Orthop. 2014;2014:189803.CrossRefPubMedPubMedCentral
35.
Altissimi M, Antenucci R, Fiacca C, Mancini GB. Long-term results of conservative treatment of fractures of the distal radius. Clin Orthop Relat Res. 1986;206:202–10.
36.
37.
38.
Abbaszadegan H, von Sivers K, Jonsson U. Late displacement of Colles’ fractures. Int Orthop. 1988;12(3):197–9.CrossRefPubMed
Metadata
Title
Radiographic results after plaster cast fixation for 10 days versus 1 month in reduced distal radius fractures: a prospective randomised study
Authors
Albert Christersson
Sune Larsson
Bengt Östlund
Bengt Sandén
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2016
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-016-0478-7

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