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

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 10days (range 8-13days) followed by randomisation to one of two groups: early mobilisation (n=54, active group) or continued plaster cast fixation for another 3weeks (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 10days to 1month, 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 (0.5mm, p=0.01) compared with the control group. However, during the entire study period (i.e. from admission to 12months), the active group displaced significantly more than the controls only in radial angulation (3.2°, p=0.002) and axial compression (0.7mm, p=0.02). Conclusions: Early mobilisation 10days 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 10days after reduction cannot be recommended for the routine treatment of reduced distal radius fractures. Trial registration: ClinicalTrail.gov, NCT02798614. Retrospectively registered 16 June 2016.