Abstract
Background Patients with non- or minimally displaced distal radial fractures, that do not need
repositioning, are mostly treated by a short-arm cast for a period of 4 to 6 weeks.
A shorter period of immobilization may lead to a better functional outcome.
Purpose We conducted a randomized controlled trial to evaluate whether the duration of cast
immobilization for patients with non- or minimally displaced distal radial fractures
can be safely shortened toward 3 weeks.
Materials and Methods The primary outcomes were patient-reported outcomes measured by the Patient-Related
Wrist Evaluation (PRWE) and Quick Disability of Arm, Shoulder and Hand (QuickDASH)
score after 1-year follow-up. Secondary outcome measures were: PRWE and QuickDASH
earlier in follow-up, pain (Visual Analog Scale), and complications like secondary
displacement.
Results Seventy-two patients (male/female, 23/49; median age, 55 years) were included and
randomized. Sixty-five patients completed the 1-year follow-up. After 1-year follow
up, patients in the 3 weeks immobilization group had significantly better PRWE (5.0
vs. 8.8 points, p = 0.045) and QuickDASH scores (0.0 vs. 12.5, p = 0.026). Secondary displacement occurred once in each group. Pain did not differ
between groups (p = 0.46).
Conclusion Shortening the period of immobilization in adult patients with a non- or minimally
displaced distal radial fractures seems to lead to equal patient-reported outcomes
for both the cast immobilization groups. Also, there are no negative side effects
of a shorter period of cast immobilization. Therefore, we recommend a period of 3
weeks of immobilization in patients with distal radial fractures that do not need
repositioning.
Keywords conservative treatment - distal radial fractures - wrist fractures - immobilization
period
