Non- or Minimally Displaced Distal Radial Fractures in Adult Patients: Three Weeks versus Five Weeks of Cast Immobilization—A Randomized Controlled Trial
| Autor: | E. A. K. van Delft, J. C. Goslings, Jefrey Vermeulen, N. de Korte, Nico L. Sosef, Niels W. L. Schep, Taco S. Bijlsma, Abdelali Bentohami |
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| Rok vydání: | 2018 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty Adult patients Visual analogue scale business.industry Wrist Surgery law.invention Radial fractures 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Randomized controlled trial law medicine Cast immobilization Orthopedics and Sports Medicine In patient 030212 general & internal medicine business Lead (electronics) |
| Zdroj: | Journal of Wrist Surgery. :043-048 |
| ISSN: | 2163-3924 2163-3916 |
| DOI: | 10.1055/s-0038-1668155 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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