scholarly journals Cast OFF-2: 1 week of plaster cast immobilization for non-reduced distal radius fractures—a study protocol for an implementation study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Emily Boersma ◽  
Erik van de Krol ◽  
Tjarda Tromp ◽  
Maria Nijhuis - van der Sanden ◽  
Michael Edwards
Keyword(s):  
Cost Effectiveness ◽  
Functional Outcome ◽  
Distal Radius ◽  
Study Protocol ◽  
Plaster Cast ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Cast Immobilization ◽  
Usual Practice ◽  
Patient Reported

Abstract Background The distal radius fracture (DRF) is a common fracture, with the majority of these fractures being stable. Of all diagnosed fractures, 17% is a DRF, of which a large part is extra-articular and one-third is non-displaced. There is a large variation in treatment advisements for non-reduced DRF. Four to 5 weeks of immobilization is often the usual practice. Existing evidence shows that 1 week of immobilization is safe and does not lead to an increase in secondary displacement. Additionally, shorter immobilization periods may lead to less outpatient clinic visits and less home care for elderly people and may lead to earlier return to work and other social activities. Therefore, shorter immobilization periods for non-reduced distal radius fractures may also prove to be cost-effective. In this study, we aim to successfully implement 1 week of plaster cast immobilization for non-reduced distal radius fractures in twelve medical centers and to evaluate the functional outcome and cost-effectiveness. Methods This study will be performed using a multicenter randomized stepped wedge design in 12 centers. We aim to include in the study 440 patients with an isolated non-reduced DRF between the age of 18 and 85 years old. The patients in the intervention group will be treated with plaster cast immobilization for 1 week. Acceptability of the study protocol, patient-reported outcomes, quality of life, complications, pain catastrophizing score, pain and patient satisfaction, and cost-effectiveness will be measured. The total follow-up will be 12 months. Discussion The strength of this study is the combination of implementing 1 week of plaster cast immobilization for non-reduced DRF and the evaluation of functional outcome, acceptability of the study protocol, and cost-effectiveness in actual practice. Trial registration Netherlands Trial Register NL9278. Registered on 17 February 2021

Is a short arm cast appropriate for stable distal radius fractures in patients older than 55 years? A randomized prospective multicentre study

2017 ◽  
Vol 42 (5) ◽  
pp. 487-492 ◽  
Author(s):  
M. J. Park ◽  
J. P. Kim ◽  
H. I. Lee ◽  
T. K. Lim ◽  
H. S. Jung ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
The Elderly ◽  
Plaster Cast ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Cast Immobilization ◽  
Level Of Evidence

We conducted a prospective randomized, multicentre study to compare short arm and long arm plaster casts for the treatment of stable distal radius fracture in patients older than 55 years. We randomly assigned patients over the age of 55 years who had stable distal radius fracture to either a short arm or long arm plaster cast at the first review 1 week after their injury. Radiographic and clinical follow-up was conducted at 1, 3, 5, 12 and 24 weeks following their injury. Also, degree of disability caused by each cast immobilization was evaluated at the patient’s visit to remove the cast. There were no significant differences in radiological parameters between the groups except for volar tilt. Despite these differences in volar tilt, neither functional status as measured by the Disabilities of the Arm, Shoulder and Hand, nor visual analogue scale was significantly different between the groups. However, the mean score of disability caused by plaster cast immobilization and the incidence rate of shoulder pain were significantly higher in patients who had a long plaster cast. Our findings suggest that a short arm cast is as effective as a long arm cast for stable distal radius fractures in the elderly. Furthermore, it is more comfortable and introduces less restriction on daily activities. Level of evidence: II

Comparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures

2019 ◽  
Vol 46 (3) ◽  
pp. 591-598 ◽  
Author(s):  
Paphon Sa-ngasoongsong ◽  
Manuela Rohner-Spengler ◽  
Dimitri E. Delagrammaticas ◽  
Reto Hansjörg Babst ◽  
Frank J. P. Beeres
Keyword(s):  
Fracture Healing ◽  
Functional Outcome ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Patient Reported

scholarly journals The CAST study protocol: a cluster randomized trial assessing the effect of circumferential casting versus plaster splinting on fracture redisplacement in reduced distal radius fractures in adults

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Britt Barvelink ◽  
◽  
Max Reijman ◽  
Niels W. L. Schep ◽  
Vanessa Brown ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Distal Radius ◽  
Closed Reduction ◽  
Patient Reported Outcomes ◽  
Distal Radius Fractures ◽  
Adult Patients ◽  
Primary Study ◽  
Radius Fractures ◽  
Patient Reported ◽  
Cluster Randomized

Abstract Background There is no consensus concerning the optimal casting technique for displaced distal radius fractures (DRFs) following closed reduction. This study evaluates whether a splint or a circumferential cast is most optimal to prevent fracture redisplacement in adult patients with a reduced DRF. Additionally, the cost-effectiveness of both cast types will be calculated. Methods/design This multicenter cluster randomized controlled trial will compare initial immobilization with a circumferential below-elbow cast versus a below-elbow plaster splint in reduced DRFs. Randomization will take place on hospital-level (cluster, n = 10) with a cross-over point halfway the inclusion of the needed number of patients per hospital. Inclusion criteria comprise adult patients (≥ 18 years) with a primary displaced DRF which is treated conservatively after closed reduction. Multiple trauma patients (Injury Severity Score ≥ 16), concomitant ulnar fractures (except styloid process fractures) and patients with concomitant injury on the ipsilateral arm or inability to complete study forms will be excluded. Primary study outcome is fracture redisplacement of the initial reduced DRF. Secondary outcomes are patient-reported outcomes assessed with the Disability Arm Shoulder Hand score (DASH) and Patient-Rated Wrist Evaluation score (PRWE), comfort of the cast, quality of life assessed with the EQ-5D-5L questionnaire, analgesics use, cost-effectiveness and (serious) adverse events occurence. In total, 560 patients will be included and followed for 1 year. The estimated time required for inclusion will be 18 months. Discussion The CAST study will provide evidence whether the type of cast immobilization is of influence on fracture redisplacement in distal radius fractures. Extensive follow-up during one year concerning radiographic, functional and patient reported outcomes will give a broad view on DRF recovery. Trial registration Registered in the Dutch Trial Registry on January 14th 2020. Registration number: NL8311.

scholarly journals Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis

2013 ◽  
Vol 8 (2) ◽  
pp. 67-75 ◽  
Author(s):  
J. C. Goslings ◽  
Monique M. J. Walenkamp ◽  
Abdelali Bentohami ◽  
M. Suzan H. Beerekamp ◽  
Rolf W. Peters ◽  
...  
Keyword(s):  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius ◽  
Locking Plate ◽  
Meta Analysis ◽  
Distal Radius Fractures ◽  
Plate Versus ◽  
Volar Locking Plate ◽  
Radius Fractures

scholarly journals Osteosynthesis of Unstable Fractures of Distal Radius with Volar Locking Plate

2013 ◽  
Vol 2 (1) ◽  
pp. 27-34
Author(s):  
RL Pradhan ◽  
S Sharma ◽  
BK Pandey ◽  
RR Manandhar ◽  
S Lakhey ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Volar Aspect ◽  
Clinical And Radiological Outcome ◽  
Clinical Scoring ◽  
Unstable Fractures

Background: Various surgical treatment methods are available for unstable distal radius fractures. Clinical and radiological outcome with volar locking plate has been very satisfactory. The purpose of this prospective study is to evaluate the results of the treatment of unstable fractures with the volar locking plate with regard to loss of reduction, functional outcome and complications. Methods: Unstable distal radius fractures were enrolled for the study from May 2008 until July 2010. All patients were treated with 3.5 mm distal radius volar locking plate and assessed by clinical and radiological examination. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome. Results: Eighteen male and 12 female patients with the average age of 42.53 (range 30- 64years) were followed up for a period of 9 to 34 months (average.23 months). There were fourteen A3 fractures, nine C1 fractures, six C2 fractures, and one C3 fracture, whereas one had a Gustilo grade I open wound on the volar aspect. Seven of the fractures had associate fracture of the ulnar styloid. The functional outcome was excellent in 23 (76%), good in 6 (20%), fair in 1 (4%) and none had poor outcome. There were very few complications in our series. Conclusion: Unstable fractures of distal radius treated by open reduction with volar locking plate provides adequate fixation with no collapse in reduction and also have satisfactory functional outcome with minimal complications. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8137 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 27-34

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