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A comparison of immediate postreduction splinting constructs for controlling initial displacement of fractures of the distal radius: a prospective randomized study of long-arm versus short-arm splinting.

Authors:
Matthew R Bong Kenneth A Egol Matthew Leibman Kenneth J Koval

J Hand Surg Am 2006 May-Jun;31(5):766-70

Department of Orthopaedic Surgery, New York University/Hospital for Joint Diseases, New York, USA.

Purpose: To compare, in a prospective, randomized manner, the sugar tong splint with a short-arm radial gutter splint in terms of patient satisfaction and the ability to maintain reduction of distal radius fractures.

Methods: A total of 118 patients with displaced distal radius fractures were enrolled; 85 patients (85 fractures) were available for follow-up evaluation and were included in the study population. There were 26 men and 59 women with a mean age of 64 years. Thirty-eight fractures were immobilized in a short-arm radial gutter splint and 47 in a sugar tong splint. Forty fractures had a stable pattern and 45 had an unstable fracture pattern. The initial patient follow-up examination occurred a mean of 8 days after splint application.

Results: A total of 33 fractures showed loss of fracture reduction at the initial follow-up evaluation. Sixteen of 38 fractures immobilized with the radial gutter splint displaced, whereas displacement was seen in 17 of 47 fractures immobilized with a sugar tong splint; this difference was not significant. When the splint constructs were evaluated based on fracture stability no differences were found between the splints' ability to maintain fracture reduction in both stable and unstable displaced fractures. Patients in the short-arm radial gutter splint group had significantly better Disabilities of the Arm, Shoulder, and Hand scores than those patients whose fractures were immobilized with a sugar tong splint.

Conclusions: Both the sugar tong splint and the short-arm radial gutter splint had comparable performance in maintaining the initial reduction of distal radius fractures, with the short-arm splint tolerated better by patients. Based on our study we recommend the use of a short-arm radial gutter splint for initial immobilization of displaced distal radius fractures.

Type Of Study/level Of Evidence: Prognostic, level II.

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http://dx.doi.org/10.1016/j.jhsa.2006.01.016DOI Listing
October 2006

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