Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial

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Raittio , L , Launonen , A P , Hevonkorpi , T P , Luokkala , T , Kukkonen , J , Reito , A , Laitinen , M K & Mattila , V 2020 , ' Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial ' , PLoS One , vol. 15 , no. 5 , e0232153 . https://doi.org/10.1371/journal.pone.0232153

Title: Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial
Author: Raittio, Lauri; Launonen, Antti P.; Hevonkorpi, Teemu P.; Luokkala, Toni; Kukkonen, Juha; Reito, Aleksi; Laitinen, Minna K.; Mattila, Ville
Contributor: University of Helsinki, HUS Musculoskeletal and Plastic Surgery
Date: 2020-05-29
Language: eng
Number of pages: 7
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/317742
Abstract: Background: Distal radius fractures are common fractures and the cornerstone of treatment remains immobilization of the wrist in a cast. At present, there is a scarcity of studies that compare different cast immobilization methods. The objective of the study was therefore to compare volar-flexion and ulnar deviation cast to functional cast position in the treatment of dorsally displaced distal radius fracture among elderly patients. Methods and findings: We performed a pragmatic, randomized, controlled trial in three emergency centers in Finland. After closed reduction of the fracture, the wrist was placed in either volar-flexion and ulnar deviation cast or functional cast position. The follow-up was 12 months. The primary outcome was patient-rated wrist evaluation (PRWE) score at 12 months. The secondary outcomes were Quick-DASH score, grip strength, health-related quality of life (15D), and pain catastrophizing scale. The number of complications was also recorded. In total, 105 participants were included in the study. Of these, 88% were female and the mean age was 73.5 (range 65-94) years. In the primary analysis, the mean difference in patient-rated wrist evaluation measure between groups was -4.9 (95% CI: -13.1.- 3.4., p = .24) in favor of the functional cast position. Operative treatment due to loss of reduction of fracture was performed for four patients (8%) in the FC group and for seven patients (13%) in the volar-flexion and ulnar deviation cast group (OR: 0.63, 95% CI: 0.16-2.1). Conclusion: In this study, the data were consistent with a wide range of treatment effects when comparing two different cast positions in the treatment of distal radius fracture among elderly patients at 12-month follow-up. However, the functional cast is more likely to be superior when compared to volar-flexion and ulnar deviation cast.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
DISTAL RADIUS FRACTURES
PRACTICAL CLINICAL-TRIALS
LOCKING PLATE FIXATION
EXTERNAL FIXATION
EXTRAARTICULAR FRACTURES
NONOPERATIVE TREATMENT
PATIENTS OLDER
PLASTER CAST
IMMOBILIZATION
OUTCOMES
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