The contralateral side is used as a reference. This study is based on the hypothesis that above-elbow (AE) splint immobilization in patients with DRF will present better results for loss of reduction and radiographic parameters, but more complication rate and worse functional outcomes when compared to below-elbow (BE) immobilization methods at the end of a six-month follow-up.ĭisplaced and reducible fractures classified by AO as type A2, A3, C1, C2 and C3 will be included if one of these conditions is present. Other studies found similar results between immobilization methods in maintaining the initial fracture reduction. Casts that include the elbow joint, which prevents the rotation of the forearm, may result in greater stability of the fracture and less risk of loss of reduction and need for re-reduction. īelow-elbow (BE) splinting is easier to apply, is lower in cost, lighter, provides greater comfort, better function for daily life activities and less articular stiffness of the elbow. Regarding non-surgical treatment, Cochrane review based on randomized controlled trials has concluded there are controversial in terms of the type of casting to be applied after the initial fracture reduction and there is no conclusive evidence of difference in outcome between different positions and methods of plaster and brace management for the common types of DRF. Trial registrationĪlthough distal radius fractures (DRF) are among the most frequent of the upper limb, the best method of treatment and outcome of these fractures has not yet been fully defined. Results from this study protocol will help to define the need for elbow immobilization in maintenance of reduction, as well as functional performance of below elbow cast versus above elbow cast immobilization during the immobilization period. We consider an extra 10% for balancing follow up losses results in 64 patients per group. For the Student’s t-test, a difference of 10 points in DASH score, with 95% confidence interval, a statistical power of 95%, and 20% sampling error. Evaluations will be performed at 1, 2, 3, 4, 6, 8, 12 and 24 weeks. Secondary outcomes include function measured by Patient Rated Wrist Evaluation (PRWE), pain measured by the Visual Analogue Scale (VAS), objective functional evaluation (goniometry and dynamometry) and rate of complications. ![]() ![]() The primary outcome will be the maintenance of reduction by evaluation of radiographic parameters and Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH). A hundred twenty eight consecutive adult patients with acute (up to 7 days) displaced DRF of type A2, A3, C1, C2 or C3 by the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification will be included. There are two non-surgical interventions: AE and BE. This is a randomized clinical trial with parallel groups and a blinded evaluator. This study aimed to evaluate the best method of immobilization between above-elbow (AE) and below-elbow (BE) cast groups at the end of six-month follow-up. ![]() However, the literature is inconclusive regarding the need to immobilize the elbow joint after reduction in order to prevent rotation of the forearm in order to maintain the reduction of DRF. A variety of cast options are available for the non-surgical treatment of distal radius fractures (DRF) in adults.
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