Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial.
<h4>Background</h4>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 compa...
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2020-01-01
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| author | Lauri Raittio Antti P Launonen Teemu Hevonkorpi Toni Luokkala Juha Kukkonen Aleksi Reito Minna K Laitinen Ville M Mattila |
| author_facet | Lauri Raittio Antti P Launonen Teemu Hevonkorpi Toni Luokkala Juha Kukkonen Aleksi Reito Minna K Laitinen Ville M Mattila |
| author_sort | Lauri Raittio |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusion</h4>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.<h4>Trial registration</h4>ClinicalTrials.gov identifier: NCT02894983 Accessible: https://clinicaltrials.gov/ct2/show/NCT02894983. |
| format | Article |
| id | doaj-art-6971f06c63b347ea89bb387eb3046069 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2020-01-01 |
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| spelling | doaj-art-6971f06c63b347ea89bb387eb30460692025-08-20T02:59:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01155e023215310.1371/journal.pone.0232153Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial.Lauri RaittioAntti P LaunonenTeemu HevonkorpiToni LuokkalaJuha KukkonenAleksi ReitoMinna K LaitinenVille M Mattila<h4>Background</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusion</h4>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.<h4>Trial registration</h4>ClinicalTrials.gov identifier: NCT02894983 Accessible: https://clinicaltrials.gov/ct2/show/NCT02894983.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0232153&type=printable |
| spellingShingle | Lauri Raittio Antti P Launonen Teemu Hevonkorpi Toni Luokkala Juha Kukkonen Aleksi Reito Minna K Laitinen Ville M Mattila Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial. PLoS ONE |
| title | Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial. |
| title_full | Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial. |
| title_fullStr | Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial. |
| title_full_unstemmed | Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial. |
| title_short | Two casting methods compared in patients with Colles' fracture: A pragmatic, randomized controlled trial. |
| title_sort | two casting methods compared in patients with colles fracture a pragmatic randomized controlled trial |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0232153&type=printable |
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