Early results after colles' fracture: functional bracing in supination vs dorsal plaster immobilization

Abstract

A randomized clinical study of functional bracing in supination (FUSU) versus dorsal plaster immobilization (DPI) was conducted in 145 patients with Colles' fracture. A dynamic wrist unit was developed and used in 68 patients allocated for FUSU. The anatomical end result after FUSU was excellent or good in 80% of the patients versus 64% after DPI (P less than 0.05), in particular due to less dorsal angulation (P less than 0.001) and less radial shortening. The functional recovery was equal after 7 weeks and 3 months. At 6 months, 92% satisfactory results were achieved after FUSU versus 86% after DPI (P less than 0.05). Both anatomical and functional benefits were recorded in Frykman type V, VI, and VIII fractures and in the group of displaced intra-articular fractures. The functional benefit from FUSU is suggested primarily to be secondary to decreased fracture redislocation.

Common Myths and Evidence in the Management of Distal Radius Fractures

“…Some investigators argued that the brachioradialis is a major deforming force, and consequently, the injured forearm must be splinted in a long arm brace that maintains the forearm in supination to reduce the brachioradialis’ influence. 20, 21 Others have made a case that the pronator quadratus is more deformational and thus splinted in pronation. 22 The sugar-tong splint is the most commonly used option for bracing a DRF after reduction.…”

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

“…2 Numerous studies have focused on the best forearm position for fracture immobilization and as a result a large amount of conflicting data have been generated. Sarmiento et al 3 4 identified the brachioradialis as a major deforming force and concluded that a long-arm brace in supination is required to neutralize its action. Other investigators have proposed the use of a long-arm cast in pronation, implicating the pronator quadratus as the major factor leading to redisplacement.…”

Aberdeen Colles’ fracture brace as a treatment for Colles’ fracture

“…The reported efficacy of this treatment varies. Bunger et al 17 found no difference in the functional outcome after treatment in a plaster cast, a functional brace, and external fixation at three and six months, although the anatomical results were better after external fixation. Ledingham et al 13 reported good early functional results and a better radiological appearance with a plaster functional brace when compared with conventional treatment in a cast.…”