Distal radial fractures in adults: 4 versus 6weeks of cast immobilisation after closed reduction, a randomised controlled trial.

Abstract

In this study, we aim to evaluate whether the functional outcome of Distal Radius Fractures (DRFs) could be enhanced by shortening the period of immobilisation from six weeks to four weeks. This study is a single blinded randomised controlled trial. Four week plaster cast immobilisation was compared with six week plaster cast immobilisation in adult patients (older than 18years) with adequately reduced DRFs. The primary outcome parameters were functional outcome measured by Quick DASH score after 1-year follow-up. Secondary outcomes were: Quick DASH after three months, 6months, range of motion, and complications (such as number of re-interventions, secondary displacement, delayed and non-union). 80 patients (16 male and 64 female, mean age, 61.76years) were included and randomized. 65 patients completed the 1-year follow-up. After 1-year follow up, no significant differences were found between the two groups in the QUICK DASH score (P = 0.55). Moreover, no significant differences in DASH Score after three and six months (P = 0.24, 0.28, respectively). The complication rate among both cohorts was almost similar, (P = 0.51). Reduction in the time of cast immobilisation in patients with DRFs in accepted position reported similar outcomes. Of note, the complication rate in the four and six weeks was also the same. Thus, 4weeks in cast is a safe immobilisation period. Clinical Trials Number Trial registration number and date of registration for prospectively registered trials at http://ClinicalTrials.gov (NCT05012345), on 19/08/2021.