Cast-OFF Trial: One Versus 4 to 5 Weeks of Plaster Cast Immobilization for Nonreduced Distal Radius Fractures: A Randomized Clinical Feasibility Trial

• Published in: Hand (New York, N.Y.) Vol. 17; no. 1_suppl; pp. 60S - 69S
• Main Authors: Boersma, Emily Z., Hekma, Edo J., Kraaijvanger, Nicole, Mollen, Roland M. H. G., Nijhuis-van der Sanden, Maria W. G., Edwards, Michael J. R.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.12.2022
• Subjects: Casts, Surgical; Feasibility Studies; Humans; Pain; Pilot Projects; Radius Fractures - therapy; Wrist Fractures; distal radius; fracture/dislocation; nonreduced; specialty; nonoperative treatment; diagnosis; pain management; wrist
• ISSN: 1558-9447; 1558-9455
• DOI: 10.1177/15589447211044775

Background Distal radius fracture is a common fracture of which the incidence appears to be increasing worldwide. This pilot study investigated whether 1 week of plaster cast is feasible for nonreduced (stable fractures including nondisplaced and displaced fractures) distal radius fractures. Methods The study was a multicenter randomized clinical feasibility trial including patients from regional acute care providers. Patients with a nonreduced distal radius fracture were included in the study. Nonreduced fractures meant intra-articular or extra-articular fractures and including nondisplaced and minimal displaced fractures (dorsal angulation less than 5°-10°, maximum radial shortening of 2 mm, and maximum radial shift of 2 mm) not needing a reduction. Forty Patients were included and randomized. After 1 week of plaster cast, patients were randomized to 1 of the 2 treatment groups: plaster cast removed (intervention group) versus 4 to 5 weeks of plaster cast (control group). Results The analysis shows no significant differences between the 2 groups in having less pain, better function after 6 weeks, and better overall patient satisfaction. No difference was shown in secondary displacement between the 2 groups (control 1 vs intervention 0) Conclusion One week of plaster cast treatment for nonreduced distal radius fracture is feasible, preferred by patients, with at least the same functional outcome and pain scores. Level of Evidence According to the Oxford 2011 level of evidence, the level of evidence of this study is 2.