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Early alteration after distal radius fracture casting not associated with loss of alignment
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Although cast alteration after casting for distal radius fractures is common, early cast alteration was safe and not associated with loss of alignment, according to study results.
Researchers retrospectively reviewed patient records for 296 adult patients who presented with distal radius fracture and were treated with a below-elbow circumferential plaster cast at a tertiary care hospital from 2006 to 2009. Outcome measures included patient demographics, polytrauma at the time of injury, subspecialty of the physician performing the reduction and type of cast alteration.
The researchers used radiographs to assess initial fracture characteristics and secondary displacement of reduction over time, and an analysis was performed to identify predictive variables for the early cast alteration and determine the alterations’ effects on fracture alignment.
Study results showed 22.2% of patients underwent cast alteration during the early treatment, with splitting as the most common alteration performed, followed by application of new cast and cast trimming.
Upon stratifying by fracture classification, the researchers found patients with type A fractures had an alteration frequency of 23% compared with 22% in patients with type B fractures and 21% in patients with type C fractures.
Among patients treated by orthopedic residents, 22% had their cast altered compared with 21% of patients treated by emergency room physicians.
According to study results, 36% of patients with multiple injuries had their cast altered, whereas 21% of patients with isolated distal radius fractures had their cast altered.
No type of cast alteration was found to be significantly predictive of loss of fracture alignment at 2 or 6 weeks, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.
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