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Comparison of Volar-flexion, Ulnar-deviation and Functional Position Cast Immobilization in the Non-operative Treatment of Distal Radius Fracture in Elderly Patients: a Pragmatic Randomized Controlled Trial (NCT02894983)

Central Finland Hospital District
Satakunta Central Hospital
There is no consensus about the best conservative treatment for patients with dorsally displaced distal radius fractures. The previous studies that have examined the most valid method for cast immobilization have lacked uniform and patient-rated outcome measures, proper randomization and sufficient study population. The aim of this study is to compare functional position cast to flexion-ulnar -deviation with dorsally displaced distal radius fractures in patients aged 65 years or older. The conservative treatment is performed in clinical practice by various health care professionals with different techniques of reduction which are not limited to any specific technique in this pragmatic, randomized controlled trial.
  • Other: Flexion-ulnar cast
    The group will be treated with closed reduction and flexion-ulnar deviation position cast. This will take place under local anaesthesia by means of local infiltration commonly used in Finland. There is no preferable method for performing the reduction. Additional radiographs will be taken to verify the success of the reduction one week after the reduction and after two and five weeks of casting if treating health care professional it requires. The cast will be disposed after weeks.
    • Conservative treatment
  • Other: Functional cast
    The group will be treated with closed reduction and functional position cast. This will take place under local anaesthesia by means of local infiltration commonly used in Finland. There is no preferable method for performing the reduction. Additional radiographs will be taken to verify the success of the reduction one week after the reduction and after two and five weeks of casting if treating health care professional it requires. The cast will be disposed after weeks.
    • Conservative treatment
Ages eligible for Study
65 Years and older
Genders eligible for Study
All
Accepts Healthy Volunteers
No
Inclusion Criteria:
  • Low energy intra- or extra-articular dorsal primarily stable, reducible DRF within 3 cm of the radiocarpal joint diagnosed with lateral and posterior-anterior radiographs in ER
  • Physician on-call (general practitioner, acute physician, orthopedic resident, orthopedic consult) thinks patient could be appropriate for non-operative treatment
Exclusion Criteria:
  • Operative treatment
  • Refuse to participate the study
  • Open fracture more than Gustilo 1 gradus
  • Age under 65 years
  • Chauffeure's or Barton´s fracture
  • Smith´s fracture (volar angulation of the fracture)
  • Does not understand written and spoken guidance in local languages
  • Pathological fracture or previous fracture in the same wrist, forearm or elbow

3 locations

Finland (3)
  • Central Finland Central Hospital
    Not specified
    Jyväskylä, Finland
  • Satakunta Central Hospital
    Not specified
    Pori, Finland
  • Tampere Univeristy Hospital
    Not specified
    Tampere, Finland
Status:
active not recruiting
Type:
Interventional
Phase:
-
Start:
31 May, 2016
Updated:
13 August, 2017
Participants:
114
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