The Effect of Long Arm Cast and Thumb Spica Arm Cast in the Treatment of Patients with Distal Radius Fractures: A Randomized Clinical Trial

Distal radius fracture is among the most common fractures of the long bones that are seen in all age groups. Treatment of these fractures in simple cases with displacement or intra-articular fractures is immobilizatgion, and if the fracture has dislocation, surgery may be required.

The aim of the study is a comparison of treatment efficacy and satisfaction in the methods of a long cast and thumb Spica cast in the patients with distal radius fractures without displacement.

This study is a randomized clinical trial with a non blinded parallel design. Eighty patients with distal radius fractures without displacement were randomly assigned to long cast and thumb Spica cast groups. Patients were randomly using a random number table assigned to one of two long cast and thumb Spica castmethods. Both groupswere examined atweeks 4 and 5 and after six weeks plaster was opened and after one week they were evaluated by DASH questionnaire. Performance (limitation of motion, grip strength) and patients’ satisfaction was assessed in the two groups.

Themean age of patientswas 49.87±13.81 years. Therewere no significant differences between two groups regarding age(P= 0.84). In thumb Spica group 60% and in the long cast group 55% were male. There was no significant difference in sex distribution between treatment groups. The DASH scores in all subjectswere 11.68±5.53. Average total DASH score in thumb Spica cast group was 7.19 ± 6.80 and in the long cast was 16.02 ± 6.23. The mean of total DASH score in thumb Spica cast group was significantly higher than long cast group that presented better performance (limitation of motion, grip strength) in thumb Spica cast group respect to long cast group (P < 0.001). Satisfaction was similar between two groups (P = 0.40).

Regarding better performance and treatment, thumb Spica cast is recommended as the preferred treatment for distal radius fractures without displacement.