Clinical and Radiographic Comparison of Splinting Constructs for Distal Radius Fractures: An Effort to Free the Elbow

Objectives: To compare short-term functional outcomes, reduction loss, and rates of surgery for distal radius fractures initially immobilized with a traditional sugar-tong splint versus clamshell splint freeing the elbow. Design: Prospective randomized trial. Setting: Level 1 trauma center. Patients: Eighty-nine consecutive patients sustaining distal radius fractures were enrolled between 2018 and 2020. Short-term first follow-up (1-2 weeks) radiographic parameters and 6 weeks for functional questionnaires were established to assess initial outcomes. Main Outcome Measures: The main outcome measures were reduction loss based on radiographic criteria, rate of surgery, and short-term patient functional outcome using the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results: There were no differences noted in DASH scores (P-value = 0.8) or loss of reduction (P-value = 0.69), and splint type was not correlated with likelihood to have surgery (P = 0.22). A binomial regression model demonstrated splint type was not a significant predictor variable of loss of fracture reduction in the regression model. Conclusions: These results suggest both sugar-tong splint and clamshell splint construct are acceptable options in the acute management of distal radius fractures.

Automated summary

This study compared the effects of a traditional sugar-tong splint and a clamshell splint on the acute management of distal radius fractures. The results showed no significant differences in short-term functional outcomes, reduction loss, or rates of surgery between the two splint types.