Distal Radius Fractures
Conditions
Keywords
radius fracture, finger-trap traction, manual reduction, closed reduction
Brief summary
Participants with distal radius fractures treated conservatively with cast immobilization are assigned to one of two approaches: (1) closed reduction under local anesthesia (hematoma block) followed by traction and casting, or (2) traction and casting without formal reduction. While reduction aims to restore anatomical alignment, loss of reduction may occur during follow-up. The study evaluates whether reduction under local anesthesia provides any benefit over traction alone. The hypothesis is that both treatments result in comparable radiographic alignment and functional outcomes at the end of treatment.
Detailed description
Participants have sustained a distal radius fracture treated with cast immobilization. Two common conservative management approaches are being compared: (1) closed reduction under a local anesthetic (hematoma block) followed by traction and casting, and (2) immobilization after traction alone without formal reduction under anesthesia. While the first method aims to restore anatomical alignment initially, loss of reduction may occur over time. The second method improves alignment but does not attempt full anatomical reduction. The study hypothesis is that both approaches result in similar wrist alignment and functional outcomes after completion of treatment. The objective of this study is to determine whether reduction under local anesthesia followed by traction provides any advantage over traction alone in patients with distal radius fractures.
Interventions
PROCEDUREFinger-trap traction
15 minutes finger-trap traction only and then cast application
PROCEDUREManual reduction
Hematoma block 5 mL 2% lidocaine, followed by 15 minutes finger-trap traction and then manual reduction + cast application
Sponsors
Medical University Innsbruck
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Dorsally tilted distal radius fracture (DRF) \> 10° (intra-articular or extra-articular) Dorsal comminution of the distal radius fracture Fracture classification (AO), dorsally displaced: * A2 * A3 * C1 * C2 * C3
Exclusion criteria
* Age under 18 years * Non-displaced fractures of the radius * Previous palmar displaced fractures of the radius * Displacement greater than one shaft width * Open fractures of the radius * Bilateral radius fractures * History of a previous radius fracture * Inability to provide informed consent due to physical or mental disability * Unavailability for follow-up examinations (e.g., abroad, polytrauma) * Lack of full legal capacity * Alcohol or drug abuse * Allergy to local anesthetics * Median nerve irritation * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain difference between the groups | From enrollment (Baseline) to the 12month Follow Up. | Comparison of the pain score in the course of the follow ups between the groups. 0= no pain 10 = worst pain (maximal pain) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| MHQ Hand Score (Patient reported outcome) | Enrollment until 12 month follow up | Difference in functional outcome measured with MHQ (Michigan Hand Outcome Questionaire) between the two groups. 0 points= very poor hand function / maximum impairment; 100 points → optimal hand function, no impairment. |
| PRWE - Patient reported outcome | Enrollment until 12month follow up | Difference in functional outcome measured with PRWE (Patient-rated wrist evaluation) between the two groups. 0 points= optimal hand function, no impairment; 100 points → very poor hand function / maximum impairment. |
| Grip strength | 12 weeks until 12mo Follow up | Difference in grip strength measured with dynanometer between the two groups. Grip strength is compared to the contralateral non-injured wrist. |
| Range of motion - functional outcome | 12 weeks until 12 mo follow-up | Difference in functional outcome (range of motion) measured with goniometer after treatment between the two groups. Range of Motion is compared to the contraltaeral non-injured wrist. |
| Radiological outcome | Enrollment until 12 month Follow up | Difference in radiological outcome between the two groups; especially, dorsal tilt, radial inclination and ulnar variance. |
| Complications | After treatment until 12 month Follow up | Complications between the two groups. |
Countries
Austria
Outcome results
None listed