COMPARATIVE-STUDY OF 2 METHODS OF PLASTER CAST FIXATION IN THE TREATMENT OF COLLES FRACTURE - A PROSPECTIVE RANDOMIZED STUDY

The purpose of this study was to compare the functional and radiologic al result of two different positions of the wrist in a plaster cast fo llowing Colles' fracture. For this prospective study, each of 50 patie nts with type A 2.2, A 3.3, C 1.2 or C 2.2 (AO classification) fracutr es of the radius was randomly assigned to one of two groups. Both grou ps were treated in the same way as far as anaesthesia and reduction we re concerned. The only difference in treatment lay in the position of fixation in plaster. In group 1 the wrist was immobilized in neutral f lexion-extension. In group 2 the wrist was dorsiflexed 20-degrees, whi le the carpus was pushed in a volar direction by an impression in the plaster cast. At review 2-7 years after the accidents, the two groups were compared with reference to symptoms, range of motion at the wrist , power of first closure and radiographic appearance. In group 1 there were 5 patients with significant disability, compared with only 1 in group 2. A significant difference was found in the range of movement b etween the two groups for flexion and ulnar abduction (p < 0.01). The loss of power of first clenching (difference between injured and healt hy hand) was 6.2 mmHg for group 1 and 3.8 mmHg for group 2 (not signif icant). The radiographic examination showed significant differences bo th in sagittal inclination (p < 0.001) and in radial shortening (p < 0 .05). The position of plaster cast fixation of the wrist used in group 2 is a suitable means of reducing the rate of redislocation during th e treatment of Colles' fracture.