Park M J, Kim J P, Lee H I, Lim T K, Jung H S, Lee J S
1 Department of Orthopedic Surgery, SungKyunKwan University School of Medicine, Seoul, Korea.
2 Department of Orthopaedic Surgery, Dankook University, Cheonan, Korea.
J Hand Surg Eur Vol. 2017 Jun;42(5):487-492. doi: 10.1177/1753193417690464. Epub 2017 Mar 1.
We conducted a prospective randomized, multicentre study to compare short arm and long arm plaster casts for the treatment of stable distal radius fracture in patients older than 55 years. We randomly assigned patients over the age of 55 years who had stable distal radius fracture to either a short arm or long arm plaster cast at the first review 1 week after their injury. Radiographic and clinical follow-up was conducted at 1, 3, 5, 12 and 24 weeks following their injury. Also, degree of disability caused by each cast immobilization was evaluated at the patient's visit to remove the cast. There were no significant differences in radiological parameters between the groups except for volar tilt. Despite these differences in volar tilt, neither functional status as measured by the Disabilities of the Arm, Shoulder and Hand, nor visual analogue scale was significantly different between the groups. However, the mean score of disability caused by plaster cast immobilization and the incidence rate of shoulder pain were significantly higher in patients who had a long plaster cast. Our findings suggest that a short arm cast is as effective as a long arm cast for stable distal radius fractures in the elderly. Furthermore, it is more comfortable and introduces less restriction on daily activities.
II.
我们进行了一项前瞻性随机多中心研究，以比较短臂和长臂石膏固定治疗55岁以上患者稳定型桡骨远端骨折的效果。我们将55岁以上患有稳定型桡骨远端骨折的患者在受伤后1周的首次复查时随机分配至短臂或长臂石膏固定组。在受伤后的1、3、5、12和24周进行影像学和临床随访。此外，在患者拆除石膏就诊时评估每种石膏固定导致的残疾程度。除掌倾角外，两组间放射学参数无显著差异。尽管掌倾角存在这些差异，但两组间用手臂、肩部和手部功能障碍量表测量的功能状态以及视觉模拟评分均无显著差异。然而，长臂石膏固定导致的残疾平均评分和肩部疼痛发生率在长臂石膏固定的患者中显著更高。我们的研究结果表明，对于老年患者的稳定型桡骨远端骨折，短臂石膏与长臂石膏同样有效。此外，短臂石膏更舒适，对日常活动的限制更少。
II级。
