Blomstrand Johanna, Sellbrant Irén, Nellgård Bengt, Karlsson Jon, Fagevik Olsén Monika, Kjellby Wendt Gunilla
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Mölndal, Sweden.
J Orthop Surg Res. 2025 Jul 21;20(1):691. doi: 10.1186/s13018-025-06097-0.
A distal radius fracture (DRF) is one of the most common fractures and is often treated with open reduction and volar-plate fixation, followed by immobilisation with a cast. Both the type and length of immobilisation are still the subject of debate, and studies investigating a prefabricated brace as an alternative to a cast are lacking. The aim of this study was to evaluate and compare the outcomes in terms of patients’ perceived disability, pain and grip strength, in patients treated with conventional immobilisation using a plaster cast compared with a prefabricated, stable wrist brace. The hypothesis was that the brace would have equal effect compared to the traditional cast regarding perceived disability, pain and grip strength.
The study is a randomised controlled study (RCT), in which 60 patients were allocated to two groups, to either a cast or a prefabricated brace, following surgery after a distal radius fracture. The patients were assessed at five follow-ups in terms of perceived disability, pain and grip strength.
The analysis of equivalence between the cast group and the brace group showed that the outcomes in the groups can be regarded as equivalent, since all the minimal clinical important differences (MCID) limits were outside the confidence range of differences ( < 0.05). This indicates that there is no difference in terms of a cast or brace in either patients’ perceived disability, pain or grip strength at the measured time points.
A prefabricated, removable brace was shown to be an equally good choice for immobilisation as a cast, following surgery after distal radius fracture, in terms of patients’ perceived disability, pain and grip strength.
FoU i VGR, project number: 228311, registered 13 June 2017, https://www.researchweb.org/is/vgr/project/228311. Retrospectively registered at http://www.clinicaltrials.gov (NCT03749174) on 21 November 2018 with information on inclusion start 3 September 2018.
桡骨远端骨折（DRF）是最常见的骨折之一，通常采用切开复位和掌侧钢板固定治疗，随后用石膏固定。固定的类型和时长仍存在争议，且缺乏关于预制支具替代石膏的研究。本研究的目的是评估并比较在接受传统石膏固定与预制稳定腕部支具治疗的患者中，患者的感知残疾、疼痛和握力方面的结果。假设是在感知残疾、疼痛和握力方面，支具与传统石膏具有同等效果。
本研究为随机对照试验（RCT），60例桡骨远端骨折术后患者被分为两组，分别使用石膏或预制支具。在五次随访中对患者的感知残疾、疼痛和握力进行评估。
石膏组和支具组的等效性分析表明，两组结果可视为等效，因为所有最小临床重要差异（MCID）界限均超出差异置信范围（<0.05）。这表明在测量时间点，无论是使用石膏还是支具，患者在感知残疾、疼痛或握力方面均无差异。
就患者的感知残疾、疼痛和握力而言，预制可移除支具在桡骨远端骨折术后固定方面显示出与石膏同样良好的选择。
韦斯特福尔郡研究伦理委员会，项目编号：228311，于2017年6月13日注册，https://www.researchweb.org/is/vgr/project/228311。于2018年11月21日在http://www.clinicaltrials.gov（NCT03749174）进行回顾性注册，包含2018年9月3日纳入起始信息。
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