Published: 2019-04-26

Cast immobilization in fracture distal radius with wrist in dorsiflexion

Pradeep K. Verma, Rajesh Singh, Abhishek Thakur


Background: The purpose of this study was to evaluate the anatomical and functional outcome of cast immobilization in fracture distal radius with wrist in dorsiflexion. Study design selected was prospective cohort study.

Methods: The study group comprised 60 patients, with a mean follow-up of 3 month. Patients were evaluated for radial height, radial inclination and volar tilt according to Lindstrom criteria. Functional outcome were assessed with PRWE score.

Results: Mean loss of radial height was 4.11 mm. Mean loss of radial inclination was 6.85 degree and mean loss of volar tilt was 7.06 degree at the end of 3 month follow up. As per Lindstrom criteria 88% were excellent to fair and 93% were excellent to fair functional outcome as per PRWE score.

Conclusions: Cast immobilization in fracture distal radius with wrist in dorsiflexion produces better anatomical and functional outcome.



Distal radius fracture, Cast immobilization, Dorsiflexion

Full Text:



Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37(8):691-7.

Mallmin H, Ljunghall S. Distal radius fracture is an early sign of general osteoporosis: bone mass measurements in a population-based study. Osteoporos Int. 1994;4(6):357-61.

Sigurdardottir K, Halldorsson S, Robertsson J. Epidemiology and treatment of distal radius fractures in Reykjavik, Iceland, in 2004. Comparison with an Icelandic study from 1985. Acta Orthop. 2011;82(4):494-8.

Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001;26(5):908-15.

Ipaktchi K, Livermore M, Lyons C, Banegas R. Current concepts in the treatment of distal radial fractures. Orthopedics. 2013;36(10):778-84.

Sarmiento A, Pratt GW, Berry NC, Sinclair WF. Colles’ fractures, functional bracing in supination. J Bone Joint Surg Am 1975;57:311-7.

MacDermid JC. Development of a scale for patient rating of wrist pain and disability. J Hand Ther. 1996;9:178-83.

Charnley J. The closed treatment of common fractures. 3rd ed. E. & S. Livingstone Ltd, London; 1963: 139-140.

Sarmiento A, Latta LL. Colles' fractures: functional treatment in supination. Acta Chir Orthop Traumatol Cech. 2014;81(3):197-202.

Gupta A. The treatment of Colles' fracture. Immobilisation with the wrist dorsiflexed. J Bone Joint Surg Br. 1991;73(2):312-5.

Phillips AR, Al-shawi A. Restoration of the volar cortex: predicting instability after manipulation of distal radial fractures. Injury. 2014;45(12):1896-9.

Leone J, Bhandari M, Adili A, Mckenzie S, Moro JK, Dunlop RB. Predictors of early and late instability following conservative treatment of extra-articular distal radius fractures. Arch Orthop Trauma Surg. 2004;124(1):38-41.

Wadsten MÅ, Sayed-noor AS, Englund E, Buttazzoni GG, Sjödén GO. Cortical comminution in distal radial fractures can predict the radiological outcome: a cohort multicentre study. Bone Joint J. 2014;96(7):978-83.

Hove LM, Solheim E, Skjeie R, Sörensen FK. Prediction of secondary displacement in Colles' fracture. J Hand Surg Br. 1994;19(6):731-6.

Baruah RK, Islam M, Haque R. Immobilisation of extra-articular distal radius fractures (Colles type) in dorsiflexion. The functional and anatomical outcome. J clin orthopaedics trauma. (2015);6(3):167-72.

Rajan S, Jain S, Ray A, Bhargava P. Radiological and functional outcome in extra-articular fractures of lower end radius treated conservatively with respect to its position of immobilization. Indian journal of orthopaedics. (2008);42(2):201-7.