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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
64
15 minutes finger-trap traction only and then cast application
Hematoma block 5 mL 2% lidocaine, followed by 15 minutes finger-trap traction and then manual reduction + cast application
Univ.-Klinik für Orthopädie und Traumatologie
Innsbruck, Tyrol, Austria
Pain difference between the groups
Comparison of the pain score in the course of the follow ups between the groups. 0= no pain 10 = worst pain (maximal pain)
Time frame: From enrollment (Baseline) to the 12month Follow Up.
MHQ Hand Score (Patient reported outcome)
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.
Time frame: Enrollment until 12 month follow up
PRWE - Patient reported outcome
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.
Time frame: Enrollment until 12month follow up
Grip strength
Difference in grip strength measured with dynanometer between the two groups. Grip strength is compared to the contralateral non-injured wrist.
Time frame: 12 weeks until 12mo Follow up
Range of motion - functional outcome
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.
Time frame: 12 weeks until 12 mo follow-up
Radiological outcome
Difference in radiological outcome between the two groups; especially, dorsal tilt, radial inclination and ulnar variance.
Time frame: Enrollment until 12 month Follow up
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Complications
Complications between the two groups.
Time frame: After treatment until 12 month Follow up