Functional bracing in distal radius fractures: a cadaveric pilot study

Abstract

Background Extra-articular distal radius fractures are often treated by circular casting. A functional brace, however, may equally support the fracture zone but allows early mobilization of the radiocarpal joint. Since the amount of fracture movement for different types of fixation is currently unknown, a study was initiated to investigate the degree of bone displacement in extra-articular distal radius fractures fixated by regular circular casting, functional bracing, or no-fixation. Methods In four cadaveric arms, an extra-articular distal radius fracture was simulated and immobilized by the three ways of fixation. After creating an extra-articular distal radius fracture, the fracture was reduced anatomically and the cadaveric arm was strapped in a test frame. Hereafter, flexion, extension and deviation of the hand were then induced by a static moment of force of one newton meter. Subsequently CT scans of the wrist were performed and bone displacement was quantified. Results Immobilization of an extra-articular distal radius fracture by functional bracing provides comparable fixation compared to circular casting and no fixation, and shows significantly less extension-rotation displacement of the distal bone segment for the wrist in flexion and palmodorsal translation and extension-rotation for the wrist in extension. Conclusion Functional bracing of extra articular distal radius fractures in cadaveric arms provides significant less extension-rotation displacement in flexion and palmodorsal translation and extension-rotation in extension compared to circular casting and no fixation.