Cast Immobilization Versus Percutaneous Pinning for Fracture of Radius in an Elderly Patient

Queen Savang Vadhana Memorial Hospital, Thailand

Status: Completed

Conditions: Closed Fracture of Lower End of Radius

Treatments: Procedure: Cast immobilization; Procedure: Percutaneous pinning

Study type: Interventional

Funder types: Other

Identifiers

NCT06209242

027/2564

Details and patient eligibility

About

Distal radius fractures, particularly in elderly individuals, are a common problem associated with increasing age and hormonal changes. The choice of treatment, such as cast immobilization or percutaneous pinning, plays a crucial role in achieving optimal functional outcomes and facilitating a return to normal activities. This study aimed to compare the radiological and clinical outcomes of cast immobilization and percutaneous pinning in elderly patients with distal radius fractures.

Full description

Background: Distal radius fractures, particularly in elderly individuals, are a common problem associated with increasing age and hormonal changes. The choice of treatment, such as cast immobilization or percutaneous pinning, plays a crucial role in achieving optimal functional outcomes and facilitating a return to normal activities. This study aimed to compare the radiological and clinical outcomes of cast immobilization and percutaneous pinning in elderly patients with distal radius fractures.

Methods: This prospective randomized controlled trial enrolled participants aged over 60 years with AO23-A2 or AO23-A3 distal radius fractures and no contraindications for local anesthesia. The participants were randomly assigned to either the cast immobilization or percutaneous pinning group. Follow-up was conducted for 3 months, during which radiological outcomes and clinical outcomes were assessed. Radiological parameters included radial angulation, while clinical outcomes were evaluated using the Disability of Arm, Shoulder, and Hand (DASH) score, range of motion, and grip strength. Additionally, data on complications and pain levels measured using the Visual Analog Scale (VAS) were collected for the percutaneous pinning group under local anesthesia.

Enrollment: 26 patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged >60 years
• primary distal end radius fracture type AO23-A2 or AO23-A3

Exclusion criteria

• multiple trauma
• onset > 2 weeks
• systemic diseases such as RA
• steroid user
• contraindication for LA

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: Single Blind

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26 participants in 2 patient groups

Cast immobilization

Experimental group

Description:

Using cast immobilization with sugar tong and short arm splinting

Treatment:

Procedure: Cast immobilization

Percutaneous pinning

Experimental group

Description:

Using k-wire percutaneous pinning

Treatment:

Procedure: Percutaneous pinning