COMPLICATIONS ASSOCIATED WITH CASTING OF ACUTE DISTAL RADIUS FRACTURES IN ADULTS - A PROSPECTIVE OBSERVATIONAL STUDY

Aim: Closed treatment of distal radius fractures is still a controversy. In children, circumferential casting of acute distal radius fractures is found to be safe. However, research is lacking to demonstrate its safety in adults. The purpose of this study was to assess the risk of complications associated with casting acute distal radius fractures in adult patients. Methods: Study is conducted in 60 patients with a distal radius fracture arriving at the Emergency department in Govt Theni Medical College. Patients were evaluated in the red zone and were provisionally immobilized with plaster of Paris casts. Patients were followed for a minimum of 12 weeks. Complication rates associated with casting were recorded, including rates of fracture displacement, tenosynovitis, carpal tunnel syndrome and malunion. Results: 60 patients were included in this study. A total of 45 patients met inclusion criteria for placement of a short arm cast in the Emergency Department. The majority of patients sustained their injuries from a ground level fall. A minority of patients had radiographic evidence of intra-articular extension or underwent a reduction prior to casting. The majority of patients did not require a cast change. The data analysis showed the complications such as fracture displacement, tenosynovitis, carpal tunnel syndrome malunion were of insignificant value and closed reduction proved to the safest and benefitted method of management in distal radius fractures with lesser complications. Conclusion: There were no major complications associated with casting of acute, distal radius fractures in this series of 45 adult patients. While further studies with larger numbers of patients are necessary to establish safety of casting, this study suggests that casting may be a safe and effective treatment for distal radius fractures in adult patients presenting with a normal neurovascular exam.