Distal radius fracture reduction using the looped-stockinette technique

Improvement, Validation, and Analysis of Colles Fracture Treated with an Integrated Retainer Pad Splint

Objective

To observe the effectiveness and safety of the Colles fracture treated with the integrated retainer pad splint and to compare the clinical and radiological outcomes of the integrated retainer pad splint and the traditional bamboo curtain splint in the treatment of the Colles fracture.

Methods

A total of 100 patients with Colles fractures were randomly divided into two groups: the treatment group was fixed with the integrated retainer pad splint (IS), and the control group was fixed with the traditional bamboo curtain splint (TS).The range of wrist motion was measured at follow-up examinations, and volar inclination, ulnar deviation, and radial height were measured on radiographs. Regular follow-up wrist imaging examinations and functional examinations were performed before reduction, after reduction, and at the 1st, 3rd, 5^th, and 8th weeks. The two groups were compared in terms of convenience, fracture healing time, X-ray data of volar inclination, ulnar deviation, radial height, and wrist joint function. The relevant data were analyzed with SPSS 25.0 statistical software.

Results

There were no notable differences in gender, age, and injured side between IS and TS groups. In terms of operation time, IS was better than the TS group (P < 0.05), and the operation time in the IS group was shorter. On the basis of X-ray data of volar inclination, ulnar deviation, and radial height measured on radiographs, the difference between the IS and TS groups was statistically significant (P < 0.05), which showed that the IS group was more stable in fracture fixation and had less reduction loss during the treatment process. At the 8th week of treatment, the wrist Gartland–Werley score of the two groups showed that the two fixation methods are equivalent in restoring wrist joint function (P > 0.05); however, in terms of the excellent and good rate of wrist joint function, the IS group scored 96% was higher than the TS group (80%).

Conclusion

Compared with the traditional bamboo curtain splint, the integrated retainer pad splint is more convenient and stable, and it has less reduction loss during the treatment. Repair of the Colles fracture using the integrated retainer pad splint with external fixation results in nearly normal return of function, which is significantly better than using the traditional bamboo curtain splint.

Closed Unassisted Reduction in Emergency: A Technique for Unassisted Closed Reduction of Colles Fractures Without Equipment

BACKGROUND

Colles fractures are fractures of the distal radius that are often encountered in the emergency department. They result from accidents and sport injuries in the young but are a common outcome of falls in the elderly population. While Colles fractures are frequently expected to heal with good results, improper reduction, malunion, or later displacement are related to poor functional outcomes in the long term. Treatment is usually by closed reduction either manually or using longitudinal traction. The disadvantage of this is the need for either trained assistants or equipment. We propose a technique for closed unassisted reduction without the use of equipment that can be useful in acute settings where there is shortage of assistance and tools.

DISCUSSION

Fifty-two patients with distal radius fractures were treated with closed unassisted reduction in emergency. The steps of the technique are explained in detail and shown in the accompanying videos. The key lies in the placement of the patient, the use of the doctor's thigh as a lever for the reduction, and positioning of the arm to support the reduction using its own weight. All 52 reductions were successful, while the duration of the reduction process was in all cases under 10 min.

CONCLUSIONS

Closed unassisted reduction in emergency for Colles fractures is a reliable and simple technique, its major advantage being that it can be performed quickly by 1 physician without equipment.