What is the appropriate splinting for a distal radius (radius bone) fracture?

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Last updated: May 27, 2025 • View editorial policy

From the Guidelines

Splinting for a distal radius fracture should involve a sugar-tong or volar splint to immobilize the wrist, with the wrist in slight extension (10-20 degrees) and neutral ulnar deviation, as this position optimizes healing while minimizing stiffness, as supported by the most recent evidence 1, 2. The splint should extend from below the elbow to the palmar crease, and be well-padded and not circumferential to accommodate swelling.

  • Elevation of the extremity above heart level and application of ice for 15-20 minutes every 2-3 hours during the first 48-72 hours helps control swelling.
  • Patients should be instructed to monitor for signs of compartment syndrome (increasing pain, numbness, pallor) and to return for follow-up within 5-7 days for reassessment and possible transition to a cast if the fracture is stable.
  • Non-displaced or minimally displaced fractures typically require 4-6 weeks of immobilization, while displaced fractures may need reduction before splinting or surgical intervention, with the decision for surgical intervention being based on patient-specific factors, including age, functional demand, and fracture characteristics, as indicated by the American Academy of Orthopaedic Surgeons (AAOS) and American Society for Surgery of the Hand (ASSH) clinical practice guideline summary 1, 2.
  • Regular finger exercises should be encouraged to prevent stiffness while the wrist remains immobilized, with some evidence suggesting that supervised therapy may be beneficial for certain patients, although the evidence is inconsistent 2. Key considerations in the management of distal radius fractures include the type and severity of the fracture, patient age and functional demand, and the presence of any associated injuries or comorbidities, with the goal of treatment being to optimize functional outcomes and minimize morbidity and mortality, as emphasized by the AAOS and ASSH guideline 1, 2.

From the Research

Splinting for Distal Radius Fracture

  • The use of splints after distal radius fracture surgery has been studied in several trials, with varying results 3, 4, 5, 6, 7.
  • A study published in the Journal of Wrist Surgery in 2018 found that immobilization in supination did not result in superior outcomes compared to no restriction of forearm range of motion 3.
  • Another study published in the same journal in 2018 found that wearing a splint after volar locking plate fixation of a distal radius fracture was unnecessary, and that patients who were allowed immediate mobilization had better results in terms of pain, Quick DASH, and PRWE scores 4.
  • A systematic review and meta-analysis published in the Journal of Hand Therapy in 2023 found that immobilization for ≤1 week or 2-3 weeks showed improvements in patient-reported outcomes and functional outcomes compared to immobilization for 5-6 weeks 5.
  • A retrospective study published in the European Journal of Orthopaedic Surgery and Traumatology in 2021 found that there was no significant difference in loss of reduction rates between sugar-tong and volar-dorsal splints 6.
  • A prospective randomized trial published in Clinical Rehabilitation in 2022 found that immediate mobilization after volar locking plate fixation of distal radius fractures resulted in a better short-term outcome than a five-week immobilization, with significant improvements in range of motion, grip strength, and patient-reported outcome measurements 7.

Types of Splints

  • Sugar-tong splints and volar-dorsal splints have been compared in several studies, with no significant difference in loss of reduction rates found between the two types of splints 3, 6.
  • Volar splints have also been used in several studies, with results showing that they can be effective in immobilizing the wrist after distal radius fracture surgery 3, 4.

Duration of Immobilization

  • The optimal duration of immobilization after distal radius fracture surgery is still unclear, with studies showing varying results for different periods of immobilization 4, 5, 7.
  • A systematic review and meta-analysis found that immobilization for ≤1 week or 2-3 weeks showed improvements in patient-reported outcomes and functional outcomes compared to immobilization for 5-6 weeks 5.
  • A prospective randomized trial found that immediate mobilization after volar locking plate fixation of distal radius fractures resulted in a better short-term outcome than a five-week immobilization 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.