From the Guidelines
The best orthopedic brace for a wrist fracture is typically a removable thermoplastic splint or a prefabricated wrist brace with rigid support, as recommended by the American Academy of Orthopaedic Surgeons 1. When it comes to managing distal radius fractures, the type of brace used can significantly impact the outcome.
- For stable distal radius fractures, a volar wrist splint that immobilizes the wrist in slight extension while allowing finger movement is often recommended.
- The brace should extend from mid-forearm to the palm, leaving the thumb and fingertips free for functionality.
- Treatment duration generally ranges from 4-6 weeks, with regular follow-up appointments to assess healing progress.
- The specific type of brace depends on the fracture location, severity, and stability as determined by your orthopedic provider. Proper immobilization is crucial because it maintains bone alignment during healing, prevents further displacement, and reduces pain.
- Some fractures may initially require a full cast before transitioning to a removable brace.
- It's essential to follow your doctor's instructions about when it's safe to remove the brace, and you'll likely need physical therapy after the immobilization period to restore strength and range of motion, as emphasized by the EULAR/EFORT recommendations 1. In terms of post-treatment care, early finger motion is essential to prevent oedema and stiffness, and aggressive finger and hand motion is necessary to facilitate the best possible outcomes 1.
From the Research
Orthopedic Braces for Wrist Fractures
- The best orthopedic brace for a wrist fracture can depend on various factors, including the type and severity of the fracture, as well as the patient's individual needs and preferences.
- A study published in the Journal of Wrist Surgery in 2018 found that wearing a splint after volar locking plate fixation of a distal radius fracture may be unnecessary, as patients who did not wear a splint had better outcomes in terms of flexion, extension, pronation, supination, pain, and strength 2.
- Another study published in the Medical Journal of the Islamic Republic of Iran in 2021 compared the effects of volar wrist cock-up splint and dorsal lock wrist hand orthosis on reducing signs of carpal tunnel syndrome, and found that the dorsal lock wrist hand orthosis was more effective in improving pain and neurological symptoms 3.
- A more recent study published in the Journal of Experimental Orthopaedics in 2024 evaluated the wrist stabilizing properties of different materials used in short-arm splints, and found that plaster of Paris (PoP) had the highest capability to resist wrist flexion and extension when applied as a volar splint, while Woodcast exhibited a lower wrist flexion and a similar wrist extension when applied as a dorsal splint 4.
Key Considerations
- The choice of orthopedic brace for a wrist fracture should be based on the individual patient's needs and the specific type of fracture.
- The brace should provide adequate support and stability to the wrist, while also allowing for some degree of mobility and flexibility.
- The material used in the brace can also be an important consideration, with some materials (such as PoP) providing better wrist stabilizing properties than others.
Available Options
- Volar wrist cock-up splint
- Dorsal lock wrist hand orthosis
- Short-arm splints made of different materials (such as PoP, Woodcast, X-lite, or 3D-printed polypropylene)