From the Guidelines
Management of an undisplaced distal radius fracture typically involves immobilization with a short arm cast or a removable splint for 4-6 weeks, with a focus on early finger range of motion exercises to prevent stiffness. The most recent and highest quality study, 1, provides moderate evidence to support the use of supervised therapy in non-operatively treated distal radius fractures, but also notes that evidence is inconsistent and that specific subsets of patients may benefit from supervised hand therapy. Key considerations in the management of undisplaced distal radius fractures include:
- Immobilization with a short arm cast or removable splint for 4-6 weeks
- Early finger range of motion exercises to prevent stiffness
- Pain management with acetaminophen or NSAIDs as needed
- Elevation of the extremity above heart level and application of ice to reduce swelling
- Regular follow-up radiographs to ensure the fracture remains stable and properly aligned, although the frequency of radiographic evaluation does not appear to impact outcomes, as noted in 1. It is also important to consider the patient's age, functional demand, and values when making treatment decisions, as surgical fixation may not lead to improved outcomes in geriatric patients, as noted in 1. Overall, the goal of management is to promote healing, prevent complications, and optimize functional outcomes, with a focus on individualized patient care.
From the Research
Management of Undisplaced Fracture of the Distal Radius
The management of an undisplaced fracture of the distal radius typically involves immobilization to allow for proper healing. The following are key points to consider:
- Immobilization duration: Studies have shown that a shorter period of immobilization may be beneficial for patients with non- or minimally displaced distal radial fractures. A study published in 2019 found that 3 weeks of cast immobilization resulted in significantly better patient-reported outcomes compared to 5 weeks of immobilization 2.
- Immobilization methods: Different methods of immobilization, such as casting or bracing, may be used. A study protocol published in 2024 aims to compare 1 week of brace immobilization with 3 weeks of cast immobilization in patients with non- or minimally displaced distal radius fractures 3.
- Rehabilitation: Early mobilization and rehabilitation may be important for improving functional outcomes. A study published in 2020 found that early mobilization after surgical management of distal radius fractures resulted in better wrist function at 6 weeks compared to splinting 4.
- Potential complications: Potential complications of immobilization, such as stiffness and decreased range of motion, should be considered. A study published in 1999 found significant impairments in flexibility, grip strength, and motor control immediately after cast immobilization of closed reductions of simple distal radius fractures 5.
Key Considerations
- Patient age and activity level may influence the management of an undisplaced fracture of the distal radius. A study published in 2014 aimed to evaluate the duration of immobilization in adult patients with non- or minimally displaced distal radial fractures 6.
- The use of patient-reported outcome measures, such as the Patient-Related Wrist Evaluation (PRWE) score, may be important for evaluating the effectiveness of different management strategies 2, 3.