What is the typical duration for splinting a nondisplaced radius fracture?

Duration of Splinting for Nondisplaced Radius Fractures

A nondisplaced distal radius fracture should be immobilized in a splint or cast for a minimum of three weeks. 1

Immobilization Protocol

The management of nondisplaced radius fractures follows these principles:

1. Initial immobilization:

   • A sugar-tong splint is typically applied initially
   • This is followed by conversion to a short-arm cast for the remainder of the treatment period 1

2. Duration of immobilization:

   • Minimum of 3 weeks for adults with nondisplaced fractures 1
   • The American Academy of Orthopaedic Surgeons suggests limiting the duration of immobilization as prolonged immobilization is associated with poorer outcomes 2

3. Early mobilization considerations:

   • Early finger motion should be encouraged regardless of immobilization type to minimize the risk of finger stiffness 2
   • Patients should be instructed to move fingers regularly through a complete range of motion for optimal outcomes 2

Special Considerations

Age-specific factors:

• Children:
  • Buckle (torus) and greenstick fractures are common in children
  • These can often be managed with immobilization, with duration depending on the degree of angulation 1
  • For pediatric finger fractures through the metaphysis ending at the epiphyseal plate, expected recovery time is 6-8 weeks 2

Complications to monitor:

• Joint stiffness is the most common complication, particularly with prolonged rigid immobilization 2
• Median nerve injury can complicate distal radius fractures 1
• Cold therapy may improve pain scores and reduce edema but should never be applied directly to the skin 2

Follow-up and Rehabilitation

After splint removal:

• A directed home exercise program including active finger motion exercises helps prevent stiffness 2
• Recent evidence suggests that splint removal in the acute post-injury period does not result in distal radius fracture displacement 3
• Early mobilization after stable fixation may be beneficial for optimal outcomes, with evidence suggesting better wrist function and reduced pain scores 2, 4

Common Pitfalls to Avoid

1. Prolonged immobilization: This can lead to joint stiffness and poorer functional outcomes 2
2. Inadequate finger movement: Failure to encourage finger motion during immobilization increases risk of stiffness 2
3. Insufficient follow-up imaging: Radiographs should be used to assess fracture healing and potential complications 2
4. Overlooking associated injuries: Be vigilant for median nerve injuries that may accompany distal radius fractures 1

By following these guidelines, optimal healing and functional outcomes can be achieved for patients with nondisplaced radius fractures.