From the Guidelines
A short arm cast is typically used after a wrist fracture.
Key Considerations
- The use of a short arm cast is mentioned as an option when initial radiographs are negative or equivocal, and there is a clinical suspicion of a hand or wrist fracture 1.
- This approach allows for immobilization of the affected area while awaiting further evaluation, such as repeat radiographs at 10 to 14 days 1.
- It is essential to note that this method may result in a delay of diagnosis, potentially leading to functional impairment 1.
- Other imaging modalities like CT or MRI may be used to confirm or exclude suspected wrist fractures, especially when initial radiographs are equivocal 1.
- However, the primary focus in the context of the question is on the type of cast used, which is identified as a short arm cast.
From the Research
Types of Casts Used After Wrist Fracture
- A plaster cast is commonly used for immobilization after a wrist fracture, with the duration of immobilization varying depending on the type and severity of the fracture 2, 3, 4.
- The type of cast used can include a volar-flexion and ulnar deviation cast or a functional cast position, with some studies suggesting that a functional cast position may be more effective in treating distal radius fractures among elderly patients 4.
- In some cases, external fixation may be used as an alternative to a cast, particularly for more complex or displaced fractures, although this method may be associated with a higher rate of complications 5.
- Removable orthoses may also be considered as an alternative to cast immobilization, particularly for nonsurgical pediatric distal radius fractures, nonsurgical metacarpal fractures, mallet fingers, and UCL tears of the thumb MCP joint 6.
Duration of Immobilization
- The optimal duration of immobilization after a wrist fracture is still a topic of debate, with some studies suggesting that shorter periods of immobilization (e.g. 1 week or 4 weeks) may be sufficient for non- or minimally displaced fractures 2, 3.
- Other studies have compared different durations of immobilization, such as 4 weeks versus 6 weeks, and found no significant differences in terms of functional outcomes or complications 3.