What type of splint is recommended for a non-displaced mid radius fracture?

Splinting for Non-Displaced Mid-Radius Fracture

For a non-displaced mid-radius fracture, apply a sugar-tong splint initially, which provides adequate immobilization while allowing for swelling and can be converted to a short-arm cast after 1-2 weeks once swelling subsides. 1, 2

Splint Selection and Application

• A sugar-tong splint is the preferred initial immobilization method for non-displaced mid-shaft radius fractures, as it prevents forearm rotation while accommodating post-injury swelling 1, 2
• The sugar-tong configuration extends from the metacarpal heads, around the elbow, and back to the dorsal metacarpals, effectively controlling pronation and supination 2
• After 7-14 days when swelling has resolved, transition to a short-arm cast for continued immobilization if needed 1

Critical Management Principles

Immediate active finger motion exercises must be initiated at the first encounter to prevent finger stiffness, which is one of the most functionally disabling complications of radius fractures 3, 4

• Finger motion does not adversely affect an adequately stabilized radius fracture and is extremely cost-effective 3
• The splint should never obstruct full finger range of motion 3

Duration of Immobilization

• Maintain immobilization for a minimum of 3 weeks for non-displaced fractures 1
• Obtain radiographic follow-up at approximately 3 weeks to confirm maintenance of alignment and adequate healing 4
• Repeat imaging at the time of immobilization removal 4

Important Caveats

Monitor closely for loss of reduction, as even initially non-displaced fractures can displace during the healing process:

• If post-reduction displacement exceeds 3mm, surgical fixation becomes indicated 3, 4
• Sugar-tong splints maintain reduction comparably to acute casting, with approximately 22-24% requiring operative intervention for loss of reduction 2
• Watch for complications including skin irritation and muscle atrophy, which occur in approximately 14.7% of immobilization cases 4

What NOT to Do

• Do not use removable splints for mid-shaft radius fractures - these are appropriate only for minimally displaced distal radius buckle fractures, not mid-shaft fractures 4
• Do not restrict wrist motion indefinitely after the fracture is stable, as early wrist motion is not routinely necessary but prolonged immobilization increases stiffness risk 3
• Do not allow the splint to obstruct finger motion at any point during treatment 3