Splint Type for Radial Styloid Nondisplaced Fracture
A removable short-arm splint is recommended for nondisplaced radial styloid fractures, with immobilization for 3 weeks followed by active mobilization. 1, 2
Initial Immobilization Strategy
- Apply a removable short-arm splint (sugar-tong splint initially, then transition to short-arm cast or removable splint) for 3 weeks. 1, 2, 3
- The American Academy of Orthopaedic Surgeons specifically recommends removable splinting for 3 weeks for non-displaced or minimally displaced distal radius fractures in older adults, which includes radial styloid fractures. 2
- Research evidence supports that 3 weeks of immobilization produces superior patient-reported outcomes compared to 5 weeks, with no increase in secondary displacement risk. 4
Immediate Rehabilitation Measures
- Begin active finger motion exercises immediately upon diagnosis, even while splinted. 5, 1
- Finger stiffness is one of the most functionally disabling complications of distal radius fractures and is entirely preventable with early motion. 5
- The splint should allow full finger range of motion—instruct patients to move fingers regularly through complete range of motion at the first encounter. 5
Symptomatic Management
- Apply ice at 3 and 5 days post-injury for symptomatic relief. 1
- Consider vitamin C supplementation for prevention of disproportionate pain (moderate strength recommendation from AAOS). 1, 2
- Consider low-intensity ultrasound for short-term improvement in pain and radiographic union, though long-term benefits remain unproven. 1
Follow-Up Protocol
- Obtain radiographic follow-up at 3 weeks to assess healing and rule out secondary displacement. 1, 2
- At 3 weeks, if healing is progressing appropriately, discontinue immobilization and advance to active wrist range of motion exercises. 2, 4
Critical Pitfalls to Avoid
- Do not immobilize beyond 3 weeks for nondisplaced fractures—prolonged immobilization increases stiffness without improving fracture outcomes. 2, 4
- Do not restrict finger motion—failure to initiate immediate finger exercises is the most common preventable cause of functional disability. 5, 1
- Do not use rigid casting when a removable splint is sufficient, as removable splinting allows for hygiene and early controlled motion while maintaining adequate stability. 2