Radiographic and clinical outcomes of muenster and sugar tong splints for distal radius fractures: a comparative study.

BACKGROUND: Non-operative management is typically indicated for extra-articular distal radius fractures. Conservative treatments such as Sugar tong splints (STs) and Muenster splints (MUs) are commonly used. However, there is limited research and outcome data comparing the two splint types. Therefore, this study aimed to investigate and compare the radiographic and clinical outcomes of treatment using STs and MUs. METHODS: In this retrospective comparative study, we aimed to evaluate and compare the radiographic and clinical outcomes of STs and MUs for the treatment of distal radius fractures. The study included 64 patients who underwent closed reduction (CR) in the emergency room and were treated with either STs or MUs splints (STs group: n = 38, MUs group: n = 26). Initial X-rays, post-CR X-rays, and last outpatient follow-up X-rays were evaluated. Radial height (RH), ulnar variance (UV), radial inclination (RI), and volar tilt (VT) were measured by a blinded investigator. The Quick DASH form was applied to measure patients' satisfaction after treatments. RESULTS: There were no significant differences in baseline characteristics, initial radiographic measurements, or radiographic measurements immediately after CR between the two groups. However, the overall radiological values deteriorated to some degree in both groups compared to the post-CR images. Furthermore, using a paired test, the STs group showed significant differences in RH and RI, and the MUs group showed significant differences in RH and UV between the last follow-up and post-CR images. CONCLUSIONS: The study concluded that there was no difference in clinical outcomes between the two splint types. However, both STs and MUs groups showed reduced radiographic parameters, and the MUs group showed a significant reduction of RH and UV in the treatment of distal radius fractures. LEVEL OF EVIDENCE: Level IV; Retrospective Comparison; Treatment Study.

Comparison of the forearm rotation restriction capacities of four upper-extremity immobilization methods: there is no difference between single and double sugar tong splinting.

BACKGROUND: The aim of this study was to compare the effects of four different immobilization methods [single sugar tong splint (SSTS), double sugar tong splint (DSTS), short arm cast (SAC), and long arm cast (LAC)] commonly used for restricting forearm rotation in the upper extremity. METHODS: Forty healthy volunteers were included in the study. Dominant extremities were used for measurements. Basal pronation and supination of the forearm were measured with a custom-made goniometer, and the total rotation arc was calculated without any immobilization. Next, the measurements were repeated with the SAC, LAC, SSTS and DSTS. Each measurement was compared to the baseline value, and the percentage of rotation restriction was calculated. RESULTS: The most superior restriction rates were observed for the LAC (p = 0.00). No statistically significant difference was detected between the SSTS and DSTS in terms of the restriction of supination, pronation or the rotation arc (p values, 1.00, 0.18, and 0.50, respectively). Statistically significant differences were not detected between the SAC and the SSTS in any of the three parameters (p values, 0.25; 1.00; 1.00, respectively). When the SAC and DSTS were compared, while there was no significant difference between the two methods in pronation (p = 0.50), a statistically significant difference was detected in supination (p = 0.01) and in the total rotation arc (p = 0.03). CONCLUSION: The LAC provides superior results in restricting forearm rotation. The SAC and SSTS had similar effects on forearm rotation. The DSTS, which contains, in addition to the SSTS, a sugar tong portion above the elbow, does not provide additional rotational stability.

Assessment of "YouTube" Content for Distal Radius Fracture Immobilization.

OBJECTIVE: Distal radius fractures (DRFs) are the most common orthopedic fractures, with >70% of cases treated by closed immobilization using a short arm cast or a sugar tong splint. However, inadequate immobilization is a risk factor for loss of reduction requiring repeat reduction or surgical treatment. Therefore, education of clinical skills for appropriate immobilization of DRFs is important. With the increasing use of web-based information by medical learners, our aim was to assess the quality and quantity of videos regarding closed immobilization of DRFs on YouTube. DESIGN: Retrospective review of YouTube videos on distal radius fracture immobilization using specific search terms. SETTING: Identified videos were analyzed for their educational value, quality of the technical skill demonstrated, and overall metrics. Educational value was scored on a 5-point scale, with "1" indicative of low quality and "5" of high quality. PARTICIPANTS: Not applicable. RESULTS: Among the 68,366 videos identified, 16 met our inclusion criteria of being in English; performed by a health care professional or institution; and with casting being the major theme of the educational information provided. Of these 16 videos, 6 had an educational value score of 4 or 5, with the remaining 10 having a score ≤3. Although immobilization was demonstrated by cast technician specialized in orthopedics, skills were also performed by orthopedic attendants, urgent care physicians, orthopedic residents, and nurse practitioners. The credentials of the performer in 3 videos were not identified. CONCLUSION: There is a need to promote high-quality educational videos produced by established medical school faculty members on open, web-based, portals.

Effect of Different Splints on Displacement after Closed Reduction of the Distal Radius Fractures: A Comparison of Short Arm Double Splint and Sugar-Tong Splint

PURPOSE: This study was to compare short arm double splint allowing forearm rotation with sugar tong splint in terms of loss of reduction and incidence of shoulder stiffness after closed reduction of the distal radius factures. METHODS: From June 2012 to February 2013, we retrospectively reviewed patients with distal radius fractures applied short arm double splint or sugar tong splint after closed reduction. Patients with more than 18 years old, acceptable reduction in X-ray and followed up at least 4 weeks were enrolled. Short arm double splint (SD) group was applied in 47 cases and sugar tong splint (ST) group was 34 cases. Gender, age and fracture types were not significantly different between two groups. The radiographic parameters were measured for palmar tilt, articular step-off, radial length, radial inclination, ulnar variance. The incidence and time of the reduction loss were also evaluated. In functional outcomes, the occurence of ipsilateral shoulder stiffness and the disabilities of the arm, shoulder and hand (DASH) score were evaluated with the medical records or telephone questionnaires at 6 months after initial trauma. RESULTS: Loss of reduction was occured 16 cases in SD group (34%) and 10 cases in ST group (29.4%), which did not differ significantly between the groups (p=0.169). The DASH score and shoulder stiffness were not statistically different between two groups. CONCLUSION: There was no significant difference in loss of reduction after closed reduction of distal radius fractures and functional outcomes in both groups.

A Comparison of Sugar Tong Splint and Radial Gutter Short Arm Splint after Closed Reduction of Distal Radius Fracture

PURPOSE: Various methods of immobilization exist in the nonsurgical treatment of the distal radius fracture, among which sugar tong splint is the most commonly used. In this study, we observed the results after treating the distal radius fracture with radial gutter short arm splint without elbow immobilization. MATERIALS AND METHODS: Among the fracture of distal radius who have been under conservative treatment after closed reduction, 48 patients (from January to December of 2005) were treated with sugar tong splint, and 57 patients (from January to December of 2007) were treated with radial gutter short arm splint. The loss of reduction after closed reduction of the two groups was compared. The types of fractures were determined as either stable or unstable based on the fracture segment. Follow up examination of the stability was performed 8 weeks later. RESULTS: There were 105 patients (male, 52; female, 53) with mean age of 50.2. Of the 57 patients with the sugar tong splint, loss of reduction was shown in 11 cases out of the 31 unstable fractures and none in 17 stable fractures. In the radial gutter short arm splint group, 12 cases out of 33 unstable fractures showed loss of reduction. Only one case in 24 stable fractures treated by the radial gutter splint has failed. There was no statistically significant difference in the reduction loss rate between the two immobilizing methods (p-value=0.37), as well as the type of reduction loss (p-value>0.05). CONCLUSION: Sugar tong splint and radial gutter short arm splint had no difference in maintaining reduction. Sugar tong splint has been considered as the most effective method of maintaining reduction by preventing rotation of the forearm and flexion-extension of the elbow. Furthermore, radial gutter short arm splint can minimize limitation of the elbow motion and daily life activity. Based on our results, radial gutter short arm splint, which only immobilize the wrist joint, had a good results as well.

A Clinical Study of Colles Fractures / 대한정형외과학회잡지

Twenty-six cases of Colles fracture were treated with closed reduction and percutaneous K-wire fixation under C-arm field and then wrist was immobilized by sugar tong splint and then short arm splint from Jan. 1982 to Dec. 1985 at the department of orthopaedic surgery of St. Benedict hospital. A prospective study was made and evaluated under the subjective and objective criteria of Gartland and Werley, and the objective criteria of Scheck. The result of this study were as follow: 1. The incidence of Colles fracture was highest in 3rd decade(26.9%) and 7th decade(23.1%) respectively. In the 3rd decade the reason for the highest incidence was the job-related accident during the productive age and they were male patients. 2. The main cause of the injury was falling accident comprising of 53.8% and the male to female ratio was about equal. 3. Among the 26 cases treated with the percutaneous K-wire fixation, the result was satisfactory in 92.2% but was unsatisfactory in one case with severe comminuted fracture. 4. The percutaneous K-wire fixation for Colles fracture had less complication and more advantages such as the early disappearance of edema by early exercies, the early returning of range of motion of joint to normal, and the comfortable cast immobilization in neutral position of wrist. 5. The percutaneous K-wire fixation for Colles fracture was applicable to the concept that the anatomical reduction and maintenance would lead to the improvement of the joint function. 6. The percutaneous K-wire fixation for Colles fracture was indicated when neurologic sign developed after reduction of fracture by classic methord and when the exercise of joint was required in the old age. 7. When the articular surface of the radius was severely comminuted and the distal radius became severely osteoporotic, the result from the use of percutaneous K-wire fixation was also poor. In this case we considered the use of an external fixator.