BACKGROUND Distal radial fractures are common traumatic injuries, but their management remains controversial also in case of conservative treatment regarding the type of immobilisation. Hence, we conducted a two-arm, parallel-group, prospective randomised trial to compare the capacity of long casts (above-elbow) and short casts (below-elbow) to maintain the reduction of extra-articular distal radius fractures with dorsal displacement (AO/OTA classification: 2R3A2.2). METHODS Seventy-four eligible patients with AO/OTA 2R3A2.2 fractures treated with closed reduction and cast immobilisation were randomised to the long cast group (n°= 37) or to the short cast group (n°= 37). Baseline radiological parameters, radial inclination (RI), radial height (RH), ulnar variance (UV) and palmar tilt (PT) were taken, and compared with clinical (DASH, Mayo Wrist and Mayo Elbow) and radiological scores taken at 7-10 days, 4 weeks and 12 weeks. Furthermore, to evaluate correlations between radiological parameters and functional outcomes, patients were divided into two groups according to whether or not their radiological parameters at Follow-ups 2 and 3 were acceptable, i.e. within the range 11-12 mm for RH, 16°-28° for RI, - 4-+ 2 mm for UV and 0°-22° for PT. RESULTS Patient demographic and baseline radiological parameters were similar between groups. At follow-up, there were no statistically significant differences between the two types of cast in terms of RI, RH, UV or PT, or Mayo wrist or DASH scores. Short cast group patients displayed better Mayo elbow score at follow-up 2 (4 weeks), but this difference was no longer statistically significant at follow-up 3 (12 weeks). No statistically significant differences in clinical outcomes were found between patients who presented acceptable radiographic parameters at follow-up and those who did not. CONCLUSION As there were no significant differences between short casts and long casts in terms of fracture reduction maintenance or clinical outcomes, short casts are an effective method of post-reduction immobilisation in AO/OTA 2R3A2.2 fracture of the radius. Radiological parameters outside the range conventionally considered acceptable do not preclude a satisfactory clinical outcome. TRIAL REGISTRATION ClinicalTrials.gov PRS, NCT04062110. Registred 20 August 2019.

中文翻译：

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肘部以下或肘部以上石膏用于保守治疗关节背侧radius骨远端骨折并移位的前瞻性随机试验。

背景技术radial骨远端骨折是常见的创伤性损伤，但是在关于固定类型的保守治疗的情况下，其处理仍然存在争议。因此，我们进行了两臂，平行组的前瞻性随机试验，比较了长石膏（肘上）和短石膏（下肘）保持关节背侧distal骨远端骨折并减少背侧移位的能力（AO / OTA分类：2R3A2.2）。方法将74例经闭合复位和石膏固定治疗的AO / OTA 2R3A2.2骨折合格患者随机分为长石膏组（n°= 37）或短石膏组（n°= 37）。取基线放射学参数，radial骨倾角（RI），radial骨高度（RH），尺骨方差（UV）和掌掌倾斜（PT），并与临床（DASH，梅奥手腕（Mayo Wrist）和梅奥肘（Mayo Elbow）），并在7-10天，4周和12周时进行放射学评分。此外，为了评估放射学参数与功能结局之间的相关性，根据患者在随访2和3时的放射学参数是否可接受（即，相对湿度在11-12 mm范围内，16°- RI为28°，UV为-4- + 2 mm，PT为0°-22°。结果两组之间的患者人口统计学和基线放射学参数相似。随访时，两种类型的石膏在RI，RH，UV或PT或Mayo手腕或DASH评分方面没有统计学上的显着差异。矮型组患者在随访2（4周）时表现出更好的Mayo肘关节评分，但在随访3（12周）时，这种差异不再具有统计学意义。在随访时表现出可接受的放射学参数的患者与未接受随访的放射学参数之间，在临床结局方面未发现统计学上的显着差异。结论由于短石膏与长石膏在骨折复位维持或临床结果方面无显着差异，因此短石膏是AO / OTA 2R3A2.2 fracture骨骨折复位复位后固定的有效方法。放射学参数超出通常认为可接受的范围并不排除令人满意的临床结果。试验注册ClinicalTrials.gov PRS，NCT04062110。注册于2019年8月20日。结论由于短石膏与长石膏在骨折复位维持或临床结果方面无显着差异，因此短石膏是AO / OTA 2R3A2.2 fracture骨骨折复位复位后固定的有效方法。放射学参数超出通常认为可接受的范围并不排除令人满意的临床结果。试验注册ClinicalTrials.gov PRS，NCT04062110。注册于2019年8月20日。结论由于短石膏与长石膏在骨折复位维持或临床结果方面无显着差异，因此短石膏是AO / OTA 2R3A2.2 fracture骨骨折复位复位后固定的有效方法。放射学参数超出通常认为可接受的范围并不排除令人满意的临床结果。试验注册ClinicalTrials.gov PRS，NCT04062110。注册于2019年8月20日。NCT04062110。注册于2019年8月20日。NCT04062110。注册于2019年8月20日。