A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population

IntroductionDistal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar–dorsal splint versus sugar-tong splint prior to conversion into a short arm cast.MethodsWe performed a retrospective study of patients with distal radius fractures placed in a sugar-tong (n = 45) and volar–dorsal splint (n = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar–dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured.ResultsThe average age was not significantly different between groups (Diff: 1.1 years, P = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar–dorsal group (17.1 vs. 19, P = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar–dorsal group (8.4 vs. 9.2, P = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar–dorsal group (P = 0.696).ConclusionOur results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar–dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar–dorsal splint compared to a sugar-tong splint.Level of evidenceTherapeutic level III.