Short vs Long Arm Cast for Distal Radius Fractures: the Verona Trial

Short vs Long Arm Cast for Distal Radius Fractures: the Verona Trial. Randomized Clinical Trial to Assess the Efficacy of Short Arm Cast Versus Long Arm Cast in Conservative Management of Distal Radius Fractures

This study prospectively compares the performance of an above-elbow cast (long arm cast) and a below-elbow cast (short arm cast) to maintain reduction in conservatively managed distal radius fractures.

The choice of cast length in conservative management of distal radius fractures still represents a much debated controversy. Classic teaching was to immobilize the elbow to reduce risk of secondary displacement; however, short arm casts are felt to be equally effective with less complications and higher patient comfort. There is currently no conclusive evidence for or against immobilization of the elbow in patients treated with cast immobilization.

Inclusion Criteria:

• Diagnosis of distal radius fracture
• Indication to conservative treatment
• Need for manipulation to reduce fracture

Exclusion Criteria:

• Open fractures
• Existence of any skin lesion or wound that would impair cast treatment
• Neurovascular deficits
• Bilateral fractures
• Association with any other fracture of the homolateral arm