Functional Bracing Versus Rigid Plaster Casting for the Immobilization of Colles Fractures in Adults: A Meta-Analysis of Randomized Controlled Trials.
Guy Awad, Marc Boutros, Christèle Asmar et al.
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In 30 seconds
This meta-analysis of six randomized controlled trials compared functional bracing with rigid plaster casting for conservative immobilization of Colles fractures in 697 adults. Pain scores were similar at 2 and 6 weeks. Bracing was associated with better functional scores at 12 weeks, greater grip strength at 6 weeks, and better anatomical outcomes at 6 weeks, including lower dorsal angulation and better modified Lidström scores. Re-manipulation rates and most complications were similar, although hand and finger swelling was more frequent with bracing. The authors describe the advantages as modest and support bracing in selected adults.
Key findings
- Across six trials involving 697 adults, pain scores were similar between bracing and casting at 2 and 6 weeks.
- Functional scores favored bracing at 12 weeks, and grip strength was higher with bracing at 6 weeks.
- At 6 weeks, bracing was associated with lower dorsal angulation and better modified Lidström anatomical scores.
- Most complication rates and re-manipulation rates were similar, but hand and finger swelling was more frequent with bracing.
Why it matters
The findings suggest that the choice of immobilization may affect early functional recovery and fracture alignment, even when pain outcomes are similar. The higher rate of hand and finger swelling with bracing is also relevant when weighing its potential benefits. Together, these results inform comparison of two commonly used conservative approaches without establishing that one is preferable for every adult with a Colles fracture.
What to keep in mind
The abstract does not report pooled effect sizes or confidence intervals, limiting assessment of the magnitude and precision of the differences.