Dib G, Maluta T, Cengarle M, Bernasconi A, Marconato G, Corain M, Magnan B. Short arm cast is as effective as long arm cast in maintaining distal radius fracture reduction: Results of the SLA-VER noninferiority trial. World J Orthop 2022; 13(9): 802-811 [PMID: 36189333 DOI: 10.5312/wjo.v13.i9.802]
Corresponding Author of This Article
Giovanni Dib, MD, Surgeon, Department of Orthopaedics and Trauma Surgery, University of Verona Medical School, AOUI Borgo Trento, Piazzale Aristide Stefani 1, Verona 37126, Italy. dib.giovanni@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Sep 18, 2022; 13(9): 802-811 Published online Sep 18, 2022. doi: 10.5312/wjo.v13.i9.802
Short arm cast is as effective as long arm cast in maintaining distal radius fracture reduction: Results of the SLA-VER noninferiority trial
Giovanni Dib, Tommaso Maluta, Matteo Cengarle, Alice Bernasconi, Giulia Marconato, Massimo Corain, Bruno Magnan
Giovanni Dib, Tommaso Maluta, Matteo Cengarle, Giulia Marconato, Bruno Magnan, Department of Orthopaedics and Trauma Surgery, University of Verona Medical School, AOUI Borgo Trento, Verona 37126, Italy
Alice Bernasconi, MsC Biostatistics, Evaluative Epidemiology Unit, Department of Research, National Cancer Institute Foundation IRCSS, Milano 20133, Italy
Massimo Corain, Department of Hand Surgery, University of Verona Medical School, AOUI Borgo Roma, Verona 37134, Italy
Author contributions: Dib G and Cengarle M equally conceptualized and designated the research work; Maluta T contributed to organizing and performing the research; Marconato G performed the research and was actively involved together with Dib G and Cengarle M in reviewing patients' X-ray; Bernasconi A analyzed the data; Dib G drafted the manuscript; Magnan B and Corain M revised the manuscript.
Institutional review board statement: This study was approved by the local Institutional Review Board (CE1165CESC).
Clinical trial registration statement: This study was registered on ClinicalTrials.org (NCT03468023).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Each author certifies that he or she has no conflict of interest in connection with the submitted article.
Data sharing statement: Dataset and statistical code is available from the corresponding author on request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giovanni Dib, MD, Surgeon, Department of Orthopaedics and Trauma Surgery, University of Verona Medical School, AOUI Borgo Trento, Piazzale Aristide Stefani 1, Verona 37126, Italy. dib.giovanni@gmail.com
Received: February 27, 2022 Peer-review started: February 27, 2022 First decision: May 31, 2022 Revised: June 15, 2022 Accepted: August 7, 2022 Article in press: August 7, 2022 Published online: September 18, 2022 Processing time: 200 Days and 22.7 Hours
ARTICLE HIGHLIGHTS
Research background
Distal radius fracture (DRF) treatment is a common challenge in orthopaedic trauma care. Uncertainty exists on how best to immobilize a DRF.
Research motivation
The necessity of blocking the elbow when immobilizing a DRF is still a matter of debate.
Research objectives
To test the hypothesis that blocking the elbow is not necessary and that a below arm cast (BEC) performs as well as an above elbow cast (AEC).
Research methods
A noninferiority randomized clinical trial was conducted on 280 patients diagnosed with a DRF managed nonsurgically. Loss of reduction was evaluated considering variation in radiographic parameters [radial length (RL), radial inclination (RI), and volar tilt (VT)].
Research results
Rates of loss of reduction were similar between BEC and AEC. Variation of radiographic parameters (RL, RI, and VT) was similar between BEC and AEC and fell within the predetermined noninferiority thresholds.
Research conclusions
BEC performs as well as AEC in maintaining reduction of a manipulated DRF.
Research perspectives
Further large population randomized controlled trials and meta-analyses are required to confirm the hypothesis that BEC should become the option of choice for DRF treatment.
