Closed reduction in distal radius fractures: manual manipulation vs. finger trap traction-a prospective randomized controlled clinical trial.
Stefan Benedikt, Lukas Horling, Simone Bode et al.
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In 30 seconds
This prospective, single-centre, 1:1 randomized controlled trial compared finger-trap traction (FTT) with additional manual reduction (MR) under haematoma block in 53 patients with acute distal radius fractures (AO types A2, A3 or C) and dorsal tilt ≥ 10°. Treatment could be conservative or operative, according to functional demand and fracture configuration, with clinical and radiological follow-up over one year. Neither method achieved sufficient radiological reduction, and neither was superior; clinical outcomes in conservatively treated groups were comparable, with no significant difference. The authors concluded that MR offered no benefit over FTT.
Key findings
- At one year, median dorsal tilt was - 16 to -18; neither FTT nor MR achieved sufficient reduction, and neither technique was superior.
- Clinical results were comparable between conservatively treated groups, with no significant difference.
- Reported complications included three cases of CRPS or secondary carpal tunnel syndrome and one skin lesion.
Why it matters
The trial addresses whether adding manual manipulation to traction improves outcomes in displaced distal radius fractures. Its findings suggest that the more invasive reduction step did not improve radiological or clinical results in the studied population, while complications occurred in both groups. This helps frame the choice of reduction method, although the results should be interpreted in light of the trial’s size and setting.
What to keep in mind
The trial was single-centre and included 53 patients. Treatment could be conservative or operative, and the reported clinical comparison was between conservatively treated groups.