அதிர்ச்சி மற்றும் சிகிச்சை இதழ்

Prospective Case Study for Evaluation of Clinical Efficacy and Patient Satisfaction of a Novel Adjustable Wrist Splint for Simple Distal Radius Fracture

Abstract

Pregasen Naicker *

Background: Distal radius fractures are one of the most common fractures. Plaster casting remains the common treatment of choice for simple distal radius +/- ulna fractures. Casting has been noted by patients to be heavy, itchy, cumbersome, restrictive of work and leisure activity, and presents a hygiene risk. To alleviate the difficulties noted with casting, an evaluation of a novel adjustable wrist orthosis in the non-operative management of distal radius fractures was performed.

Methods: All patients presenting to the participating clinic and who met the inclusion criteria were invited to participate in the study. The Zero- Cast™ device was applied by a trained healthcare professional. All patients were followed-up at 1, 2, and 4-6 weeks. Participants completed the Patient Questionnaire and the Patient Rated Wrist Evaluation (PRWE) at their final clinic visit. X-rays examinations were undertaken. The healthcare professionals who applied the orthosis also completed the Healthcare professional questionnaire. Complications from the treatment were recorded.

Results: This trial took place at a single clinic; 5 clinicians participated in the trial. 32 patients were included in this study. Radiologically all fracture were stable with no loss of position. There were no reported complications. Patients provided an overall rating for orthosis comfort scoring of 2.2 out of 10 (10 being least comfortable). Most patients felt the orthosis was convenient for hygiene scored 2.7. On ease of activity to daily living the orthosis was scored at an average of 2.7. An overall average PRWE score of 2.5 (scoring 1=best – 10=worst). Clinician feedback was generally positive. Average time taken to apply the orthosis was 5.2 mins.

Discussion: This study was limited by the lack of a ‘control’ group and by the limited number of patients in the cohort. This study was performed as a new-technology, early evaluation of patient experience and the outcomes were found to be positive. This study should encourage other investigators to design studies that will further test the potential benefits offered by new treatment devices.

Conclusion: We recommend using this new device for simple and stable fracture however more research is warranted prior to its utilisation in complex distal radius fractures.