Is radial slab better than a dorsal slab in maintaining initial reduction in distal radius fractures?

Background: Displaced extra-articular fractures with dorsal comminution of distal radius are initially immobilised in a radial or a dorsal plaster slab after manipulation. The theoretical advantage of the radial slab is that it allows three point moulding. If reduction of the fracture is acceptable on radiograph, the plaster slab is changed to a full plaster cast, otherwise the fracture is either re-manipulated or a surgical intervention is undertaken. Objectives: The aim of this study was to assess if radial slab is better than the dorsal plaster slab in maintaining distal radius fracture reduction after initial manipulation. Patients and Methods: In this prospective comparative study of matched cohorts, patients with dorsally comminuted extra-articular fractures of distal radius were initially immobilised in either a dorsal or a radial slab following manipulation of the fracture. Antero-posterior and lateral radiographs were taken after fracture manipulation, and followed up at one week. Post manipulation radiographs were compared with radiographs at one week. Results: There were 49 patients in Group 1 (dorsal slab) and 47 patients in Group 2 (radial slab). The mean age of patients in Group 1 was 78 (71-95), compared to 74(72-89) in Group 2.There was statistically no significant difference in the radial height, radial inclination and volar tilt between groups. Conclusion: There is no difference between Radial and Dorsal slab in maintaining reduction in an extra-articular distal radius fracture. Level of evidence: I