# Outcome analysis of conservative treatment of a distal radius fracture with OPTIVOhand orthosis versus plaster cast: a randomized controlled trial

## TL;DR

A study compared a modern orthosis to plaster casts for treating wrist fractures and found similar effectiveness with higher patient satisfaction.

## Contribution

This study provides clinical evidence that orthoses can be as effective as plaster casts for distal radius fractures with better patient outcomes.

## Key findings

- Orthosis and plaster cast groups had similar rates of secondary dislocations.
- Patients using orthoses reported better subjective function and quality of life at early follow-ups.
- Application time for orthoses was significantly shorter than for plaster casts.

## Abstract

Distal radius fractures (DRF) are often immobilized using a conventional plaster cast although orthoses offer a time- and resource-saving alternative. This prospective randomized study compared the conservative DRF treatment using an orthosis (OPTIVOhand®) with plaster cast immobilization. Besides the maintenance of reduction result (primary endpoint), functional and subjective outcomes (secondary endpoints) were examined.

53 patients with isolated DRF were randomized to the orthosis group (OG) or the control group (CG). The follow-up examinations included radiological, clinical, and functional evaluations (ROM, grip strength, DASH score, SF-36) as well as patient satisfaction questionnaire.

41 of the 53 patients included (OG: n = 21, CG: n = 20) were followed up until the 12 months follow-up. The rate of secondary dislocations was comparable in both groups (OG: n = 3; CG: n = 2; p > 0.05). Additionally, the OG showed significantly (p < 0.05) better subjective function (DASH score) 6 weeks and 3 months after injury, and a higher quality of life (SF-36 physical component summary) at 2 and 6 week follow-up. Patient satisfaction was significantly higher in OG and mean application time was significantly shorter (OG: 02:35 min vs. CG: 07:35 min; p < 0.001).

This study’s functional and radiological results on conservative DRF treatment did not reveal a significant difference in maintenance of reduction result between modern orthoses and conventional plaster casts, while achieving higher patient satisfaction. Hence, orthoses offer a good alternative to plaster casts, especially for stable fracture types.

German Clinical Trials Register, Identifier: DRKS00017695. Trial registration date 04.11.2019, (https://drks.de/search/en/trial/DRKS00017695)

The online version contains supplementary material available at 10.1186/s12891-026-09585-4.