Closed reduction in distal radius fractures: manual manipulation vs. finger trap traction-a prospective randomized controlled clinical trial

Initial treatment of distal radius fractures (DRF) can be either performed without reduction or with a reduction method as finger-trap traction (FTT) only or by additional manual reduction (MR) under hematoma block. There is no clear evidence on which reduction method is superior, however, MR is more invasive and seems to lead to higher pain levels and more post reduction complications. The objective of this study was to evaluate the clinical relevance of MR compared to FTT in acute DRFs.

Study design was a prospective, single-centre, balanced randomized [1:1], and parallel grouped, controlled trial. Inclusion criteria were patients with a DRF type A2, A3 or C according to the AO classification and a dorsal tilt of ≥ 10°. The patients were randomized either in the FTT or in the MR group. Depending on the patient's functional demand and the fracture configuration, conservative or operative treatment was initiated. Over one year, clinical and radiological data were assessed at six follow-ups.