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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EShort arm casting with a 3-point molding resulted in improved flexion, supination, and pronation compared with long arm casting in patients with type A2 fractures of the distal radius. Amir R. Kachooei, MD, Mashhad University of Medical Sciences, Mashhad, Iran, presented data from a study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT02286661\u0026amp;atom=%2Fspmdc%2F14%2F41%2F15.atom\u0022\u003ENCT02286661\u003C\/a\u003E] evaluating the treatment of type A2 fractures of the distal radius by casting.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cp id=\u0022p-2\u0022\u003EShort arm casting with a 3-point molding resulted in improved flexion, supination, and pronation compared with long arm casting in patients with type A2 fractures of the distal radius. Amir R. Kachooei, MD, Mashhad University of Medical Sciences, Mashhad, Iran, presented data from a study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT02286661\u0026amp;atom=%2Fspmdc%2F14%2F41%2F15.atom\u0022\u003ENCT02286661\u003C\/a\u003E] evaluating the treatment of type A2 fractures of the distal radius by casting.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAbout 17% of fractures are of the distal radius, with about two-thirds requiring surgical treatment; however, initial treatment typically includes closed reduction and immobilization with a plaster cast [Walenkamp MMJ et al. \u003Cem\u003EBMC Musculoskelet Disord.\u003C\/em\u003E 2014]. The purpose of this study was to assess outcomes of 2 different types of casting methods.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn this prospective, multicenter trial, 100 patients with distal radius fractures were randomly assigned to receive a short or long arm cast. All fractures were type A2, and patients with dorsal angulations \u0026gt; 20\u00b0, radial shortening \u0026gt; 10 mm, and extensive cortical comminution were excluded. Patients in the short arm cast (SAC) group had their wrist positioned in neutral rotation with volar-ulnar deviation. In the SAC, distal extension of the cast was to the metacarpophalangeal joints dorsally, and to the proximal palmar crease volarly. The cast was extended proximally to 1 inch distal to the antecubital fossa and posteriorly to the olecranon. In the long arm cast (LAC) group, the elbow was positioned in 90\u00b0 of flexion and the cast was extended to the middle of the arm.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPatients assigned to the LAC group were converted to an SAC at 4 weeks, and all patients had their casts removed at 6 weeks. Reduction failure was defined as \u0026gt; 5 mm displacement or \u0026gt; 5\u00b0 of angulations. Range of motion was considered abnormal if there was \u0026gt; 10\u00b0 difference with the unaffected wrist. Baseline, preoperative characteristics including radial inclination in the plain anteroposterior view, dorsal tilt angulations in the lateral view, and radial shortening in the plain anteroposterior view were similar among the SAC and LAC groups.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EPatients in the SAC group demonstrated greater range of flexion and extension of the elbow at 6 and 18 weeks compared with the LAC group; however, the difference between the groups decreased substantially by the 18th week (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/41\/15\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Effect of Casting Type on Elbow Extension\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-531334637\u0022 data-figure-caption=\u0022Effect of Casting Type on Elbow Extension\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/41\/15\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/41\/15\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/41\/15\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15120\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EEffect of Casting Type on Elbow Extension\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003ELAC, long arm cast; SAC, short arm cast.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from AR Kachooei, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003ESimilarly, patients treated with the SAC experienced greater range of supination and pronation of the forearm at 6 and 18 weeks compared with patients who received the LAC, with the difference between the 2 arms decreasing by week 18. The SAC arm demonstrated fewer blisters and wounds compared with the LAC arm. There was no significant difference in distal radio ulnar joint instability and reduction loss between the 2 arms. Patients reported greater satisfaction with the SAC compared with the LAC. There was no evidence of malunion, nonunion, carpal tunnel syndrome, and compartment syndrome in either group.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EProf Kachooei stated that the data from this study indicate that an SAC with proper 3-point and inter osseous molding provides good therapeutic outcomes in patients with a type A2 fracture.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/41\/15.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzolkd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzolkd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}