Colles' fracture: dorsal splint or complete cast during the first 10 days?

In a prospective randomised trial of conservatively treated Colles' fractures, we compared radiological outcomes and complication rates for two immobilisation methods, either complete cast (34 cases) or dorsal splint (38 cases), during the first 10 days after reduction. Radiographs were evaluated for dorsal tilt, radial tilt and radial shortening; results were almost identical in the two groups. There was a mean difference of 3.4 degrees in dorsal angulation in favour of dorsal splinting 10 days after reduction and a mean difference of 1.6mm in radial length in favour of complete casting at 5 weeks. There was no difference between the two treatments groups in reported pain or cast problems. Thus individual preference may be followed in choice of immobilisation method.