Abstract

Distal radius fractures constitute one of the most frequent upper limb injuries in emergency departments (EDs) and can be seen in pediatric, adult, and elderly patients. Immobilization is crucial in the conservative treatment of these fractures. Despite this, clinical practice is not completely consistent concerning the most effective technique of immobilization. This systematic review aimed to assess and compare the effectiveness of the various immobilization methods-regional volar splint clinching, sugar-tong splint, and long arm cast-in the emergency setting of acute distal radius fractures. A systematic search was carried out in PubMed, Scopus, and Web of Science to find original peer-reviewed studies published from 2015 to 2025. Articles that included adult and pediatric patients with acute distal radius fractures treated in the ED using different immobilization methods were reviewed. Reviews and meta-analyses were not included. Radiographic outcomes, complications, re-intervention rates, and patient satisfaction were extracted. Seven eligible articles, including more than 5,000 patients, were studied. The radiological outcomes of most techniques were comparable. Sugar-tong splints were found to control rotational instability better, whereas volar splints provided more comfort and patient satisfaction. Long arm casts were found to give a better sagittal alignment, however, with a higher complication rate. This research indicated that there is no universally superior immobilization technique. The type of selection must be based on fracture’s stability, patient comfort, and resource availability.

Key words: Distal radius fractures, emergency department, immobilization techniques, conservative management, Systematic review