A functional brace for treating Colles fractures; volunteer trial of a new design

• Published in: Clinical biomechanics (Bristol) 2024-02, Vol.112, p.106181-106181, Article 106181
• Main Authors: Wardlaw, Douglas, Murdoch, Ann H.
• Format: Article
• Language: English
• Subjects: Aberdeen fracture brace; Casts, Surgical; Closed reduction; Colles' fracture; Colles' Fracture - therapy; Functional bracing; Humans; Immediate application; Immediate mobilisation; Radius; Radius Fractures - therapy; Three-point loading; Volunteers
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2024.106181

Presently used Colles' fracture treatments have similar outcomes with significant complications. Previous studies of a dynamic functional fracture brace, achieving similar or better results had no significant complications. A novel brace design is described to achieve optimal patient outcomes. Patient forearm measurements combined with data from a previously tested brace provided parameters for a brace formed using computer assisted design. Fracture swelling was simulated using a 40 ml (ml) plastic water filled bag placed over the dorsum of the lower radius. The interface pressure between the brace, skin and bag were measured on twelve human volunteers, four with forearm measurements to fit each of small, medium and large brace sizes. Measurements were taken at intervals reducing volume of fluid in the bag by 10 ml until empty, first wearing a brace, and then with a Colles plaster of Paris cast. The brace produced interface pressures over the lower radius in the range of 62.5–90 (mm Hg) and when the bag was completely empty the pressure range was 43–83 mmHg. The initial interface pressures in the Colles casts were in the range of 15–18 mm of Mercury (mm Hg) and when 10 mls were removed from the plastic bag the interface pressure dropped immediately to almost zero. The brace measurements show pressures higher than a Colles cast which compensate for reduction of simulated swelling. It is safe and is potentially the optimal design to achieve significantly improved patient outcomes. •Plaster of Paris interface pressures in pad one were consistent and all others inconsistent.•Plaster of Paris interface pressures are low and allow the facture to displace in some cases.•The brace interface pressures are consistent.•The brace interface pressures are at a level likely to prevent fracture displacement.•The brace is comfortable and had no complications in eighteen patients.