Outcome of application of complete below elbow plaster of Paris cast for Colles' fractures after manipulation

Abstract

BACKGROUND: Application of plaster of Paris (POP) cast for Colles' fracture is a universal practice around the world. The widely accepted practice is to apply a dorso-radial slab or a complete POP with a split. Yet, application of a complete POP without splitting is the long term practice in the Sri Lankan context. OBJECTIVE: To measure the clinical outcome of this practice with a focus on complications and the association between patients’ perceptions on POP cast and clinical examination findings. METHODS: This was a longitudinal descriptive study with 78 study units recruited from one orthopedic unit at the NHSL The duration of the study was two years. A structured questionnaire was used after pre-testing with an emphasis on post-POP complications after 2 weeks of application. RESULTS: Two patients out of 78 have undergone split of POP owing to complications. Two patients had developed numbness, whilst rest had no other neurological problems. None of the POPs were found to be loose and 13 (n=10) percent of patients had tight casts. Eight patients have developed some degree of restriction of movements. 18% (n=14) had developed moderate swelling of fingers during this period. CONCLUSIONS: There is no statistically significant evidence for development of severe complications. The patient’s perceptions about POP complications were significantly associated with the clinical examination findings. However, the patient’s opinions about swelling and function were not proportionate with examination findings. This method of POP application for Colles’ fracture is a viable treatment option.