Closed reduction and casting versus Kapandji technique for the treatment of Colles fractures: a prospective, randomized clinical trial

Abstract

Objectives: To compare the outcome of closed reduction and cast immobilization with Kapandji method for the treatment of the Colles fractures.
Patients and methods: Between 2003-2006, 33 patients with 33 Colles fractures that referred and followed in the Orthopaedics and Traumatology department or emergency service were included into the study. The patients were randomly allocated into the closed reduction and cast immobilization and Kapandji method groups. Radiological and clinical results were evaluated. Nine patients were male, twenty-four were female and the mean age was 51.9 years (23-76 ). The mean follow up period was 14 months (6-30 ).
Results: There were 14 patients treated with the Kapandji method. The functional outcome was good or excellent in %85.7 of these patients according to the Gartland-Werley evaluation score. There were 19 patients treated with closed reduction and casting. The functional outcome was good or excellent in %94.7 of them. There were no significant difference between the two treatment groups (p=0,971). In radiological evaluation, the palmar inclination angle was found to be preserved much more better in the Kapandji group than the closed reduction and cast immobilization group (p=0,003). There were no significant difference between two groups according to the radial length (p=0,524) and radial inclination angle (p=0,594).
Conclusion: Closed reduction and cast immobilization is an effective treatment method in Colles fractures. In spite of the need for fluoroscopic examination, Kapandji method is an easily applicable treatment modality with very low cost and morbidity. As the functional results are similar, Kapandji method is a reliable option for older patients who refuse cast immobilization or noncompliable with casting.