CAST STUDY
Multicenter RCT: displaced radius fractures 
Published

The CAST study is a multicentre randomized trial that compared circumferential casting with plaster splinting as initial treatment for displaced distal radial fractures in adults after successful closed reduction. 

A total of 420 patients were included. The primary outcome was fracture redisplacement within five weeks, with secondary outcomes including pain, cast-related complaints, clinical and patient-reported outcomes, and adverse events during one year of follow-up. 

There was no significant difference in redisplacement rates between the two groups (47% in the plaster splint group vs 49% in the circumferential cast group). Patients treated with a plaster splint reported slightly higher pain levels during the first week, but no significant differences were found in cast-related complaints, clinical outcomes, patient-reported outcome measures, or complications. No cases of compartment syndrome occurred. 

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Conclusion 

Circumferential casting did not reduce fracture redisplacement compared with plaster splinting, and overall outcomes were similar between the two treatment methods.