***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Summary A r and omized clinical study of functional bracing in supination ( FUSU ) versus dorsal plaster immobilization ( DPI ) was conducted in 145 patients with Colles ' fracture . A dynamic wrist unit was developed and used in 68 patients allocated for FUSU . The anatomical end result after FUSU was excellent or good in 80 % of the patients versus 64 % after DPI ( P<0.05 ) , in particular due to less dorsal angulation ( P<0.001 ) and less radial shortening . The functional recovery was equal after 7 weeks and 3 months . At 6 months , 92 % satisfactory results were achieved after FUSU versus 86 % after DPI ( P<0.05 ) . Both anatomical and functional benefits were recorded in Frykman type V , VI , and VIII fractures and in the group of displaced intra-articular fractures . The functional benefit from FUSU is suggested primarily to be secondary to decreased fracture redislocation . ZusammenfassungEs wird über eine r and omisierte prospektive Studie von dynamischer Schienenbeh and lung in Supination ( FUSU ) gegenüber konventionellem dorsalen Gipsverb and ( DPI ) bei 145 Colles-Frakturen berichtet . Die anatomischen Beh and lungsergebnisse nach FUSU ergaben statistisch bessere Result ate als DPI ( P<0.05 ) , insbesondere in Abhängigkeit von geringerer dorsaler Angulation ( P<0.001 ) und geringer radialer Verkürzung . Die funktionellen Beh and lungsergebnisse zeigten keinen Unterschied 7 Wochen oder 3 Monate nach den Colles-Frakturen . Nach 6 Monaten wurden die funktionellen Ergebnisse bei 92 % der mit FUSU beh and elten Patienten als hervorragend oder gut beurteilt ( P<0.05 ) . Der Vorteil der FUSU Beh and lung zeigte sich besonders bei dislozierten , intraartikulären Frakturtypen In a prospect i ve study of Colles ’ fractures , 100 patients with Older type 1 and 2 fractures were r and omized in two groups . One group was immobilized for 3 weeks and the other one for 5 weeks . Both groups were immobilized with a below-elbow plaster splint . At 1 year follow-up , there were 73 patients with 74 fractures .  Dorsal angulation , radial length , wrist motion , grip strength and pain were measured . There was no significant difference in the measured parameters in the two groups . We found that 3 weeks of immobilization is a satisfactory treatment for Older type 1 and 2 Colles ’ fractures Unilateral Colles ' fractures in 187 patients over the age of 55 years were studied in a r and omised prospect i ve trial : 97 fractures were minimally displaced and were treated either conventionally or in a crêpe b and age ; 90 displaced Colles ' fractures were reduced and of these 47 were treated conventionally while 43 were encouraged to mobilise the wrist in a cast which restricted extension . Early wrist movement hastened functional recovery and led to earlier resolution of wrist swelling . Discomfort was no greater than in patients who were treated conventionally . The bony deformity , which recurred irrespective of the method of treatment , was not adversely affected by early mobilisation A new prefabricated brace for the functional treatment of Colles ' fractures has been developed . It is applied at fracture reduction and maintains fracture position by the application of three-point loading . In a prospect i ve r and omized clinical trial treating 85 displaced Colles ' fractures , with blind independent follow-up , the brace gave better functional results than conventional plaster treatment . The improved function was apparent up to 6 months after injury . Finger function and pinch strength were also better in the brace-treated patients . Anatomical results were similar in the two groups We carried out a r and omised , prospect i ve , multicentre clinical trial of the treatment of Colles ' fractures . A total of 339 patients was placed into two groups , those with minimally displaced fractures not requiring manipulation ( 151 patients ) and those with displaced fractures which needed manipulation ( 188 patients ) . Treatment was by either a conventional Colles ' plaster cast ( a control group ) or with a prefabricated functional brace ( the Aberdeen Colles ' fracture brace ) . Similar results were obtained in both groups with regard to the reduction and to pain scores but the brace provided better grip strength in the early stages of treatment . This was statistically significant after five weeks for both manipulated and non-manipulated fractures . At the tenth day the results were statistically significant only in manipulated fractures . There was no significant difference in the functional outcome between the two treatment groups . However , younger patients and those with less initial displacement had better functional results The results of a prospect i ve controlled trial of early mobilisation of Colles ' fractures in the elderly are presented . Early mobilisation produced less pain and a stronger grip . It did not lead to any greater loss of reduction of the fracture . However , there was no significant improvement in the final range of movement of the wrist .  Immobilisation of the wrist for six weeks in plaster is extremely inconvenient for the elderly living alone and the patients greatly appreciated the reduction of this period of time to a minimum In a prospect i ve study , 204 consecutive patients with displaced Colles ' fractures had closed reduction then plaster immobilisation . Three different positions of the wrist in plaster were r and omly allocated : palmar flexion , neutral and dorsiflexion . The results in the three groups were compared . Fractures immobilised with the wrist in dorsiflexion showed the lowest incidence of redisplacement , especially of dorsal tilt , and had the best early functional results .  Immobilisation of the wrist in palmar flexion has a detrimental effect on h and function ; it is suggested that it is also one of the main causes for redisplacement of the fracture . This is discussed in relation to the functional anatomy of the wrist and the mechanics of plaster fixation Summary Thirty-three patients with undisplaced fractures of the distal radius were included in a clinical controlled trial with the purpose of evaluating whether it was safe to reduce the time of immobilisation in a plaster splint from 5 to 3 weeks . We did not find any difference in radiological healing at 3 months or in the functional scores after 3 and 9 months . RésuméTrente-trois patients présentant une fracture sans déplacement de l'extrémité inférieure du radius ont été inclus dans un essai clinique contrôlé dans le but d'évaluer la possibilité de réduire de 5 à 3 semaines la durée d'immobilisation par attelle plâtrée . On n'a observé aucune différence radiologique au 3ème mois entre les deux groupes , de même que sur le plan fonctionnel au 3ème et au 9ème mois Ninety consecutive women with unilateral Colles ' fractures were r and omized into two different treatment groups . The control group was treated for 5 weeks in conventional short-arm , below the elbow plaster of Paris casts . The other group ( N = 45 ) was treated similarly in plaster casts for 3 weeks and then had flexible casting applied for the remaining 2 weeks which allowed for early joint mobilization . Functional recovery was assessed by measuring grip strength and joint mobility at intervals over the 3 years . Radiographic and overall assessment s were also made during 3 year course of study . Virtually all patients reported greater comfort after switching to the flexible casting . Mean grip scores and joint mobilities were higher at all time points with early mobilization , reaching levels of statistical significance at 6 months for grip score and at 3 months for joint mobility . By 3 years most differences between treatment groups had resolved . We found no evidence that early mobilization was detrimental to recovery . We conclude that early mobilization is a satisfactory treatment option for Colles ' fracture , and may , in fact , hasten functional recovery Background Fracture of the distal radius is a common clinical problem , particularly in older white women with osteoporosis . We report our work towards evidence -based and patient-centred care for adults with these injuries . Methods We developed a systematic programme of research that built on our systematic review of the evidence of effectiveness of treatment interventions for these fractures . We devised schemata showing ' typical ' care pathways and identified over 100 patient management questions . These depicted the more important decisions taken when progressing along each care pathway . We compiled a comprehensive document summarising the evidence available for each decision point from our review s of r and omised trials of treatment interventions . Using these documents , we undertook a formal and structured consultation process involving key players , including a patient representative , to obtain their views on the available evidence and to establish a research agenda . The result ing feedback was then processed and interpreted , using systematic methods . Results Some evidence from 114 r and omised trials was available for 31 of the 117 patient management questions . However , there was sufficient evidence to base some conclusions of effectiveness for particular interventions in only five of these . Though only 60 % of those approached responded , the responses received from the consultation group were often comprehensive and provided important insights into treatment practice and policy . There was a clear acceptance of the aims of the project and , aside from some suggestions for the more explicit inclusion of secondary prevention and management of complications , of the care pathways scheme . Though some respondents stressed that r and omised trials were not always appropriate , there was no direct overall criticism of the evidence document and underlying processes . We were able to identify important core themes that underpin management decisions and research from the feedback of the consultation exercise . Conclusions Overall , this project is an important advance towards evidence -based and patient-centred management of adults with distal radial fractures . It exposes the serious deficiency in the available evidence but also provides a template for further action . As well as being a valuable basis for viewing and informing current practice , the insights gained from this project should inform a future research agenda Cast immobilization remains the most commonly employed method in the treatment of distal radius fractures . In an effort to test a new shrinkable polymer-coated casting material ( QuickCast ) , a prospect i ve r and omized study was performed on 30 consecutive distal radius fractures . Fractures were divided into three groups based on the severity of fracture and treated with either a conventional short-arm fibreglass tape cast or a QuickCast . Results showed no significant differences in minor cast complications or maintenance of fracture reduction between conventional fibreglass tape and the QuickCast material . The shrinkable QuickCast , however , result ed in an average of one less cast change in all groups . This reduction in time and labour must be weighed against the slightly increased cost of the QuickCast immobilizer A prospect i ve r and omized trial was carried out in 60 consecutive patients with Colles ' fractures requiring manipulation . They were treated by either a st and ard Colles ' plaster ( control group ) or in a functional plaster brace applied immediately after reduction of the fracture . The brace extended from the proximal radius and ulna to the level of the radial styloid and allowed a full range of movement at the radiocarpal joint . Both groups comprised 30 patients and were matched for age , sex and dominance of h and . There was no significant difference in initial severity of fracture or the quality of reduction . Radiological results on cast removal ( 35 - 42 days ) were significantly better in the brace group compared with those treated with a below-elbow cast ( P less than 0.05 ) . Wrist function was also significantly better in the brace treated group at 12 weeks after fracture ( P less than 0.05 ) . This brace has a number of advantages over st and ard plaster treatment , but requires a degree of skill and experience in its application . A prefabricated brace has now been developed with a similar ' built in ' three-point loading which will be easier for inexperienced staff to apply Functional treatment of Colles fractures is a recently developed approach to fracture injury . It aims to bring about faster recovery and a better functional end result by permitting early motion and function by means of a functional brace . Early motion and function , however , might jeopardize the anatomical result . Whether an inferior anatomical result jeopardizes the functional end result is not clear , as the relationship between anatomy and function has not been established . In a prospect i ve clinical study it was concluded that in displaced Colles fractures functional treatment with a below-the-elbow functional brace offers little advantage over conventional plaster of Paris immobilisation . Minimally displaced Colles fractures ( volar angle greater than or equal to 0 degrees ) should be treated with a b and age after one week of plaster immobilisation . The relationship between the anatomical and functional end result is weak and probably depends on initial displacement and complications . To improve the functional result after a Colles fracture , prevention and better treatment of complications seem to be more important than improvement of the method of fracture treatment of the anatomical end result A series of 68 undisplaced or minimally displaced Colles ' fractures was r and omized into two groups undergoing treatment with either a plaster cast or an elastic b and age .  Pain , function , grip strength , and range of motion were evaluated 1 year later . There was a difference in the functional outcome in favor of the patients treated with an elastic b and age , who did not have more fracture redislocations than those treated with a plaster cast Torus ( buckle ) fractures of the distal radius are common in childhood . Based on the results of a postal question naire and a prospect i ve , r and omised trial , we describe a simple treatment for this injury , which saves both time and money . Over a six-month period , we r and omised 201 consecutive patients with this injury to treatment with either a traditional forearm plaster-of-Paris cast or a ' Futura-type ' wrist splint .  All patients were treated for a period of three weeks , followed by clinical and radiological review . There was no difference in outcome between the two groups , and all patients had a good result . Only one patient did not tolerate the splint which was replaced by a cast . The question naire showed a marked variation in the way in which these injuries are treated with regard to the method and period of immobilisation , the number of follow-up visits and radiographs taken . We suggest that a ' Fut 
    Output:
    
REVIEW ER 'S CONCLUSIONS There remains insufficient evidence from r and omised trials to determine which methods of conservative treatment are the most appropriate for the more common types of distal radial fractures in adults .