***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 This paper reports a prospect i ve study of the treatment of Colles ' fractures , either by bipolar fixation or a forearm cast . Bipolar fixation reduced the degree of secondary displacement and no patient required a repeat manipulation . The functional results at 6 months , as assessed by the Scheck system , showed a strong trend in favour of bipolar fixation , but did not reach 95 per cent confidence limits . The technique of bipolar fixation proved to be safe and suitable for use in a busy district general hospital , without the necessity of elaborate equipment OBJECTIVE To examine the relative effectiveness of ice therapy and /or pulsed electromagnetic field in reducing pain and swelling after the immobilization period following a distal radius fracture . METHODS A total of 83 subjects were r and omly allocated to receive 30 minutes of either ice plus pulsed electromagnetic field ( group A ) ; ice plus sham pulsed electromagnetic field ( group B ) ; pulsed electromagnetic field alone ( group C ) , or sham pulsed electromagnetic field treatment for 5 consecutive days ( group D ) . All subjects received a st and ard home exercise programme . A visual analogue scale was used for recording pain ; volumetric displacement for measuring the swelling of the forearm ; and a h and -held goniometer for measuring the range of wrist motions before treatment on days 1 , 3 and 5 . RESULTS At day 5 , a significantly greater cumulative reduction in the visual analogue scores as well as ulnar deviation range of motion was found in group A than the other 3 groups . For volumetric measurement and pronation , participants in group A performed better than subjects in group D but not those in group B. CONCLUSION The addition of pulsed electromagnetic field to ice therapy produces better overall treatment outcomes than ice alone , or pulsed electromagnetic field alone in pain reduction and range of joint motion in ulnar deviation and flexion for a distal radius fracture after an immobilization period of 6 weeks BACKGROUND Plate fixation of the distal part of the radius is believed to improve wrist motion by allowing earlier exercises . We performed a clinical trial comparing mobilization of the wrist joint within two weeks ( early motion ) or at six weeks ( late motion ) after volar plate fixation of a fracture of the distal part of the radius in order to test the null hypothesis that there are no differences in the flexion-extension arc three and six months after surgery . METHODS Sixty patients with an isolated fracture of the distal part of the radius that was treated with a single , fixed-angle volar plate and screws were enrolled . Thirty patients were r and omized to the early motion group , and thirty were r and omized to the late motion group . Three and six months after surgery , patients underwent  range of motion measurements , grip strength measurements , and radiographic evaluation . The patients also were evaluated according to the modified Gartl and and Werley score and the Mayo wrist score , rated pain on a 10-point ordinal scale , and completed the Disabilities of the Arm , Shoulder and H and ( DASH ) question naire . RESULTS There were no significant differences between the early motion group and the late motion group with regard to the average flexion-extension arc of the injured wrist at three months ( 104 degrees compared with 107 degrees ; p = 0.61 ) or six months ( 124 degrees compared with 126 degrees ; p = 0.65 ) after surgery . In secondary analyses , there were no significant differences in terms of selected other motions , grip strength , radiographic parameters , or the Gartl and and Werley , Mayo , pain , or DASH scores . CONCLUSIONS The initiation of wrist exercises six weeks after volar plate fixation of a fracture of the distal part of the radius does not lead to decreased wrist motion compared with the initiation of wrist motion within two weeks after surgery BACKGROUND Distal radius fractures with a large metaphyseal defect often need defect filling . We assessed the reliability of a new allogenic transplant as a bone-graft substitute in comparison to autologous iliac crest bone-grafting . METHODS This prospect i ve , r and omized study included 90 patients . Fracture-osteo synthesis was done with 2.7 mm quarter-tube plates . Tutoplast-cancellous-chips were used as allografts .  Clinical and radiologic parameters were determined at three and 12 months after surgery . RESULTS Overall outcomes were assessed according to the Demerit Point System : There were 71 % good-to-excellent results in the " Tutoplast " ; group and 75 % good-to-excellent in the " iliac crest " group . Radiologic parameters were comparable and within normal range . Complications deriving from iliac bone harvesting were notably more frequent in the iliac crest group . Operation time was significantly shorter in the Tutoplast group . CONCLUSION By the use of the investigated allograft no adverse effects were detected on the outcome of the treated radius fractures . Therefore , this new allograft could be a desirable alternative to autologous bone grafting from the iliac crest , as operating and anesthetics times are shortened and complications of iliac crest bone grafting avoided 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 performed a prospect i ve , r and omised trial on 120 patients with redisplaced fractures of the distal radius comparing four methods of treatment . The four treatment groups , each containing 30 patients , were remanipulation and plaster , open reduction and bone grafting , and closed external fixation with and without mobilisation of the wrist at three weeks . The radiological results showed improvement in angulation of the distal radius for the open reduction and bone grafting group . Functional results at six weeks , three and six months and at one year , however , showed no difference between any of the four groups . The main influence on final outcome was carpal malalignment  which had a statistically significant negative effect on function 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 BACKGROUND Complex regional pain syndrome type I is treated symptomatically . A protective effect of vitamin C ( ascorbic acid ) has been reported previously . A dose-response study was design ed to evaluate its effect in patients with wrist fractures . METHODS In a double-blind , prospect i ve , multicenter trial , 416 patients with 427 wrist fractures were r and omly allocated to treatment with placebo or treatment with 200 , 500 , or 1500 mg of vitamin C daily for fifty days . The effect of gender , age , fracture type , and cast-related complaints on the occurrence of complex regional pain syndrome was analyzed . RESULTS Three hundred and seventeen patients with 328 fractures were r and omized to receive vitamin C  , and ninety-nine patients with ninety-nine fractures were r and omized to receive a placebo . The prevalence of complex regional pain syndrome was 2.4 % ( eight of 328 ) in the vitamin C group and 10.1 % ( ten of ninety-nine ) in the placebo group ( p=0.002 ) ; all of the affected patients were elderly women . Analysis of the different doses of vitamin C showed that the prevalence of complex regional pain syndrome was 4.2 % ( four of ninety-six ) in the 200-mg group ( relative risk , 0.41 ; 95 % confidence interval , 0.13 to 1.27 ) , 1.8 % ( two of 114 ) in the 500-mg group ( relative risk , 0.17 ; 95 % confidence interval , 0.04 to 0.77 ) , and 1.7 % ( two of 118 ) in the 1500-mg group ( relative risk , 0.17 ; 95 % confidence interval , 0.04 to 0.75 ) . Early cast-related complaints predicted the development of complex regional pain syndrome ( relative risk , 5.35 ; 95 % confidence interval , 2.13 to 13.42 ) . CONCLUSIONS Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures . A daily dose of 500 mg for fifty days is recommended PURPOSE To compare , in a prospect i ve , r and omized manner , the sugar tong splint with a short-arm radial gutter splint in terms of patient satisfaction and the ability to maintain reduction of distal radius fractures . METHODS A total of 118 patients with displaced distal radius fractures were enrolled ; 85 patients ( 85 fractures ) were available for follow-up evaluation and were included in the study population . There were 26 men and 59 women with a mean age of 64 years . Thirty-eight fractures were immobilized in a short-arm radial gutter splint and 47 in a sugar tong splint . Forty fractures had a stable pattern and 45 had an unstable fracture pattern . The initial patient follow-up examination occurred a mean of 8 days after splint application . RESULTS A total of 33 fractures showed loss of fracture reduction at the initial follow-up evaluation . Sixteen of 38 fractures immobilized with the radial gutter splint displaced , whereas displacement was seen in 17 of 47 fractures immobilized with a sugar tong splint ; this difference was not significant . When the splint constructs were evaluated based on fracture stability no differences were found between the splints ' ability to maintain fracture reduction in both stable and unstable displaced fractures . Patients in the short-arm radial gutter splint group had significantly better Disabilities of the Arm , Shoulder , and H and scores than those patients whose fractures were immobilized with a sugar tong splint . CONCLUSIONS Both the sugar tong splint and the short-arm radial gutter splint had comparable performance in maintaining the initial reduction of distal radius fractures , with the short-arm splint tolerated better by patients . Based on our study we recommend the use of a short-arm radial gutter splint for initial immobilization of displaced distal radius fractures . TYPE OF STUDY /LEVEL OF EVIDENCE Prognostic , level II OBJECTIVE To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures :  treatment by a physical therapist with 12 sessions and an unassisted home exercise program . DESIGN R and omized controlled cohort study . SETTING Hospital-based care , primary center of orthopedic surgery . PARTICIPANTS Volunteers ( N=48 ) with fractures of the distal radius after internal fixation with locking plates . There were 46 patients available for follow-up after exclusion of 2 participants due to physiother 
    Output:
    
The remaining five moderate-strength recommendations include surgical fixation , rather than cast fixation , for fractures with postreduction radial shortening > 3 mm , dorsal tilt > 10 degrees , or intra-articular displacement or step-off > 2 mm ; use of rigid immobilization rather than removable splints for nonsurgical treatment ; making a postreduction true lateral radiograph of the carpus to assess dorsal radial ulnar joint alignment ; beginning early wrist motion following stable fixation ; and recommending adjuvant treatment with vitamin C to prevent disproportionate pain