A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population



Distal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar–dorsal splint versus sugar-tong splint prior to conversion into a short arm cast.


We performed a retrospective study of patients with distal radius fractures placed in a sugar-tong (n = 45) and volar–dorsal splint (n = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar–dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured.


The average age was not significantly different between groups (Diff: 1.1 years, P = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar–dorsal group (17.1 vs. 19, P = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar–dorsal group (8.4 vs. 9.2, P = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar–dorsal group (P = 0.696).


Our results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar–dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar–dorsal splint compared to a sugar-tong splint.

Level of evidence

Therapeutic level III.

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This publication was supported by NIH/NCRR Colorado CTSI Grant Number UL1 RR025780. Its contents are the authors’ sole responsibility and do not necessarily represent official NIH views.

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Correspondence to Frank Scott.

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Ethical approval

This study was approved by the Colorado Multiple Institutional Review Board. Procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Jackson, T., Maulsby, E., Wilson, D. et al. A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population. Eur J Orthop Surg Traumatol 31, 229–234 (2021). https://doi.org/10.1007/s00590-020-02760-w

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  • Distal radius fracture
  • Splint
  • Closed reduction
  • Outcomes research