1: J Bone Joint Surg Am. 1975 Apr;57(3):311-7. Colles' fractures. Functional bracing in supination.Sarmiento A, Pratt GW, Berry NC, Sinclair WF.The classic position of immobilization of Colles' fractures with the elbow inflexion, the forearm in pronation, and the wrist in volar flexion and ulnardeviation is probably the main reason for the common and rapid recurrence of theoriginal deformity. Such a position places the brachioradialis muscle, a strongflexor of the elbow and the only muscle attached to the distal fracturefragment, in an ideal physiological position to exert a deforming force on thefracture fragments. Based on this assumption, further supported byelectromyographic studies, a method of treatment was developed which calls forthe initial immobilization of the arm in an above-the-elbow cast with the elbowin flexion, the forearm in supination, and the wrist inmoderate ulnar and volarflexion. This cast is changed a few days after application for an Orthoplastbrace that permits motion of the elbow and volar flexion of the wrist whilepreventing pronation and supination of the forearm and dorsiflexion of thewrist. The proposed method did not prevent collapse of the fragments in allinstances. However, the degree of collapse was minimum. The position ofsupination of the forearm and the freedom of motion of all joints seemed toreduce the swelling, stiffness, and incapacitation frequently found duringactive treatment of these fractures.PMID: 1123382 [PubMed - indexed for MEDLINE]