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 in
flexion, the forearm in pronation, and the wrist in volar flexion and ulnar
deviation is probably the main reason for the common and rapid recurrence of the
original deformity. Such a position places the brachioradialis muscle, a strong
flexor of the elbow and the only muscle attached to the distal fracture
fragment, in an ideal physiological position to exert a deforming force on the
fracture fragments. Based on this assumption, further supported by
electromyographic studies, a method of treatment was developed which calls for
the initial immobilization of the arm in an above-the-elbow cast with the elbow
in flexion, the forearm in supination, and the wrist inmoderate ulnar and volar
flexion. This cast is changed a few days after application for an Orthoplast
brace that permits motion of the elbow and volar flexion of the wrist while
preventing pronation and supination of the forearm and dorsiflexion of the
wrist. The proposed method did not prevent collapse of the fragments in all
instances. However, the degree of collapse was minimum. The position of
supination of the forearm and the freedom of motion of all joints seemed to
reduce the swelling, stiffness, and incapacitation frequently found during
active treatment of these fractures.

PMID: 1123382 [PubMed - indexed for MEDLINE]