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

Jackson, Trevor; Maulsby, Ethan; Wilson, Derek; Lalka, Andy; Scott, Frank A.

doi:10.1007/s00590-020-02760-w

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…Volar tilt (VT) and radial inclination (RI) angles are used to understand the anatomy and evaluate reduction quality after distal radius fractures [17]. Lower than normal VT and RI angles after distal radius fractures have been associated with poor clinical scores [3].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of radiographic measurements of the wrist in the Turkish population

Yalçın¹,

Polat²

2022

Journal of Surgery and Medicine

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Background/Aim: Wrist parameters measured on direct radiography are essential in diagnosing distal radius fractures and many specific wrist disorders and determining prognosis after treatment. Previous studies have shown the intercommunity variability of these parameters in the literature. To our knowledge, no study in the literature reflects the normal values in the Turkish population. This study aimed to determine the distribution and normal limits of parameters measured in posteroanterior (PA) and direct lateral radiographs of the wrist in our population between age and gender groups. Methods: In this retrospective cohort study, patients who presented to 2 centers in our clinic between 2014-2020 and had PA and lateral wrist radiographs were retrospectively reviewed. Images from patients who had no significant osseous pathology and had not undergone wrist surgery were randomly selected, and 320 (201 female, 119 male) digital images were retrospectively analyzed. The mean age was 40.45 (13.71). The sample was divided into three groups (18-30, 31-50, over 51) according to age and into two groups according to gender. Radial inclination (RI), lunate fossa inclination (LFA), cord of radiocarpal arch (cord RC), radial shift (Radsh), radial height (RadH), ulnar variance (UV), third metacarpal height (3 rd MH), carpal height (CH), capitate height (CapH), lunate transverse length (LL), lunate uncovering length (LUL), scapholunate joint distance (SLD), distal radioulnar joint distance (RUD), volar tilt on lateral radiographs (VT), scapholunate angle (SLA) were measured. The lunate uncovering ratio (LUR) was measured in proportion to the lunate uncovering length (LUL) / lunate transverse length (LL); carpal height ratio (CHR) by proportioning carpal height (CH) / third metacarpal height (3 rd MH); revised carpal height ratio (rCHR) was calculated by proportioning the carpal height (CH) / capitate height (CapH).Results: Although the RI and SL values of angular parameters were similar between the gender groups, the LFI and VT values were significantly higher in the female group (P=0.014 and P=0.004, respectively). All metric parameters were significantly superior in the male group (P<0.001). CHR and rCHR values were similar for proportional parameters, while LUR -values were significantly higher in the male group (P<0.001). All angular measurement parameters, Cord RC, RadH, RadS, LL, LUL, SLD of metric parameters, and CHR and rCHR values of proportional parameters were similar between age groups (P>0.05). While UV values of metric parameters increased in parallel with age, RUD values decreased significantly (P<0.001). The values of the metric parameters CH 3 rd MH, CapH, and proportional parameters LUR values also differed between the groups without being correlated with age (P=0.011, P=0.003, P=0.009, P=0.019, respectively). Conclusion: In our study, we have given the measurement parameters that can be used as a reference for the Turkish population, the relationships between gender and age groups, and the variability. The...

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Section: Discussionmentioning

confidence: 99%

Evaluation of radiographic measurements of the wrist in the Turkish population

Yalçın¹,

Polat²

2022

Journal of Surgery and Medicine

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“…These splints were found to produce similar radiographic and functional outcomes to above-elbow casts and sugar tong splints. 9,18 A potential benefit of volar-dorsal splints, as well as sugar tong splints and dorsal splints, is that they allow more space for swelling to occur compared with circumferential casts. The ability of a construct to accommodate swelling has been thought to be responsible for reduced rates of skin breakdown, necrosis, and compartment syndrome in certain conservatively treated DRFs.…”

Section: Discussionmentioning

confidence: 99%

“…Jackson et al was the only group to compare an above-elbow splint (ie, sugar tong splint) with dorsal-volar splint. 18 They found no significant differences in loss of reduction rates and radiologic outcomes between the 2 groups, including radial length, palmar tilt, and articular step-off.…”

Section: Descriptive Summarymentioning

confidence: 92%

“…Only 11 of the 22 studies included raw radiographic data (eg, mean and standard deviation of dorsal tilt) for the initial radiographs taken of the fractured wrist, and 10 of these provided similar posttreatment data. 9,12,14,16,18,20,[23][24][25]27,30 When reporting raw outcomes data, only 3 divided the results by the nature of the fracture (eg, classification and stability), by age, or by sex. 13,24,25…”

Section: S Hand 17(1s)mentioning

confidence: 99%

“…They also found no differences in the ability to perform activities of daily living or to return to work (RTW). 9 8 Ferris et al 23 X X Gamba et al 16 X X Grafstein et al 9 X X Jackson et al 18 X X X X Kachooei et al 15 X Ledingham et al 26 Mahmoudi et al 13 Maluta et al 24 X X X X X X Maluta et al 30 X X X X X X Moir et al 21 O'Connor et al 19 Park et al 12 X X X Pool 11 X X X Solgaard et al 29 Stewart et al 21 X X X Wik et al 25 X X X X X X X X X X Zhang et al 28 Note. RH = radial height; RI = radial inclination; ID = intraarticular displacement; DT = dorsal tilt.…”

Section: Descriptive Summarymentioning

confidence: 99%

See 2 more Smart Citations

The Effect Immobilization Mechanisms Have on Radiographic Outcomes and Complication Rates in the Conservative Treatment of Distal Radius Fractures: A Systematic Review

Jamnik

Chacón

Xiao

et al. 2022

Hand (New York, N,Y.)

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Distal radius fractures (DRFs) are among the most common fractures in the United States. Despite their high incidence, there is no consensus on the optimal type of cast or splint to treat these fractures. The purpose of this systematic review is to evaluate the available literature pertaining to the outcomes for different constructs used to conservatively treat DRFs. A literature search of PubMed, Medline, and Embase was conducted to identify research comparing the outcomes of various immobilization mechanisms. In particular, endpoints included complications (eg, loss of reduction, pain), radiographic outcomes, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. A total of 1655 articles were identified during the literature search, and 22 ultimately fulfilled inclusion criteria. These 22 studies included 1826 conservatively treated DRFs. The different immobilization mechanisms were divided into 8 groupings: above-elbow casts, above-elbow splints, below-elbow casts, below-elbow splints, gutter or spica casts, gutter or spica splints, dorsal-volar splints, and dorsal splints. Qualitative review of the studies determined that below-elbow constructs result in equal or better functional and radiologic outcomes when compared with above-elbow constructs. Meta-analysis demonstrated that a statistically significant difference ( P = .04) existed in the incidence of loss of reduction between the immobilization constructs, although post hoc analysis did not detect significant differences between 2 particular constructs.

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