Cast Immobilisation versus Wire Fixation in the Management of Middle-aged and Elderly Patients with Distal Radius Fractures

Jordan, Robert W.; Naeem, R.; Jadoon, Saqiba; Parsons, Helen; Shyamalan, G.

doi:10.1142/s2424835516500016

Cited by 3 publications

(4 citation statements)

References 30 publications

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“…A flowchart of the literature search and study selection is shown in eFigure 1 in the Supplement. In total, 23 unique studies were included in this systematic review and meta-analysis, including 8 RCTs and 15 observational studies …”

Section: Resultsmentioning

confidence: 99%

“…The 15 observational studies (3 prospective 39,41,44 and 12 retrospective [32][33][34]37,40,42,43,45,[50][51][52][53] cohort studies) included 1598 patients (70.9%). Operative treatment was performed in 718 patients (44.9%), and 880 (55.1%) were treated nonoperatively.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The operative method was open reduction and internal fixation with a volar plate in 6 studies, 34,39,41,42,51,53 external fixation in 1 study, 32 percutaneous pinning in 1 study, 33 intramedullary nail fixation in 1 study, 50 k-wire fixation in 1 study, 43 and unclear or a combination of methods in 5 studies. 37,40,44,45,52 The conservative method was cast immobilization in 13 studies 32,34,37,[39][40][41][42][43][44][45]50,51,53 and unclear in 2 studies. 33,52…”

Section: Study Characteristicsmentioning

confidence: 99%

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Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

et al. 2020

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IMPORTANCENo consensus has been reached to date regarding the optimal treatment for distal radius fractures. The international rate of operative treatment has been increasing, despite higher costs and limited functional outcome evidence to support this shift. OBJECTIVESTo compare functional, clinical, and radiologic outcomes after operative vs nonoperative treatment of distal radius fractures in adults. DATA SOURCES The PubMed/MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases were searched from inception to June 15, 2019, for studies comparing operative vs nonoperative treatment of distal radius fractures. STUDY SELECTION Randomized clinical trials (RCTs) and observational studies reporting on the following: acute distal radius fracture with operative treatment (internal or external fixation) vs nonoperative treatment (cast immobilization, splinting, or bracing); patients 18 years or older; and functional outcome. Studies in a language other than English or reporting treatment for refracture were excluded. DATA EXTRACTION AND SYNTHESIS Data extraction was performed independently by 2 reviewers. Effect estimates were pooled using random-effects models and presented as risk ratios (RRs) or mean differences (MDs) with 95% CIs. Data were analyzed in September 2019. MAIN OUTCOMES AND MEASURES The primary outcome measures included medium-term functional outcome measured with the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and the overall complication rate after operative and nonoperative treatment.RESULTS A total of 23 unique studies were included, consisting of 8 RCTs and 15 observational studies, that described 2254 unique patients. Among the studies that presented sex data, 1769 patients were women [80.6%]. Overall weighted mean age was 67 [range, 22-90] years). The RCTs included 656 patients (29.1%); observational studies, 1598 patients (70.9%). The overall pooled effect estimates the showed a significant improvement in medium-term (Յ1 year) DASH score after operative treatment compared with nonoperative treatment (MD,]; P = .005; I 2 = 84%). No difference in complication rate was observed (RR, 1.03 [95% CI, 0.69-1.55]; P = .87; I 2 = 62%). A significant improvement in grip strength was noted after operative treatment, measured in kilograms (MD, 2.73 [95% CI,]; P = .04; I 2 = 79%) and as a percentage of the unaffected side (MD, 8.21 [95% CI,]; P = .007; I 2 = 76%). No improvement in mediumterm DASH score was found in the subgroup of studies that only included patients 60 years or older (MD, −0.98 [95% CI, −3.52 to 1.57]; P = .45; I 2 = 34%]), compared with a larger improvement in (continued)

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

et al. 2020

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“…Although a wide variety of management options are available for distal radius fractures, there seems to be no consensus regarding the optimal therapy [4]. In the study "Cast Immobilisation vs. Wire Fixation in the Management of Middle-aged and Elderly Patients with Distal Radius Fractures," Jordan et al find that cast immobilization can lead to poor radiological outcomes, but the functional results are comparable to operative management in the elderly [5]. Still, poor radiological outcomes can lead to poor functional results, especially in the younger age group.…”

Section: Introductionmentioning

confidence: 99%

Functional Outcome of Joshi’s External Stabilization System Fixation in Distal Radius Fractures

Michael¹,

George²,

Canjirathinkal³

et al. 2022

Cureus

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BackgroundDistal radius fractures account for almost one-sixth of all fractures in a casualty setting. The usual aim of distal radius fracture treatment is to restore the function of the wrist joint, of which the distal radius is an important part. There seems to be no consensus regarding which mode of treatment is optimal for managing distal radius fracture, particularly when it is associated with distal radioulnar joint instability. ObjectiveTo describe the functional outcome in patients presenting with displaced distal radius fractures who undergo Joshi's external stabilization system (JESS) fixation. MethodsAn observational study was done among 32 working-age (18 to 55 years) patients presenting with unilateral displaced distal radius fractures (excluding volar displaced) and subsequently treated with JESS fixation. The outcomes of the patients were assessed using the Green and O'Brien Scoring System modified by Cooney et al. at six months and one year following the surgery. Radiographs were also taken postoperatively and during follow-up. The data were analyzed (using IBM SPSS software version 22 and Microsoft Excel) in terms of the proportion of patients with acceptable clinical and radiological outcomes. ResultsAcceptable functional outcomes (good and excellent scores in the Green and O'Brien Scoring System) were observed in 78.1% of the study population. Though the functional outcome scores were higher among the younger age group, a statistically significant difference was not obtained. 96.9% of the patients had acceptable radiological reductions, and infection of the pin tracts complicated 9.4% of the cases. A significant improvement in outcome scores (p-value 0.0001) was observed between the outcome scores at six months and one year after surgery. ConclusionsJESS fixation is an easy and effective method for treating displaced distal radius fractures to achieve good to excellent clinical outcomes. The functional outcome scores were better in the younger age group and male patients, but no statistically significant difference was observed.

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Experimental Study of High Energy Arcing Faults Using Medium Voltage Metalclad Switchgears

Kabashima¹,

Kasahara²

2018

Nuclear Technology

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Cast Immobilisation versus Wire Fixation in the Management of Middle-aged and Elderly Patients with Distal Radius Fractures

Abstract: Cast immobilisation can produce comparable functional results to wire fixation despite worse radiological outcomes.

Cited by 3 publications

References 30 publications

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

Functional Outcome of Joshi’s External Stabilization System Fixation in Distal Radius Fractures

Experimental Study of High Energy Arcing Faults Using Medium Voltage Metalclad Switchgears

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