Interventions for treating wrist fractures in children

Abraham, Alwyn; Handoll, HHG; Khan, Tahir Mehmood

doi:10.1002/14651858.cd004576.pub2

Cited by 51 publications

(15 citation statements)

References 22 publications

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“…Eine sekundäre Dislokation entsteht nie, sofern keine Biegungskomponente vorliegt. Die Behandlung besteht in der Gipsruhigstellung für 2 bis 3 Wochen [1]. Sobald eine Biegungskomponente als Ursache hinzukommt und die aufzunehmende Energie die Elastizität des Knochens übersteigt, kommt es zu Dislokationen.…”

Section: Wulstfrakturenunclassified

“…Um eine sekundäre Dislokation sicher vermeiden zu können, wird von vielen Autoren eine primäre Reposition mit perkutaner K-Draht-Osteosynthese gefordert [11,12,18]. Obwohl diese die sekundäre Dislokation weitgehend verhindert, gibt es keine belastbaren Daten zu den Langzeitergebnissen, die in einem Cochrane-Review dringend gefordert werden [1,13].…”

Section: Grünholzfrakturen Und Komplette Frakturen Mit Angulationunclassified

“…2008 erschien in der Cochrane Library eine Metaanalyse zur Behandlung der distalen Unterarmfraktur im Kindesalter [1]. Die Autoren kamen zu dem Schluss, dass die Spontankorrektur nachgewiesen werden konnte, es jedoch unklar ist, bis zu welchem Alter und Ausmaß diese zuverlässig möglich ist.…”

Section: Studien Zur Spontankorrekturunclassified

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Konservative oder operative Therapie der distalen metaphysären Unterarmfraktur

Adrian

Wessel

2015

Trauma Berufskrankh

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Metaphysäre distale Unterarmfrakturen sind die häufigsten Frakturen imKindes-und Jugendalter und machen 20-25% aller Frakturen in diesem Alter aus. Wulstfrakturen und komplette Frakturen mit Dislokation bieten klare Behandlungsvorgaben. Unklar ist hingegen die Behandlung der angulierten Grünholzfrakturen. Trotz Reposition kommt es in gut 30% der Fälle zur erneuten Dislokation.Abb. 1 9 Wulstfraktur. a Anterior-posteriore Aufnahme, b seitliche Aufnahme Übersichten SchlüsselwörterKnochenfrakturen · Rekorrektur · Konservative Therapie · Kinder · Frakturfixation Conservative or operative therapy of distal metaphyseal forearm fracture. Where is the boundary? Abstract Background. Incomplete greenstick fractures and complete fractures without shortening occurring at the distal metaphysis of the forearm are very frequent fractures in childhood. The treatment of these fractures is a matter of controversial discussion. Despite manipulation and/or pinning the risk of redisplacement is approximately 30 %. Objective. Is repositioning with K-wire osteosynthesis or other synthesis procedures necessary for these fractures or can the spontaneous remodeling capacity be used for treatment and make an operation superfluous? Methods. Analysis of existing studies on this topic. Results.There are no clear guidelines and not enough studies that take the remodeling potential into consideration. Conclusion.A study similar to the angulated fractures of the distal forearm in children (AFIC) study is needed that compares a purely conservative treatment with repositioning and fixation via K-wires in a controlled, randomized and prospective study.

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Section: Wulstfrakturenunclassified

Section: Grünholzfrakturen Und Komplette Frakturen Mit Angulationunclassified

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Konservative oder operative Therapie der distalen metaphysären Unterarmfraktur

Adrian

Wessel

2015

Trauma Berufskrankh

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“…Radiographs fractures are inherently stable and the risk of displacement is very low or non-existent [3][4][5][6][7] . In a review of nine studies on torus fractures [3,[6][7][8][9][10][11][12][13] , May and Grayson (2009) found that in none of the studies was there loss of position, lack of recovery, need for orthopaedic intervention or ongoing pain. The authors concluded that buckle fractures will heal regardless of the treatment the patient receives [14] .…”

Section: Introductionmentioning

confidence: 99%

“…These factors make it difficult to evaluate the reliability of the evidence presented and the review's conclusions should be interpreted with caution [19] . In the current literature, one systematic review was found that compared splint and cast in torus factures among other types of interventions in different wrist fractures in children [8] . It concluded that the limited evidence supports the use of removable splint…”

Section: Introductionmentioning

confidence: 99%

Comparison of splint and conventional cast for treating wrist torus fractures in children (systematic review)

Alsawadi¹,

Abbas²

2017

Adv Emerg Med

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Wrist torus fractures in children are common. Although it might be simple and straightforward, the management of these injuries remains controversial and depends on the personal experience and preference of the treating physician. The consensus agreement, however, is that these fractures are inherently stable. Some authors argue that splints should replace the traditional method of cast immobilisation. The splints are viewed as easier to use, more convenient and do not require follow up clinics for removal. It has also been argued that splints are more cost-effective than casts. The aim of this systematic review is to examine the effectiveness and cost-effectiveness of removable splints versus casts in the treatment of torus wrist fractures of children in the current literature. This review followed the Systematic reviews and Meta-Analyses (PRISMA) statement for reporting. Comprehensive electronic database search and handsearch were conducted. Studies were considered for review if they were randomised or quasi-randomised controlled trial and compared removable splints and casts for treating torus fractures of distal radius and/or ulna in children. Four papers identified by two reviewers as potentially eligible for inclusion were appraised and two identified for inclusion were further assessed for any risk of bias. Data were narratively presented and discussed as meta-analysis would not have been possible for the identified studies. The limited available data favours the use of splint as a clinically effective and more cost-effective method of immobilisation. However, the findings of the systematic review are limited by the quality of the identified studies. It has been viewed that explanation to patients and parents and involving them in the decision, plus implementation of safety protocol to avoid under-treatment of misdiagnosed fractures and allow easy access of patients to the clinic, is an alternative way to provide safe, convenient and cost-effective treatment.

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