Comparative Analysis of Intramedullary Nail Fixation Versus Casting for Treatment of Distal Radius Fractures

Tan, Virak; Bratchenko, Walter; Nourbakhsh, Ali; Capo, John T.

doi:10.1016/j.jhsa.2011.10.041

Cited by 25 publications

(22 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Complication rate was reported in 19 studies, including 8 RCTs 31,35,36,38,[46][47][48][49] and 11 observational studies. [32][33][34]37,[39][40][41][42]45,50,51 The overall pooled effect showed no difference in complication rate between operative and nonoperative treatment with an RR of 1.03 (95% CI, 0.69- For studies that did not present characteristics for treatment groups separately, the numbers presented are for the overall study group, and the cells are merged.…”

Section: Primary Outcome Measuresmentioning

confidence: 96%

“…Medium-term (Յ1 year) functional outcome assessed according to the DASH score was reported in 10 studies, including 4 RCTs 35,38,47,48 and 6 observational studies, [39][40][41]44,50,51 with 845 patients. The AO fracture type was known for 716 patients.…”

Section: Primary Outcome Measuresmentioning

confidence: 99%

“…Grip strength was reported in 13 studies, including 6 RCTs 35,36,46-49 and 7 observational studies, 33,34,39,40,50,51,53 and was assessed in kilograms (509 patients) and percentage of the…”

Section: Secondary Clinical Outcome Measuresmentioning

confidence: 99%

“…These studies included 247 patients (63.8%) who sustained an AO fracture type A; 9 (2.3%), type B; and 131 (33.9%), type C. The overall pooled effect showed no difference in the medium-term DASH score (MD, −0.98 [95% CI, −3.52 to 1.57]; P = .45; I 2 = 34%) (eFigure 22 in the Supplement). The mediumterm DASH score for other studies that included patients 18 years or older was reported in 6 studies (2 RCTs 47,48 and 4 observational studies41,44,50,51 ), with 458 patients and an overall mean age of 59 years. The AO fracture type was known for 329 patients, including 155 (47.1%) who sustained an AO…”

mentioning

confidence: 99%

See 3 more Smart Citations

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

et al. 2020

View full text Add to dashboard Cite

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)

show abstract

Section: Primary Outcome Measuresmentioning

confidence: 96%

Section: Primary Outcome Measuresmentioning

confidence: 99%

“…Grip strength was reported in 13 studies, including 6 RCTs 35,36,46-49 and 7 observational studies, 33,34,39,40,50,51,53 and was assessed in kilograms (509 patients) and percentage of the…”

Section: Secondary Clinical Outcome Measuresmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

et al. 2020

View full text Add to dashboard Cite

show abstract

“…42 Although evidence on outcomes using this technique is still limited, a recent study suggests improved 1-year outcomes when compared with casting. 43…”

Section: Minimally Invasive Fixationmentioning

confidence: 99%

Current Concepts in the Treatment of Distal Radial Fractures

Ipaktchi¹,

Livermore²,

Lyons³

et al. 2013

Orthopedics

View full text Add to dashboard Cite

Distal radial fractures are among the most commonly encountered traumatic fractures of the upper extremity. Initial trauma mechanism, fracture pattern, associated injuries, and patient age influence treatment and outcome. Although stable fractures are commonly treated conservatively, the past decade has seen changes in surgical practice and techniques. Indications for surgery have been extended and refined based on new insight into the pathophysiology of the distal end of the forearm and technological advances in implant design. Despite the frequency of this fracture, only limited higher-level evidence exists to guide practitioners in decision making for this injury. This article highlights key concepts in the treatment of distal radial fractures and summarizes current evidence.

show abstract

Distal Radius

Gradl¹

2014

Intramedullary Nailing

View full text Add to dashboard Cite

Comparative Analysis of Intramedullary Nail Fixation Versus Casting for Treatment of Distal Radius Fractures

Cited by 25 publications

References 23 publications

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults

Current Concepts in the Treatment of Distal Radial Fractures

Distal Radius

Contact Info

Product

Resources

About