Does operative fixation of isolated fractures of ulna shaft results in different outcomes than non-operative management by long arm cast?

Hussain, Altaf; Nema, Sandeep Kumar; Sharma, Deep; Akkilagunta, Sujiv; Balaji, Gopisankar

doi:10.1016/j.jcot.2017.12.004

Cited by 9 publications

(10 citation statements)

References 15 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Overall, no trials were judged as low risk of bias and 17 out of 52 trials [ 18 , 21 , 22 , 27 , 28 , 31 , 49 , 52 , 56 , 58 , 60 , 61 , 67 , 72 , 75 , 77 , 79 ] were associated with a high risk of bias, mainly due to the lack of possibility to blind patients and treatment providers, and lack of pre-registration of the trial in a public trial registry before enrolment of the first patient.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical or non-surgical treatment of traumatic skeletal fractures in adults: systematic review and meta-analysis of benefits and harms

et al. 2020

View full text Add to dashboard Cite

Background: A comprehensive overview of treatments of common fractures is missing, although it would be important for shared decision-making in clinical practice. The aim was to determine benefits and harms of surgical compared to non-surgical treatments for traumatic skeletal fractures. Methods: We searched Medline, Embase, CINAHL, Web of Science, and CENTRAL until November 2018, for randomized trials of surgical treatment in comparison with or in addition to non-surgical treatment of fractures in adults. For harms, only trials with patient enrollment in 2000 or later were included, while no time restriction was applied to benefits. Two reviewers independently assessed studies for inclusion, extracted data from full-text trials, and performed risk of bias assessment. Outcomes were self-reported pain, function, and quality of life, and serious adverse events (SAEs). Random effects model (Hedges' g) was used. Results: Out of 28375 records screened, we included 61 trials and performed meta-analysis on 12 fracture types in 11 sites: calcaneus, clavicula, femur, humerus, malleolus, metacarpus, metatarsus, radius, rib, scaphoideum, and thoraco-lumbar spine. Seven other fracture types only had one trial available. For distal radius fractures, the standardized mean difference (SMD) was 0.31 (95% CI 0.10 to 0.53, n = 378 participants) for function, favoring surgery, however, with greater risk of SAEs (RR = 3.10 (1.42 to 6.77), n = 436). For displaced intra-articular calcaneus fractures, SMD was 0.64 (0.13 to 1.16) for function (n = 244) and 0.19 (0.01 to 0.36) for quality of life (n = 506) favoring surgery. Surgery was associated with a smaller risk of SAE than non-surgical treatment for displaced midshaft clavicular fractures (RR = 0.62 (0.42 to 0.92), n = 1394). None of the other comparisons showed statistical significance differences and insufficient data existed for most of the common fracture types.

show abstract

Section: Resultsmentioning

confidence: 99%

“…the risk of bias assessment for the individual trials.Overall, no trials were judged as low risk of bias and 17 out of 52 trials[18,21,22,27,28,31,49,52,56,58,60,61,67,72,75,77,79] were associated with a high…”

mentioning

confidence: 99%

Surgical or non-surgical treatment of traumatic skeletal fractures in adults: systematic review and meta-analysis of benefits and harms

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Stable ulna shaft fractures can be treated nonoperatively with a mean time to union, when achieved, of approximately 18 weeks [ 5 ]. However, concerns are highlighted in the literature that nonoperatively managed fractures may result in unacceptably high rates of nonunion, ranging from 2–11% [ 11 , 12 , 13 ]. This, combined with worries about malunion, elbow and wrist stiffness, as well as heterotopic ossification of the IOM and compartment syndrome, have led to an increasing prevalence of surgical intervention in such cases.…”

Section: Discussionmentioning

confidence: 99%

Locked Intramedullary Nailing versus Compression Plating for Stable Ulna Fractures: A Comparative Study

Pavone

Ganci

Papotto

et al. 2021

JFMK

View full text Add to dashboard Cite

Background: Isolated ulna shaft fractures (USFs) are a relatively uncommon, but significant, injury. For unstable USF treatment, open reduction and internal fixation (ORIF) is the gold standard, while for stable USFs several procedures were described. The aim of this study is to compare the outcomes in patients with stable USFs treated by either ORIF or intramedullary nail (IMN). Methods: According to their surgical treatment, 23 eligible USF-affected patients were divided into ORIF (14 subjects) and IMN (nine subjects) groups. The subjects underwent postoperative clinical follow-up at 1, 3, 6, and 12 months, which included calculation of the Disabilities of the Arm, Shoulder and Hand (DASH) score and radiological follow-up. Time to union, time to return to sporting and occupational activities, duration of physical therapy, and surgical complications were recorded. Results: DASH scores improved in both groups at the 6-month follow-up (p < 0.001). The IMN cohort recorded better DASH scores at the 1- and 3-month follow-ups, while similar results were reported at the 6- and 12-month follow-ups. Earlier fracture union (p = 0.001) and return to sporting activities and work (p = 0.002) were seen in the IMN group, compared with the ORIF group. No complications were observed in the IMN group. Conclusions: The surgical treatment of isolated USF results in excellent functional and radiographic outcomes. IMN may be preferable, compared with ORIF, due to its faster recovery time, expedited union, and reduced likelihood of complications.

show abstract

“…4). Bei nur geringer Dislokation und fehlendem Defizit in der Beurteilung von Durchblutung und Neurologie kann diese Verletzung konservativ behandelt werden (Cai et al 2013;Sarmiento et al 1998;Hussain et al 2018).…”

Section: Indikation Und Kontraindikationenunclassified

Radius- und Ulnaschaftfrakturen

Rausch¹,

Hackl²,

Müller³

et al. 2020

Orthopädie Und Unfallchirurgie

View full text Add to dashboard Cite

Does operative fixation of isolated fractures of ulna shaft results in different outcomes than non-operative management by long arm cast?

Abstract: Open reduction and internal fixation results in anatomical restoration of ulna, but this does not translates to better functional outcomes in short term (12 months).

Cited by 9 publications

References 15 publications

Surgical or non-surgical treatment of traumatic skeletal fractures in adults: systematic review and meta-analysis of benefits and harms

Surgical or non-surgical treatment of traumatic skeletal fractures in adults: systematic review and meta-analysis of benefits and harms

Locked Intramedullary Nailing versus Compression Plating for Stable Ulna Fractures: A Comparative Study

Radius- und Ulnaschaftfrakturen

Contact Info

Product

Resources

About