Surgical interventions for treating intra and extra-articular distal radius fractures: a randomised controlled trial of internal fixation with plate & screws versus percutaneous K-wiring

Forearm-based Bier’s block has been advocated as a useful anaesthesic technique in hand surgery. However, there is limited data comparing forearm blocks with the conventional Bier’s block. We conducted a randomised controlled trial ( n = 30) comparing the two techniques of anaesthesia for manipulation and reduction of closed distal radius fractures in an emergency room setting. Pain scores measured using the Visual Analogue Scale during the procedure were used as the primary outcome assessment. There was no significant difference in pain scores between the forearm and conventional Bier’s block (mean VAS 18.4 SD 22.10 versus 33.7 SD 29.6). No major complications were observed in either group. The forearm-based Bier block is an effective alternative to the conventional block.

Download Full-text

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

Turkish Journal of Trauma and Emergency Surgery ◽

10.5505/tjtes.2015.05995 ◽

2015 ◽

Author(s):

Guang-shu Yu

Keyword(s):

Conservative Treatment ◽

Internal Fixation ◽

Distal Radius ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Distal Radius Fractures ◽

Controlled Trials ◽

Radius Fractures ◽

Randomised Controlled

Download Full-text

Percutaneous pinning versus volar locking plate internal fixation for unstable distal radius fractures: a meta-analysis

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193417735810 ◽

2017 ◽

Vol 43 (2) ◽

pp. 158-167 ◽

Cited By ~ 12

Author(s):

Fei Peng ◽

Yuan-xiang Liu ◽

Zhen-yu Wan

Keyword(s):

Internal Fixation ◽

Distal Radius ◽

Meta Analysis ◽

Pain Syndrome ◽

Open Reduction Internal Fixation ◽

Distal Radius Fractures ◽

Percutaneous Pinning ◽

Radius Fractures ◽

Level Of Evidence ◽

Randomised Controlled

This meta-analysis compared outcomes between percutaneous pinning/wiring and open reduction internal fixation (ORIF) with locking plates for treatment of unstable distal radius fractures. Medline, Cochrane, EMBASE, and Google Scholar were searched through December 30, 2015. Twenty randomised controlled trials (RCTs) and non-randomised two-arm studies were included. Outcomes included scores of Disabilities of the Arms, Shoulders and Hands (DASH), visual analogue scale (VAS) pain, and patient rated wrist evaluation (PRWE) score, as well as range of motion (ROM) and complication incidence. ORIF/plating was associated with lower DASH scores but longer procedure time, while there was no difference between the two methods with respect to VAS pain score and PRWE score. The overall incidence of complications, including complex regional pain syndrome, was higher with pinning/wiring, though the incidence of carpal tunnel syndrome and nerve defects was not different. Supination and grip strength were better with ORIF. Radiographically, ulnar variation was greater with pinning/wiring. These results suggest that ORIF/plating is the preferred method of managing unstable distal radius fractures. Level of evidence: II

Download Full-text

Palmar plating of distal radius fractures : 3-year follow-up with titanium and PEEK plates give similar outcomes

Acta Orthopaedica Belgica ◽

10.52628/87.3.18 ◽

2021 ◽

Vol 87 (3) ◽

pp. 521-527

Author(s):

Josephine Berger-Groch ◽

Ann-Christin Stodtmeister ◽

Jan P. Petersen ◽

Michael Hoffmann

Keyword(s):

Distal Radius ◽

Controlled Trial ◽

Clinical Results ◽

Distal Radius Fractures ◽

Dash Score ◽

Radius Fractures ◽

Polyether Ether Ketone ◽

Type C ◽

Randomised Controlled

A variety of different plate designs and materials are available to treat distal radius fractures. This study evaluates clinical results with a carbon fibre- reinforced (CFR)-polyether ether ketone (PEEK) plate in comparison to a standard titanium plate. Thirty-one distal radius fractures were included in this randomised controlled trial. Five fractures were classified as type A, 6 as type B and 20 as type C, in accordance with the AO classification. Patients were randomly allocated into two groups : 15 patients for titanium palmar plating (TPP) and 16 patients for PEEK palmar plating (PPP). Follow-up examinations were set at 2 weeks, 6 weeks, 3 months, 6 months and 3 years postop. In terms of wrist range of motion, radiological evaluation (alignment and fracture healing), DASH score (Disabilities of Arm, Shoulder and Hand), and VAS (visual analogue scale), no statistically significant differences were detected between the two groups, at all follow-up intervals. PEEK palmar plating and titanium plates give equivalent clinical and radiological outcomes up to 3 years follow-up.

Download Full-text