Unstable distal radial fractures managed with external fixation require fewer reoperations .
This report has been verified
by one or more authors of the
original publication.
تم تحديد هذه الدراسة على أنها ذات تأثير كبير محتمل.
يُقدّر مقياس التأثير العالي الذي يعتمد على الذكاء الاصطناعي من OE التأثير المحتمل لورقة بحثية ما من خلال دمج الإشارات من كل من المجلة التي نُشرت فيها والمحتوى العلمي للمقالة نفسها.
تم تطوير نموذج OE High Impact باستخدام أحدث تقنيات معالجة اللغة الطبيعية، ويتنبأ نموذج OE High Impact بدقة أكبر بأداء الاقتباس المستقبلي للدراسة أكثر من معامل تأثير المجلة وحده.
وهذا يتيح التعرف المبكر على الأبحاث ذات المغزى السريري ويساعد القراء على التركيز على المقالات التي من المرجح أن تشكل الممارسة المستقبلية.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(3):107 J Bone Joint Surg Br. 2008 Sep;90(9):1214-2188 patients with distal radius fracture were selected for surgical fixation. This group was randomized to be managed with either bridging external fixation with supplementary Kirschner-wire (K-Wire) fixation or volar locked plating with screws. The patients treated by volar plating had a significant early improvement in the range of movement of the wrist; this advantage diminished with time, and in absolute terms the difference in range of movement was clinically non-relevant. No clinically significant differences in the reductions was observed on radiographs. Both groups had comparable function at one year. No definitive advantage of either treatment could be established; however, fewer re-operations were required in the external fixation group.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
نعم = 1
غير مؤكد = 0.5
غير ذي صلة = 0
لا = 0
يقيّم تقييم معايير الإبلاغ الشفافية التي يبلغ بها المؤلفون عن الخصائص المنهجية والتجريبية للتجربة في المنشور. ينقسم التقييم إلى خمس فئات معروضة أدناه.
3/4
Randomization
2/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
مؤشر الهشاشة هو أداة تساعد في تفسير النتائج المهمة، وتوفر مقياسًا لقوة النتيجة. ويمثل مؤشر الهشاشة عدد الأحداث المتتالية التي يجب إضافتها إلى نتيجة ثنائية التفرع لجعل النتيجة غير مهمة. يمثل الرقم الصغير نتيجة أضعف ويمثل الرقم الكبير نتيجة أقوى.
لماذا كانت هناك حاجة لهذه الدراسة الآن؟
Distal radius fractures are a common injury, especially in the bones weakened by osteoporosis in post-menopausal women. As with any other fractures the anatomic reduction and immobilization is the key management principle. A wide variety of options are available ranging from conservative management in a cast to closed reduction and pinning, bridging and non-bridging external fixation, and open reduction with plate and screw fixation through a variety of approaches. Each technique has its own sets of merits and demerits.This study aimed to compare the clinical outcomes of bridging external fixation and supplementary Kirschner-wire fixation to volar locked plating.
ما هو سؤال البحث الرئيسي؟
Does the bridging external fixation and supplementary Kirschner-wire fixation has better clinical outcomes at 1 year than volar locked plating for unstable fractures of the distal radius?
- No differences in the mean DASH scores at any of the follow-up assessments were observed between the groups and compared to the patients self-reported baseline levels. A trend towards significantly improved DASH scores was, however, found at 6 months, in favour of the external fixation group (p=0.06)
- Patients treated by volar plating had a statistically significant improvement in the range of movement of the wrist at 3 months: pronation (p<0.001), supination (p=0.05), extension (p=0.05) and radial deviation (p=0.002). This improvement diminished at 6 months and 1 year.
- Radiologically, there were no clinically significant differences in the reductions, although more patients with AO/OTA (Orthopaedic Trauma Association) type C fractures were allocated to the external fixation group.
- Radiologically, all the fractures united except one. Complication rate was comparable with 7 patients (18.4%) in the external fixation group having 7 complications compared with 8 (20.5%) in the plate group.
ما الذي يجب أن أتذكره أكثر؟
The patients treated by volar plating had a statistically significant early improvement in the range of movement of the wrist, which diminished with time and was clinically non-relevant. No clinically significant differences in the reductions was observed on radiographs. Both groups had comparable function at one year. No definitive advantage of either treatment could be established; however, fewer re-operations were required in the external fixation group.
كيف سيؤثر ذلك على رعاية مرضاي؟
Each method has its own sets of merits and demerits, which must be considered for each patient's profile, and appropriate method should be chosen based on thorough assessment. Further research with larger populations is needed.
تنويه
هذا المحتوى الموجود في هذه الصفحة هو لأغراض إعلامية فقط وليس الغرض منه أن يكون بديلاً عن المشورة الطبية المتخصصة أو التشخيص أو العلاج. إذا كنت بحاجة إلى علاج طبي، اطلب دائمًا مشورة طبيبك أو اذهب إلى أقرب قسم طوارئ إليك. الآراء والمعتقدات ووجهات النظر التي يعبر عنها الأفراد في المحتوى الموجود في هذه الصفحة لا تعكس آراء ومعتقدات ووجهات نظر أورثوإيفيدنس.
0 من 4 مقالات مجانية شهرية غير مقفلة
