HAND & WRIST
Comparison between Carbon-Peek volar locking plates and titanium volar locking plates in the treatment of distal radius fractures
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2018;6(10):3 Injury. 2017 Oct;48 Suppl 3:S24-S2930 patients undergoing volar plate fixation for an AO type B or C displaced fracture of the distal radius were included in this study to compare two different plates. Patients were randomized to undergo the procedure using either Carbon-Peek volar locking plates or titanium volar locking plates. Follow-up was conducted over a 12-month period and patients were evaluated for forearm range of motion, hand grip strength, key pinch strength, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and a visual analog scale. Dorso-palmar and lateral x-rays were also used to assess radiographic parameters. The results of this study at 12 months indicated no significant differences in functional outcome or radiographic outcome between the two plates.
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)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
3/4
Randomization
2/4
Outcome Measurements
3/4
Inclusion / Exclusion
4/4
Therapy Description
4/5
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
The distal radius is one of the most common bones to be fractured, particularly among older adults. Volar plating is a widely used method of fixation for these injuries. Most plates are constructed of a titanium alloy, but more recently, a plate composed of carbon fiber reinforced polyetheretherketone (CFR-PEEK) has been introduced.
¿Cuál era la pregunta principal de la investigación?
In volar plate fixation of a distal radius fracture, is there any significant difference in functional outcome or radiographic outcome between cases completed using a carbon fiber reinforced polyetheretherketone and cases completed using a titanium plate, assessed over a minimum of 12-month follow-up
¿Cuáles fueron los hallazgos importantes?
- Mean DASH at final follow-up did not significantly differ between the CFR-PEEK group (15.3) and the titanium group (12.2) (p>0.05).
- Mean VAS score at final follow-up did not significantly differ between the CFR-PEEK group (3.6) and the titanium group (2.9) (p>0.05).
- Mean range of motion at final follow-up did not significantly differ between the CFR-PEEK group and the titanium group (p>0.05).
- No significant differences in radiographic parameters were recorded between groups at final follow-up.
- No complications were recorded in either group.
¿Qué es lo que más debo recordar?
In volar plating of a displaced distal radius fracture, no significant differences in functional outcome or radiographic outcome were noted between plates composed of carbon fiber reinforced polyetheretherketone and titanium plates after a minimum of 1 year.
¿Cómo afectará esto al cuidado de mis pacientes?
The results of this study suggest that similar outcomes are achieved by the CFR-PEEK volar plate to that of the more standard titanium plate for fixation of displaced distal radius fractures.
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