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)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
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
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
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.
Qual era a principal questão de investigação?
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
Quais foram os resultados 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.
De que é que me devo lembrar mais?
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.
Como é que isto afectará o tratamento dos meus doentes?
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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