[ { "key": "RZ3QCFDA", "version": 6, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/RZ3QCFDA", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/RZ3QCFDA", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/H6RICE7H", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "RZ3QCFDA", "version": 6, "parentItem": "H6RICE7H", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T16:02:06Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/17636827", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T16:02:06Z", "dateModified": "2013-06-04T16:02:06Z" } }, { "key": "H6RICE7H", "version": 6, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/H6RICE7H", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/H6RICE7H", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Handoll et al.", "parsedDate": "2007", "numChildren": 1 }, "data": { "key": "H6RICE7H", "version": 6, "itemType": "journalArticle", "title": "Percutaneous pinning for treating distal radial fractures in adults", "creators": [ { "creatorType": "author", "firstName": "H H G", "lastName": "Handoll" }, { "creatorType": "author", "firstName": "M V", "lastName": "Vaghela" }, { "creatorType": "author", "firstName": "R", "lastName": "Madhok" } ], "abstractNote": "BACKGROUND: Fracture of the distal radius is a common clinical problem. A key method of surgical fixation is percutaneous pinning, involving the insertion of wires through the skin to stabilise the fracture.\nOBJECTIVES: To evaluate the evidence from randomised controlled trials for the use of percutaneous pinning for fractures of the distal radius in adults.\nSEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2006), the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and other databases, conference proceedings and reference lists of articles. No language restrictions were applied.\nSELECTION CRITERIA: Randomised or quasi-randomised controlled clinical trials involving adults with a fracture of the distal radius, which compared percutaneous pinning with conservative treatment, or different aspects of percutaneous pinning.\nDATA COLLECTION AND ANALYSIS: Two authors independently assessed and extracted data from the included trials. Some pooling of data was undertaken for one comparison.\nMAIN RESULTS: Thirteen trials, involving 940 generally older adults with dorsally displaced and potentially or evidently unstable distal radial fractures, were included. Methodological weaknesses among these trials included lack of allocation concealment and inadequate outcome assessment. Factors affecting the applicability of trial evidence included inconsistent fracture classification, variations in outcome assessment and incomplete reporting. Six heterogeneous trials compared percutaneous pinning with plaster cast immobilisation. Across-fracture pinning, used in five trials, was associated with improved anatomical outcome and generally minor complications. There was some indication of similar or improved function in the pinning group. One quasi-randomised trial found an excess of complications after Kapandji pinning. Three trials compared different methods of pinning. Two trials found a higher incidence of complications after Kapandji fixation compared with two methods of across-fracture fixation. The third trial provided inadequate evidence for modified Kapandji fixation versus Willenegger fixation. Two small trials comparing biodegradable pins versus metal pins found a significant excess of complications associated with biodegradable material. Two small trials compared plaster cast immobilisation for one week versus for six weeks after surgery. One trial found duration of immobilisation after trans-styloid fixation did not have a significant effect on outcome. More complications occurred in the early mobilisation group after Kapandji pinning in the second trial.\nAUTHORS' CONCLUSIONS: Though there is some evidence to support its use, the precise role and methods of percutaneous pinning are not established. The higher rates of complications with Kapandji pinning and biodegradable materials casts some doubt on their general use.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2007", "volume": "", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "CD006080", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD006080.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 17636827", "tags": [ { "tag": "Absorbable Implants", "type": 1 }, { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Bone Nails", "type": 1 }, { "tag": "Bone Wires", "type": 1 }, { "tag": "Braces", "type": 1 }, { "tag": "Casts, Surgical", "type": 1 }, { "tag": "Colles' Fracture", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Fracture Fixation", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Radius Fractures", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Wrist Injuries", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2013-06-04T16:02:06Z", "dateModified": "2013-06-04T16:02:06Z" } }, { "key": "DIGRNINA", "version": 5, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/DIGRNINA", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/DIGRNINA", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Cui et al.", "parsedDate": "2011-09", "numChildren": 1 }, "data": { "key": "DIGRNINA", "version": 5, "itemType": "journalArticle", "title": "Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Zhuang", "lastName": "Cui" }, { "creatorType": "author", "firstName": "Jianhong", "lastName": "Pan" }, { "creatorType": "author", "firstName": "Bin", "lastName": "Yu" }, { "creatorType": "author", "firstName": "Kairui", "lastName": "Zhang" }, { "creatorType": "author", "firstName": "Xiaolong", "lastName": "Xiong" } ], "abstractNote": "PURPOSE: Our aim was to compare the effect of internal vs external fixation for unstable distal radius fractures regarding postoperative complications, clinical results and radiological outcomes.\nMETHODS: We selected PubMed; Cochrane Library; EMBASE; BIOSIS; Ovid and the relevant English orthopaedic journals and pooled data from ten eligible randomised controlled trials containing 738 patients to conduct a subgroup analysis according to different periods of follow-up. Our aim was to summarise the best available evidence.\nRESULTS: Results showed that compared with external fixation, internal fixation led to significantly fewer total surgical complications [95% confidence interval (CI) 0.39-0.81, P = 0.002] and reduced the incidence of pin-track infections (95% CI 0.08-0.46, P = 0.0002) after a one year follow-up. For clinical results, grip strength (95% CI 1.59-8.25, P = 0.004), supination (95% CI 13.99-48.83, P = 0.0004) and pronation (95% CI 5.61-26.09, P = 0.002) were superior in the internal fixation group six weeks postoperatively, and the same results were obtained three months postoperatively for grip strength (95% CI 3.21-13.47, P = 0.001) and supination (95% CI 3.61-16.01, P = 0.002). Meanwhile, the Disabilities of the Arm, Shoulder and Hand (DASH) score was superior in the internal fixation group at three months (95% CI -20.62 to -2.07, P = 0.02) and after one year (95% CI -14.37 to -2.32, P = 0.007) follow-up.\nCONCLUSIONS: We suggest that the final results are significant and there is some evidence supporting the use of open reduction and internal fixation.", "publicationTitle": "International orthopaedics", "publisher": "", "place": "", "date": "Sep 2011", "volume": "35", "issue": "9", "section": "", "partNumber": "", "partTitle": "", "pages": "1333-1341", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Int Orthop", "DOI": "10.1007/s00264-011-1300-0", "citationKey": "", "url": "http://goo.gl/wcP3g", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1432-5195", "archive": "", "archiveLocation": "", "shortTitle": "Internal versus external fixation for unstable distal radius fractures", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 21698429", "tags": [ { "tag": "Bone Malalignment", "type": 1 }, { "tag": "Colles' Fracture", "type": 1 }, { "tag": "External Fixators", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Fracture Fixation", "type": 1 }, { "tag": "Fracture Fixation, Internal", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Radius", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T15:52:54Z" } }, { "key": "TJ3PPPDX", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/TJ3PPPDX", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/TJ3PPPDX", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/44UUC2UV", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "TJ3PPPDX", "version": 4, "parentItem": "44UUC2UV", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T13:20:38Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/23523527", "note": "", "contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "CHR7IBBS", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/CHR7IBBS", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/CHR7IBBS", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/BFQQPX7S", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "CHR7IBBS", "version": 4, "parentItem": "BFQQPX7S", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T13:21:52Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/18254105", "note": "", "contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "NDKRWW7I", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/NDKRWW7I", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/NDKRWW7I", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/FF5FZQJ9", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "NDKRWW7I", "version": 4, "parentItem": "FF5FZQJ9", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T13:20:54Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/23298757", "note": "", "contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "HHMK7FA8", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/HHMK7FA8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/HHMK7FA8", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/DIGRNINA", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "HHMK7FA8", "version": 4, "parentItem": "DIGRNINA", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T13:21:25Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/21698429", "note": "", "contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "BFQQPX7S", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/BFQQPX7S", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/BFQQPX7S", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Handoll et al.", "parsedDate": "2008", "numChildren": 1 }, "data": { "key": "BFQQPX7S", "version": 4, "itemType": "journalArticle", "title": "Different methods of external fixation for treating distal radial fractures in adults", "creators": [ { "creatorType": "author", "firstName": "H H G", "lastName": "Handoll" }, { "creatorType": "author", "firstName": "J S", "lastName": "Huntley" }, { "creatorType": "author", "firstName": "R", "lastName": "Madhok" } ], "abstractNote": "BACKGROUND: Fracture of the distal radius is a common injury. A surgical treatment is external fixation, where metal pins inserted into bone on either side of the fracture are then fixed to an external frame.\nOBJECTIVES: To evaluate the evidence from randomised controlled trials comparing different methods of external fixation for distal radial fractures in adults.\nSEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and other databases, conference proceedings and reference lists of articles. No language restrictions were applied.\nSELECTION CRITERIA: Randomised or quasi-randomised controlled clinical trials which compared different methods of external fixation in adults with a distal radial fracture.\nDATA COLLECTION AND ANALYSIS: All review authors independently performed study selection. Two authors independently assessed the included trials and performed data extraction.\nMAIN RESULTS: Nine small trials involving 510 adults with potentially or evidently unstable fractures, were grouped into five comparisons. The interventional, clinical and methodological heterogeneity of trials precluded data pooling. Only one trial had secure allocation concealment. Two trials comparing a bridging (of the wrist) external fixator versus pins and plaster external fixation found no significant differences in function or deformity. One trial found tendencies for more serious complications but less subsequent discomfort and deformity in the fixator group. Three trials compared non-bridging versus bridging fixation. Of the two trials testing uni-planar non-bridging fixation, one found no significant differences in functional or clinical outcomes; the other found non-bridging fixation significantly improved grip strength, wrist flexion and anatomical outcome. The third trial found no significant findings in favour of multi-planar non-bridging fixation of complex intra-articular fractures. One trial using a bridging external fixator found that deploying an extra external fixator pin to fix the 'floating' distal fragment gave superior functional and anatomical results. One trial found no evidence of differences in clinical outcomes for hydroxyapatite coated pins compared with standard uncoated pins. Two trials compared dynamic versus static external fixation. One trial found no significant effects from early dynamism of an external fixator. The poor quality of the other trial undermines its findings of poorer functional and anatomical outcomes for dynamic fixation.\nAUTHORS' CONCLUSIONS: There is insufficient robust evidence to determine the relative effects of different methods of external fixation. Adequately powered studies could provide better evidence.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2008", "volume": "", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "CD006522", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD006522.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18254105", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Bone Nails", "type": 1 }, { "tag": "Colles' Fracture", "type": 1 }, { "tag": "External Fixators", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Fracture Fixation", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Radius Fractures", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Wrist Injuries", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "FPUWSUWI", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/FPUWSUWI", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/FPUWSUWI", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/8IQ7PIQP", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { 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"username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "56QPM2JM", "version": 4, "parentItem": "62R2TMMM", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T13:21:40Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/18425972", "note": "", "contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "JHCX4JGE", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/JHCX4JGE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/JHCX4JGE", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/173197/items/C4MIX2NI", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } } }, "data": { "key": "JHCX4JGE", "version": 4, "parentItem": "C4MIX2NI", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2013-06-04T13:21:12Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22178307", "note": "", "contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "44UUC2UV", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/44UUC2UV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/44UUC2UV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Wang et al.", "parsedDate": "2013-05", "numChildren": 1 }, "data": { "key": "44UUC2UV", "version": 4, "itemType": "journalArticle", "title": "Open reduction and internal fixation versus external fixation for unstable distal radial fractures: A meta-analysis", "creators": [ { "creatorType": "author", "firstName": "J", "lastName": "Wang" }, { "creatorType": "author", "firstName": "Y", "lastName": "Yang" }, { "creatorType": "author", "firstName": "J", "lastName": "Ma" }, { "creatorType": "author", "firstName": "D", "lastName": "Xing" }, { "creatorType": "author", "firstName": "S", "lastName": "Zhu" }, { "creatorType": "author", "firstName": "B", "lastName": "Ma" }, { "creatorType": "author", "firstName": "Y", "lastName": "Chen" }, { "creatorType": "author", "firstName": "X", "lastName": "Ma" } ], "abstractNote": "PURPOSE: To compare the clinical outcomes of open reduction and internal fixation (ORIF) versus the ones of closed reduction and external fixation (EF) in the treatment of distal radial fractures.\nMETHODS: We performed a meta-analysis of randomized controlled trials that compared the clinical results of ORIF to EF in the treatment of distal radial fractures. A systemic retrieve from PubMed, EMBASE, OVID and Cochrane Collaboration CENTRAL database resulted in 11 studies with 824 patients. We thus performed data synthesis using RevMan (version 5.1).\nRESULTS: Superior statistical differences were observed for DASH scores (at 3, 6 and 12months follow-up) grip strength (at 3months follow-up), volar tilt (at 12months follow-up), flexion and supination (at 3months follow-up), and extension (at 3 and 6months follow-up) in ORIF patients group, compared with those in EF group. We also found a significantly higher risk of infection associated with EF. There was no significant difference in the incidence of malunion and median nerve dysfunction.\nCONCLUSION: Regarding surgical fixation of unstable distal radius fractures, ORIF yields significantly better subjective outcome (DASH scores) the first year after operation, restoration of anatomic volar tilt, and forearm flexion and extension at the end of the follow-up period. However, EF results in higher incidence of infection compared to ORIF. ORIF is equal to EF for either grip strength, or range of motion of the injured wrist, or incidence of malunion or median nerve dysfunction at the end of the follow-up period.\nLEVEL OF EVIDENCE: Level II. Therapeutic study.", "publicationTitle": "Orthopaedics & traumatology, surgery & research: OTSR", "publisher": "", "place": "", "date": "May 2013", "volume": "99", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "321-331", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Orthop Traumatol Surg Res", "DOI": "10.1016/j.otsr.2012.11.018", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1877-0568", "archive": "", "archiveLocation": "", "shortTitle": "Open reduction and internal fixation versus external fixation for unstable distal radial fractures", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 23523527", "tags": [], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "8IQ7PIQP", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/8IQ7PIQP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/8IQ7PIQP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Kvernmo and Krukhaug", "parsedDate": "2013-02-19", "numChildren": 1 }, "data": { "key": "8IQ7PIQP", "version": 4, "itemType": "journalArticle", "title": "Treatment of distal radius fractures", "creators": [ { "creatorType": "author", "firstName": "Hebe Désirée", "lastName": "Kvernmo" }, { "creatorType": "author", "firstName": "Yngvar", "lastName": "Krukhaug" } ], "abstractNote": "BACKGROUND: In light of the Norwegian Orthopaedic Association's wish to prepare guidelines for treatment of distal radius fractures, we have reviewed the knowledge base for the provision of such treatment.\nMETHOD: The paper is based on systematic reviews of treatment of distal radius fractures from literature search in the following databases: the Cochrane Library, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE Cochrane), the Health Technology Assessment (HTA) database, PreMedline, Medline and Embase.\nRESULTS: There is evidence for recommending percutaneous pinning of unstable, dorsally displaced distal radius fractures rather than conservative treatment, but which pinning method is best remains uncertain. There is also documentation to support the use of external fixation rather than conservative treatment. There is insufficient documentation available to draw conclusions regarding the relative efficacy of the various methods of external fixation, but external fixation in combination with adjuvant pinning of the fracture fragment enhances the result compared to external fixation alone. The evidence indicates that plates may enhance functional short-term results for unstable distal radius fractures compared to external fixation.\nINTERPRETATION: There is evidence in support of differentiated treatment of distal radius fractures. However, many questions remain unanswered, and good prospective, randomised multi-centre trials are needed.", "publicationTitle": "Tidsskrift for den Norske lægeforening: tidsskrift for praktisk medicin, ny række", "publisher": "", "place": "", "date": "Feb 19, 2013", "volume": "133", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "405-411", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Tidsskr. Nor. Laegeforen.", "DOI": "10.4045/tidsskr.12.0297", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0807-7096", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng, nor", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 23423206", "tags": [ { "tag": "Bone Nails", "type": 1 }, { "tag": "Bone Plates", "type": 1 }, { "tag": "Bone Wires", "type": 1 }, { "tag": "Colles' Fracture", "type": 1 }, { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "External Fixators", "type": 1 }, { "tag": "Fracture Fixation", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intra-Articular Fractures", "type": 1 }, { "tag": "Outcome Assessment (Health Care)", "type": 1 }, { "tag": "Practice Guidelines as Topic", "type": 1 }, { "tag": "Review Literature as Topic", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "62R2TMMM", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/62R2TMMM", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/62R2TMMM", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Handoll and Watts", "parsedDate": "2008", "numChildren": 1 }, "data": { "key": "62R2TMMM", "version": 4, "itemType": "journalArticle", "title": "Bone grafts and bone substitutes for treating distal radial fractures in adults", "creators": [ { "creatorType": "author", "firstName": "H H G", "lastName": "Handoll" }, { "creatorType": "author", "firstName": "A C", "lastName": "Watts" } ], "abstractNote": "BACKGROUND: Surgical treatment of fractures of the distal radius can involve the implantation of bone scaffolding materials (bone grafts and substitutes) into bony defects that frequently arise after fracture reduction.\nOBJECTIVES: To review the evidence from randomised controlled trials evaluating the implanting of bone scaffolding materials for treating distal radial fractures in adults.\nSEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and other databases, conference proceedings and reference lists. No language restrictions were applied.\nSELECTION CRITERIA: Randomised or quasi-randomised controlled clinical trials evaluating the use of bone scaffolding for treating distal radial fracture in adults.\nDATA COLLECTION AND ANALYSIS: Two people independently selected studies and undertook assessment and data collection.\nMAIN RESULTS: Ten heterogenous trials involving 874 adults with generally unstable fractures were grouped into six comparisons. No trial had proven allocation concealment. Four trials (239 participants) found implantation of bone scaffolding (autogenous bone graft (one trial); Norian SRS - a bone substitute (two trials); methylmethacrylate cement (one trial)) improved anatomical outcomes compared with plaster cast alone; and two found it improved function. Reported complications of bone scaffolding were transient discomfort resulting from extraosseous deposits of Norian SRS; with surgical removal of one intra-articular deposit. One trial (323 participants) comparing bone substitute (Norian SRS) versus plaster cast or external fixation found no difference in functional or anatomical outcomes at one year. Statistically significant complications in the respective groups were extraosseous Norian SRS deposits and pin track infection. One trial (48 participants with external fixation) found that autogenous bone graft did not significantly change outcome. There was one serious donor-site complication. One trial (21 participants) found some indication of worse outcomes for hydroxyapatite bone cement compared with Kapandji's intrafocal pinning. Three trials (180 participants) found bone scaffolding (autogenous bone graft (one trial); Norian SRS (one trial); methylmethacrylate cement (one trial)) gave no significant difference in functional outcomes but some indication of better anatomical outcomes compared with external fixation. Most reported complications were associated with external fixation; extraosseous deposits of Norian SRS occurred in one trial. One trial (93 participants with dorsal plate fixation) found autografts slightly improved wrist function compared with allogenic bone material but with an excess of donor site complications.\nAUTHORS' CONCLUSIONS: Bone scaffolding may improve anatomical outcome compared with plaster cast alone but there is insufficient evidence to conclude on functional outcome and safety; or for other comparisons.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2008", "volume": "", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "CD006836", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD006836.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18425972", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Bone Substitutes", "type": 1 }, { "tag": "Bone Transplantation", "type": 1 }, { "tag": "Fracture Fixation", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Radius Fractures", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Wrist Injuries", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "FF5FZQJ9", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/FF5FZQJ9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/FF5FZQJ9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Esposito et al.", "parsedDate": "2013-04", "numChildren": 1 }, "data": { "key": "FF5FZQJ9", "version": 4, "itemType": "journalArticle", "title": "External fixation versus open reduction with plate fixation for distal radius fractures: a meta-analysis of randomised controlled trials", "creators": [ { "creatorType": "author", "firstName": "John", "lastName": "Esposito" }, { "creatorType": "author", "firstName": "Emil H", "lastName": "Schemitsch" }, { "creatorType": "author", "firstName": "Michel", "lastName": "Saccone" }, { "creatorType": "author", "firstName": "Amir", "lastName": "Sternheim" }, { "creatorType": "author", "firstName": "Paul R T", "lastName": "Kuzyk" } ], "abstractNote": "BACKGROUND: Both external fixation and open reduction with internal fixation (ORIF) using plates have been recommended for treatment of distal radius fractures. We conducted a systematic review and meta-analysis of randomised controlled trials comparing external fixation to ORIF.\nMETHODS: MEDLINE, EMBASE, and COCHRANE databases were searched from inception to January 2011 for all trials involving use of external fixation and ORIF for distal radius fractures. Eligibility for inclusion in the review was: use of random allocation of treatments; treatment arm receiving external fixation; and treatment arm receiving ORIF with plate fixation. Eligible studies were obtained and read in full by two co-authors who then independently applied the Checklist to Evaluate a Report of a Nonpharmacological Trial. Pooled mean differences were calculated for the following continuous outcomes: wrist range of motion; radiographic parameters; grip strength; and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Pooled risk ratios were calculated for rates of complications and reoperation.\nRESULTS: The literature search strategy identified 52 potential publications of which nine publications (10 studies) met inclusion criteria. Pooled mean difference for DASH scores was significantly less for the ORIF with plate fixation group (-5.92, 95% C.I. of -9.89 to -1.96, p < 0.01, I(2) = 39%). Pooled mean difference for ulnar variance was significantly less in the ORIF with plate fixation group (-0.70, 95% C.I. of -1.20 to -0.19, p < 0.01, I(2) = 0%), indicating better restoration of radial length for this group. Pooled risk ratio for infection was 0.37 (95% C.I. of 0.19-0.73, p < 0.01, I(2) = 0%), favouring ORIF with plate fixation. There were no significant differences in all other clinical outcomes.\nCONCLUSIONS: ORIF with plate fixation provides lower DASH scores, better restoration of radial length and reduced infection rates as compared to external fixation for treatment of distal radius fractures.", "publicationTitle": "Injury", "publisher": "", "place": "", "date": "Apr 2013", "volume": "44", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "409-416", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Injury", "DOI": "10.1016/j.injury.2012.12.003", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1879-0267", "archive": "", "archiveLocation": "", "shortTitle": "External fixation versus open reduction with plate fixation for distal radius fractures", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 23298757", "tags": [], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } }, { "key": "C4MIX2NI", "version": 4, "library": { "type": "group", "id": 173197, "name": "distal radius fractures", "links": { "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/173197/items/C4MIX2NI", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/distal_radius_fractures/items/C4MIX2NI", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1257, "username": "rpietro", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rpietro", "type": "text/html" } } }, "creatorSummary": "Cui et al.", "parsedDate": "2012-07", "numChildren": 1 }, "data": { "key": "C4MIX2NI", "version": 4, "itemType": "journalArticle", "title": "Dynamic versus static external fixation for unstable distal radius fractures: an up-to-date meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Zhuang", "lastName": "Cui" }, { "creatorType": "author", "firstName": "Bin", "lastName": "Yu" }, { "creatorType": "author", "firstName": "Yanjun", "lastName": "Hu" }, { "creatorType": "author", "firstName": "Qingrong", "lastName": "Lin" }, { "creatorType": "author", "firstName": "Bowei", "lastName": "Wang" } ], "abstractNote": "OBJECTS: Whether dynamic or static external fixation is more appropriate for distal radius fractures is still being debated, our aim is to determine the effect of dynamic versus static external fixation for unstable distal radius fractures in terms of postoperative complication, clinical results and radiological outcomes.\nMETHODS: We selected PubMed, Cochrane Library, EMBASE, BIOSIS, Ovid and the relevant English orthopaedic journals and pooled data from eligible trials including six eligible randomised controlled trials and two comparative studies containing 998 patients comparing dynamic and static external fixation for unstable distal radius fractures to conduct a sub-group analysis according to different periods of follow-up, aiming to summarise the best available evidence.\nRESULTS: The results showed there was an increased risk for pin-track infection in dynamic external fixation group than that in static external fixation group, however, there was the trend of obtaining better clinical effect towards less malunion in dynamic external fixation group, although the results were not statistically significant. With regard to clinical results, range of motion such as extension, supination and pronation were superior in dynamic external fixation group than that in static external fixation group at 6 weeks postoperatively. And there were the trend of obtaining better clinical effect in dynamic external fixation group towards pronation at one year follow-up and grip strength at six weeks, six months and one year follow-up, although no significant differences were viewed. With regard to radiological outcomes, better clinical result was obtained in terms of radial length in dynamic external fixation group immediately after surgery and at six weeks, one year follow-up postoperatively.\nCONCLUSIONS: The final results show that there are some evidences supporting the use of dynamic external fixation, which may also have practical advantages over static fixation by allowing earlier limb mobility during the fixation period and enabling such patients to maintain their independence. Limitations remain, a cost-effectiveness analysis and DASH-score assessments at all follow-up evaluations should be more carefully considered and reported in a reliable, consistent and standardised manner.", "publicationTitle": "Injury", "publisher": "", "place": "", "date": "Jul 2012", "volume": "43", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "1006-1013", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Injury", "DOI": "10.1016/j.injury.2011.11.018", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1879-0267", "archive": "", "archiveLocation": "", "shortTitle": "Dynamic versus static external fixation for unstable distal radius fractures", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22178307", "tags": [], "collections": [], "relations": {}, "dateAdded": "2013-06-04T13:28:25Z", "dateModified": "2013-06-04T13:28:25Z" } } ]