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PURPOSE@#The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones (RJ) bandage. The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence, child comfortability, and family satisfaction.@*METHODS@#The study was a randomized controlled non-inferiority clinical trial including children with recent (less than 5 days) fractures at the distal end of the radius OTA/AO 23-A2, which is usually treated conservatively. Those with open fractures, pathological fracture, severely displaced fracture that needs reduction or multiple injuries were excluded. The participants were divided randomly into 2 groups according to the treatment modalities. Group 1 was treated by plaster of Paris cast (the control group), and Group 2 by modified RJ bandage (the trial group). The difference between the 2 groups was found by the Chi-squared test. The difference was considered statistically significant when the p value was less than 0.05.@*RESULTS@#There were 150 children (aged 2 - 12 years, any gender) included in the study, 75 in each group. The complications occured in 5 (3.3%) cases only, pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2. There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment (p = 0.649). Children treated by RJ bandages were more comfortable than those treated by the cast (97.3% vs. 73.3%, p < 0.001) with a statistically significant difference between them. Contrary to that, the families were more satisfied with the cast than RJ bandage (88.0% vs. 81.3%), but without a statistically significant difference (p = 0.257).@*CONCLUSION@#RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.
Assuntos
Humanos , Criança , Fraturas do Rádio/terapia , Fraturas do Punho , Fixação de Fratura , Bandagens , Extremidade Superior , Moldes CirúrgicosRESUMO
RESUMEN Introducción: la fractura del radio distal es una de las entidades traumáticas más frecuentes por la que acuden enfermos a los servicios de urgencia de Traumatología. Aunque su tratamiento es por lo general conservador, existen situaciones en que es necesaria la intervención quirúrgica con la fijación externa. Objetivo: evaluar los resultados de la fijación externa en pacientes con fracturas inestables del radio distal. Materiales y métodos: se realizó un estudio preexperimental en pacientes con fracturas inestables del radio distal, tratados mediante fijación externa en el Hospital Provincial Docente Clínico Quirúrgico Manuel Ascunce Domenech, de Camagüey, entre abril de 2018 y mayo de 2021. La investigación tuvo un nivel de evidencia IV, recomendación D. Resultados: el promedio de edad de los 41 pacientes fue de 40,5 años, con edad mínima de 20 y máxima de 68. Se observó un predominio del sexo femenino (25 pacientes, para un 61 %). La razón sexo femenino-masculino fue de 1,5 a 1, y la de afección de muñeca izquierda-derecha fue de 1,9 a 1. Se encontró significación entre antes y después al emplear los parámetros imagenológicos y las escalas evaluativas, con mejoría en ambos. Conclusiones: la fijación externa en fractura inestable del radio distal resulta eficaz a los doce meses en la mayoría de los enfermos. Las complicaciones son mínimas, y de presentarse responden de forma favorable al tratamiento.
ABSTRACT Introduction: distal radius fracture is one of the most frequent traumatic entities due which patients come to Traumatology emergency services. Although their treatment is usually conservative, there are situations where surgery with external fixation is necessary. Objetive: to evaluate the results of external fixation in patients with unstable distal radius fractures. Materials and methods: a pre-experimental study was carried out in patients with unstable fractures of the distal radius treated by external fixation at the Provincial Clinical Surgical Teaching Hospital Manuel Ascunce Domenech, of Camagüey, between April 2018 and May 2021. The research has IV level of evidence, D recommendation. Results: the average age of the 41 patients was 40.5 years old, with minimum age of 20 and maximum age of 68 years. Female sex prevalence was observed (25 patients, 61%). The female-male sex ratio was 1.5 to 1, and the left-right wrist condition was 1.9 to 1. Significance was found between before and after using the imaging parameters and the evaluative scales, with improvement in both cases. Conclusions: external fixation in unstable distal radius fracture is effective at twelve months in most patients. Complications are minimal and if they are present, they favorably answer to treatment.
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Background: Distal end radius fractures are the commonest fractures occurring in upper extremity that account for 17% of all upper limb injuries. Many treatment methods for displaced distal radius fractures are available. The aim of this study to evaluate the fracture patterns of distal radius fractures & compare the results of different methods of treatment of fracture distal end radius. Materials & Methods: This prospective study was conducted in RBM Hospital, Bharatpur, Rajasthan. A total of 50 patients with fractures of the distal end radius who attended the outpatient or emergency in our hospital were included in our study. Functional outcomes were assessed at final follow up visit using “Demerit point rating system” of Gartland & Werley. Results: Our study showed that the mean age was 45.50 years with the youngest patient being 20 years old and the oldest being 70 years old. The mode of injury was fall in 30 cases (60%) and road traffic accidents in 20 cases (40%). The minimum duration of follow-up was 18 weeks and maximum of 54 weeks. Comparison of clinical and functional results by Chi square test showed significant associated with treatment types (P<0.05) in our study. Conclusion: We concluded that the treatment choice should be based on the fracture type, the patient’s characteristics, the patient’s demands and last but not least on the treating surgeon’s experience and preference.
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Objective To evaluate the effectiveness of locking compression plate (LCP) in treatment of comminuted fractures of distal end of radius. Methods A retrospective analysis of the clinical data was done for the 24 patients with comminuted fracture of distal end of radius who had been treated by locking compression plate fixation from August 2002 to August 2003. Results The follow up duration averaged 7.8 months. The satisfactory rate of functional outcome with LCP fixation was 91.6 percent. Conclusion Although LCP can provide the outstanding stability theoretically, it has not resulted in more exciting outcomes in treatment of comminuted fractures of distal end of radius than traditional methods.