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1. #Wrist distal radius fracture manual#
2. #Wrist distal radius fracture full#
3. #Wrist distal radius fracture registration#

Studies had to report on patient-reported, functional or radiological outcome. Randomised controlled trials, prospective and retrospective comparative cohort studies comparing different positions of the wrist during cast immobilisation of displaced and reduced DRFs in adults were included in this study. After deduplication, all titles and abstracts were screened independently by two reviewers (ED, TG).

#Wrist distal radius fracture full#

The full search strategies for all databases can be found in the supplementary Information.

#Wrist distal radius fracture manual#

Also, a manual reference check of the identified systematic reviews and meta-analyses was executed. After deduplication all titles were screened and appropriate abstracts reviewed. The search was performed without date or language restriction. The following terms were used (including synonyms and closely related words) as index terms or free-text words: “Conservative Treatment”, “Non-operative”, “Casts”, “Radius Fractures”, “Adults”. Ī comprehensive search was performed in the bibliographic databases Medline, Embase and Wiley/Cochrane Library from inception up to 27 November 2020, in collaboration with a medical librarian. The aim of this systematic review was to assess if there is any relation between wrist position in the cast and outcome in adult patients with non-operatively treated DRFs.Ī review protocol (PROSPERO 2018 CRD42018085546) was developed based on the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” statement. No new trials on supination were published after 1990. Since then, three new trials were published that compared DF to palmar flexion (PF) or neutral position (NP). The Cochrane review “Conservative interventions for treating distal radial fractures in adults”, analysed six articles comparing different wrist positions during cast immobilisation and showed no significant difference in clinical, functional or anatomical outcome. Some conclude that pronation is more effective in retaining the reduction, others state that supination prevents fracture displacement. Some authors believe that dorsiflexion (DF) of the wrist prevents fracture displacement since DF balances the forces of the radial extensors and flexors best. However, the best position of the wrist in lower forearm casts, remains controversial. Previous studies have shown no superiority of above-elbow casts compared to lower forearm casts. Most of these fractures are treated non-operatively with closed reduction and cast immobilisation. Nearly 20% of all fractures are distal radius fractures (DRFs).

#Wrist distal radius fracture registration#

Systematic review registration number: PROSPERO 2018 CRD42018085546. This systematic review showed statistically significant better results in favour of cast immobilisation in dorsiflexion, although this small difference does not seem to be relevant in patients daily activities. Due to heterogeneity of the included studies, data were unsuitable for a meta-analysis. There were no significant differences in patient-reported outcome, pain, grip strength or complications. Range of motion and radiological outcome was significantly better in patients who were immobilised in dorsiflexion compared to palmar flexion or neutral position, although no clinical important difference was found. Five trials, with 519 patients, were included in this systematic review. Secondary outcomes were functional outcomes measured by grip strength, patient-reported outcome, radiological outcome and complications such as secondary dislocation and pain. Primary outcome of the study was functional outcome measured by range of motion. Eligible studies were: randomised controlled trials, prospective and retrospective comparative cohort studies, analysing different positions of the wrist in cast-immobilisation following closed reduction. MethodsĪ comprehensive search was performed in the bibliographic databases Medline, Embase and Wiley/Cochrane Library from inception up to 27 November 2020. A systematic review was initiated to assess if there was any relation between wrist position in the cast and outcome in adult patients with non-operatively treated distal radius fractures. The position of the wrist during cast immobilisation following closed reduction of distal radius fractures is disputed.