Evidence map›Paper›PMID 28578470›Full record

Trial reportInternational orthopaedics2017

Which immobilization is better for distal radius fracture? A prospective randomized trial.

Carlo Gamba, Felipe Andrés Mingo Fernandez, Marta Cuenca Llavall, Xavier Lizano Diez, Fernando Santana Perez

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Carlo GambaHospital del Mar, Barcelona, Spain. CGamba@parcdesalutmar.cat.
Felipe Andrés Mingo FernandezHospital del Mar, Barcelona, Spain.
Marta Cuenca LlavallHospital del Mar, Barcelona, Spain.
Xavier Lizano DiezHospital del Mar, Barcelona, Spain.
Fernando Santana PerezHospital del Mar, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe aim of this study was to determine whether an above-elbow cast (AEC) is better than a below-elbow cast (BEC) at maintaining the initial reduction in the orthopaedic management of a distal radius fracture (DRF).

methodsIt is a prospective randomized study carried out in a single emergency trauma department. There were 72 patients older than 55 years of age (55-96) with a distal radius fracture treated orthopaedically. They were randomized into two groups: group B (AEC 32 patients) and group A (BEC 40 patients). Randomization was done by a computer program. Four subgroups were constituted according to the instability criteria: subgroup 4 the most instable fractures. Main outcome was reduction loss from initial reduction to cast removal: it was measured using the volar tilt, radial tilt and radial length on plain radiographs.

resultsNo differences were observed between group A and B when analysed globally (volar tilt loss p = 0.89 radial tilt loss p = 0.08 ulnar variance p = 0.19). Subgroups analysis revealed less radial tilt reduction loss in group A in patients within subgroup 3 (p = 0.02) and 4 (p = 0.003). DISCUSSION: Results are in contrast to what was expected. Limiting prono-supination AEC is supposed to better maintain initial fracture reduction. Effect of pronation and supination as well as distraction of brachioradialis muscle could have been overestimated until now.

conclusionThe above-elbow cast is not better than the below-elbow cast in terms of loss reduction. However, the below-elbow cast more efficiently controls radial tilt reduction.

Indexed as

Casts, SurgicalAgedAged, 80 and overElbow JointEmergency Service, HospitalFemaleFracture FixationHumansMaleMiddle AgedProspective StudiesRadius FracturesRange of Motion, ArticularTreatment OutcomeCastConservative treatmentDistal radius fractureImmobilization

Identifiers

PMID28578470

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.