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· DOS Abstracts
Closed Reduction of Distal Radius Fractures:
A Systematic Review and Meta-analysis
Hjalte Würtz, Sükriye Corap, Julie Erichsen, Bjarke Viberg
Department of Clinical Research, University of Southern Denmark; Department
of Orthopaedic Surgery and Traumatology, Hospital of South West Jutland;
Department of Orthopaedic Surgery and Traumatology, Kolding Hospital;
Department of Orthopaedic Surgery and Traumatology, Odense University
Hospital
Background:
To date, there has been insufficient evidence to determine the
best possible method of closed reduction for distal radial fractures (DRF).
Purpose / Aim of Study:
To compare reduction of DRF by finger-trap traction
(FTT) with manual traction (MT) in terms of radiographic outcome and pain in
RCTs.
Materials and Methods:
Pubmed, Embase and Cochrane databases were
searched on March 1st 2016. Two authors independently screened 4348 ar-
ticles by title and abstract. 14 articles were reviewed full-text. Bias was as-
sessed by the Cochrane Risk of Bias Tool. Meta-analysis was performed for ra-
dial shortening and dorsal tilt while it was not possible for pain assessment due
to different outcome measures.
Findings / Results:
3 RCTs with a total of 483 patients were included, 240
FTT and 243 MT. Risk of bias was generally unclear. None of the studies report-
ed any statistically or clinically significant differences in radiographic outcome.
Forest plot of the dorsal tilt showed 0.43[0.25;0.61, p<0.00001] in favor of
MT. Radial shortening forest plot showed -0.19[-0.37;-0.01, p=0.04] in favor
of FTT. One study found FTT associated with less pain, even without anesthesia,
and another found FTT to be associated with a better functional outcome.
Conclusions:
FTT seems to be slightly superior in restoring radial length com-
pared to MT whereas MT seems sligthly superior in restoring dorsal tilt com-
pared to FTT. FTT might be less painful. The studies were very heterogenic and
further studies are warranted.
No conflicts of interest reported
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