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Overriding distal forearm fractures are typically treated with reduction and percutaneous pinning. However, conservative treatment seems to have equal clinical results.
This is a randomised controlled trial comparing outcomes between percutaneous pin fixation and cast immobilisation without reduction.
Overriding fractures have been managed with anatomical reduction performed under anaesthesia with or without percutaneous pinning. This research protocol was developed due to good results reported on leaving the fractures in an overriding position.
On this randomised controlled trial we will compare objective outcomes between anatomic reduction and percutaneous pin fixation together with finger trap traction and cast immobilisation.
Inclusion criteria are patients younger than 11 years old (Tanner 0) with completely overriding distal radius fractures. At the emergency department patients are randomised into two groups: anatomic reduction and percutaneous pin fixation (control group) or finger trap traction and cast immobilisation (experimental group).
The current controversy is whether cast immobilization alone is an adequate stabilization or whether percutaneous pin fixation is more appropriate for displaced, complete, distal forearm (overriding) metaphyseal fractures. The objectives of this trial are to compare the outcomes between surgical treatment with percutaneous pinning and conservative treatment with finger trap method for completely displaced distal radius fractures. Our null hypothesis is that there are no radiological or clinically relevant differences in outcome measures between the two treatment groups. We expect operative treatment to result in earlier radiological recovery and more satisfied patients than non-operative treatment at 6 weeks, but we expect the differences to be clinically and statistically insignificant at 6 months.
Overriding Distal Forearm Fractures
Cast immobilisation, Percutaneus pinning
New Children's Hospital
Published on BioPortfolio: 2020-03-31T04:03:45-0400
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Metabolic disorder associated with fractures of the femoral neck, vertebrae, and distal forearm. It occurs commonly in women within 15-20 years after menopause, and is caused by factors associated with menopause including estrogen deficiency.
Fractures of the larger bone of the forearm.
Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES.
Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES).
Fractures of the skull which may result from penetrating or nonpenetrating head injuries or rarely BONE DISEASES (see also FRACTURES, SPONTANEOUS). Skull fractures may be classified by location (e.g., SKULL FRACTURE, BASILAR), radiographic appearance (e.g., linear), or based upon cranial integrity (e.g., SKULL FRACTURE, DEPRESSED).
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...
Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...