National clinical guideline on the treatment of distal radial fractures

Main Editor Sundhedsstyrelsen
Language en
Last Update Mar 25, 2019
Published Date Mar 25, 2019
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Abstract

PICOS
PICO 3.1
P: Patients over the age of 18 with distal radial fracture as identified durring wrist X-ray examination and with one or more of the following findings prior to reduction - more than 10 degrees of dorsal angulation of the articular surface of the radial in a side view as compared to perpendicular to the longtudinal axis of the radial -Intra-articular step-off or diastasis of more than 2 mm - Ulnar variance of more than 3 mm - Incongruity of the distal radioulnar joint - Loss of substance of the dorsal cortex
I: Treatment using K-wire, external fixation, ORIF and volar angular stable locking plate or stable reduction (which is still in position at a control after 12-14 days)
C: Conservative treatment with plaster or another immobilising material (no further intervention)
O:

PICO 4.1
P: Patients over the age of 18 years with distal radius fracture cf. focused question 1
I: CT-scan performed following conventional wrist X-ray examination
C: Wrist X-ray examination
O:

PICO 5.1
P: Patients over the age of 18 diagnosed with distal radius fracture cf. focused question 1
I: Surgery within the first 48 hours after deciding that surgery id indicated
C: Surgery more than 48 hours after deciding that surgery id indicated
O:

PICO 1.1
P: Patients over the age of 18 with distal radial fracture cf. focused questions 1
I: K-wires
C: Conservative treatment
O:

PICO 2.1
P: patients over the age of 18 with distal radial fracture cf. focused questuin 1
I: External fixation
C: Conservative treatment
O:

PICO 3.1
P: Patients over the age of 18 wuth distal radial fracture cf. focused question 1
I: Volar angular stable lockiing plate
C: Reduction and plaster (conservative treatment)
O:

PICO 4.1
P: Patients over the age of 18 with distal radial fracture cf focused question 1
I: Volar angle stable locking plate
C: External fixation
O:

PICO 5.1
P: Patients over the age of 18 with distal radial fracture cf. focused question 1
I: Volar angular stable locking plate
C: K-wires
O:

PICO 7.1
P: Patients over the age of 18 with distal radius fracture cf. focused question 1, who had undergone surgery with the iinsertion of a volar angular stable locking plate
I: Early mobilisation (within 14 days)
C: Late mobilisation (after 5 weeks)
O:

PICO 8.1
P: Patients over the age of 18 with distal radius fracture cf. focused question 1, who had undergone surgery with the insertion of a volar angular stable locking plate
I: Rehabilitation supervised by an occupational therapist or physiotherapist more than once
C: Rehabilitationbased on a training programme following a single instruction form a health care professional at the time of cast or similar immobilising bandage removal
O: