National clinical guideline on the treatment of distal radial fractures

Published by Sundhedsstyrelsen on Mar 22, 2021

Disclaimer

The Danish Health Authority's national clinical guidelines are systematically prepared statements based on relevant expert knowledge. National clinical guidelines are aimed at facilitating decision-making for professionals concerning appropriate and good clinical healthcare services in specific situations. The national clinical guidelines are publicly available, and patients are also welcome to read the guidelines. National clinical guidelines are classified as professional counselling, which implies that the Danish Health Authority recommends that the guidelines be followed by relevant professionals. The national clinical guidelines are not legally binding, and the professional judgment in the specific clinical situation will always take priority when deciding about appropriate and correct clinical healthcare services. A successful treatment outcome cannot be guaranteed, even if healthcare professionals follow the recommendations. In certain situations, a treatment method with a lower strength of evidence may be preferable, because it is considered a better choice for the patient and by the patient. Generally, healthcare professionals should involve the patient when choosing a particular treatment option.

ISBN electronic edition: 978-87-7014-313-4
Version: 1.1

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Abstract

© Sundhedsstyrelsen, 2017. Publikationen kan frit refereres med tydelig kildeangivelse.

Kategori: Faglig rådgivning
Version: 1.1
Format: PDF

ISBN electronic edition: 978-87-7014-313-4

Language

en

PICOS

PICO 1.1

Population
Patients over the age of 18 with distal radial fracture cf. focused questions 1
Intervention
K-wires
Comparator
Conservative treatment
Outcomes

PICO 2.1

Population
patients over the age of 18 with distal radial fracture cf. focused questuin 1
Intervention
External fixation
Comparator
Conservative treatment
Outcomes

PICO 3.1

Population
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
Intervention
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)
Comparator
Conservative treatment with plaster or another immobilising material (no further intervention)
Outcomes

PICO 3.1

Population
Patients over the age of 18 wuth distal radial fracture cf. focused question 1
Intervention
Volar angular stable lockiing plate
Comparator
Reduction and plaster (conservative treatment)
Outcomes

PICO 4.1

Population
Patients over the age of 18 years with distal radius fracture cf. focused question 1
Intervention
CT-scan performed following conventional wrist X-ray examination
Comparator
Wrist X-ray examination
Outcomes

PICO 4.1

Population
Patients over the age of 18 with distal radial fracture cf focused question 1
Intervention
Volar angle stable locking plate
Comparator
External fixation
Outcomes

PICO 5.1

Population
Patients over the age of 18 diagnosed with distal radius fracture cf. focused question 1
Intervention
Surgery within the first 48 hours after deciding that surgery id indicated
Comparator
Surgery more than 48 hours after deciding that surgery id indicated
Outcomes

PICO 5.1

Population
Patients over the age of 18 with distal radial fracture cf. focused question 1
Intervention
Volar angular stable locking plate
Comparator
K-wires
Outcomes

PICO 7.1

Population
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
Intervention
Early mobilisation (within 14 days)
Comparator
Late mobilisation (after 5 weeks)
Outcomes

PICO 8.1

Population
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
Intervention
Rehabilitation supervised by an occupational therapist or physiotherapist more than once
Comparator
Rehabilitationbased on a training programme following a single instruction form a health care professional at the time of cast or similar immobilising bandage removal
Outcomes