Treatment of distal radius fractures in adults

Main Editor Main editor- and author: Hebe Désirée Kvernmo; Co-authors: Leiv M. Hove, Katrine Bjørnebek Frønsdal, Ingrid Harboe, Adalsteinn Odinsson, Yngvar Krukhaug
Language en
Last Update Jul 27, 2015
Published Date Aug 10, 2015
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In accordance with new international standards for reliable guidelines and "Guidance on evidence-based medical guidelines" issued by the Norwegian Directorate of Health's, clinical guidelines should include a systematic review of available documentation and a balanced assessment of the benefits and harms of existing treatment options. Clinical guidelines set a standard for assessment, treatment and follow-up of patients or diagnosis groups, and serve as an aid to healthcare personnel in the decision-making in their everyday clinical practice. Professional guidelines are instruments, which purpose is to prevent undesired variation in treatment quality between patients or patient groups.

Sponsors Norwegian Medical Association Norwegian Society for Surgery of the Hand Norwegian Orthopaedic Association
Abstract

PICOS
PICO 9.1
P: Adult patients with unstable distal radius fractures, irrespective of age, treated with a volar locking plate
I: Supervised training by occupational- or physiotherapist
C: Home-exercise program after instruction by health personnel after cast removal
O:

PICO 6.1
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Surgery performed < 48 hours after the indication for surgery has been made
C: Surgery performed > 48 hours after the indication for surgery has been made
O:

PICO 4.1
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Percutaneous pinning
C: Conservative treatment
O:

PICO 1.1
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Volar locking plates
C: External fixation
O:

PICO 2.1
P: Adult patients with unstable distal radius fractures, irrespective of age
I: External fixation
C: External fixation with pinning of the fracture fragment
O:

PICO 3.1
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Operative stabilization of associated distal ulna fracture
C: Non-operative stabilization of associated distal ulna fracture
O:

PICO 5.1
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Ordinary X-ray examination of the wrist
C: CT scan of the wrist
O:

PICO 8.1
P: Adult patients with unstable distal radius fractures, irrespective of age, treated with a volar locking plate
I: Immobilization in cast or another stabilizing bandage in < 2 weeks
C: Immobilization in cast or another stabilizing bandage in > 5 weeks
O:

PICO 9.2
P: Adult patients with unstable distal radius fractures, irrespective of age, treated conservatively (reduction and casting)
I: Supervised training by occupational- or physiotherapist
C: Home-exercise program after instruction by health personnel after cast removal
O:

PICO 4.2
P: Adult patients with unstable distal radius fractures, irrespective of age
I: External fixation
C: Conservative treatment
O:

PICO 1.2
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Volar locking plates
C: Percutaneous pinning
O:

PICO 2.2
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Traditional percutaneous pinning
C: Kapandji pinning
O:

PICO 4.3
P: Adult patients > 65 years with unstable distal radius fractures
I: Volar locking plates
C: Conservative treatment
O:

PICO 2.3
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Pinning with biodegradable pins
C: Pinning with metal pins
O:

PICO 2.4
P: Adult patients with unstable distal radius fractures, irrespective of age
I: Operative treatment without bonegrafting or bonesubstitutes in addition to the osteosynthesis
C: Operative treatment with bonegrafting or bonesubstitutes in addition to the osteosynthesis
O: