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Treatment of distal radius fractures. 2010
David M Lichtman, and
Randipsingh R Bindra, and
Martin I Boyer, and
Matthew D Putnam, and
David Ring, and
David J Slutsky, and
John S Taras, and
William C Watters, and
Michael J Goldberg, and
Michael Keith, and
Charles M Turkelson, and
Janet L Wies, and
Robert H Haralson, and
Kevin M Boyer, and
Kristin Hitchcock, and
Laura Raymond
Department of Orthopaedics Surgery, University of North Texas Health Science Center, John Peter Smith Hospital, Fort Worth, TX, USA.
The clinical practice guideline is based on a systematic review of published studies on the treatment of distal radius fractures in adults. None of the 29 recommendations made by the work group was graded as strong; most are graded as inconclusive or consensus; seven are graded as weak. The remaining five moderate-strength recommendations include surgical fixation, rather than cast fixation, for fractures with postreduction radial shortening >3 mm, dorsal tilt >10 degrees , or intra-articular displacement or step-off >2 mm; use of rigid immobilization rather than removable splints for nonsurgical treatment; making a postreduction true lateral radiograph of the carpus to assess dorsal radial ulnar joint alignment; beginning early wrist motion following stable fixation; and recommending adjuvant treatment with vitamin C to prevent disproportionate pain.
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