The Requirement for Closed Reduction of Dorsally Displaced Unstable Distal Radius Fractures Before Operative...

Area of Science:

• Orthopedic surgery
• Traumatology
• Fracture management

Background:

• Dorsally displaced distal radius fractures typically undergo closed reduction before casting.
• Existing evidence questions the benefit of fracture reduction prior to definitive treatment.
• The impact of preoperative reduction on patient pain during casting is unstudied.

Purpose of the Study:

• To compare pain levels in patients with distal radius fractures treated with or without preoperative closed reduction.
• To evaluate the clinical and radiological outcomes of omitting preoperative reduction.
• To assess the necessity of routine closed reduction before casting for these fractures.

Main Methods:

• A prospective, randomized trial involving 47 patients with unstable distal radius fractures.
• Patients were surgically treated, with or without prior closed reduction.
• Primary endpoint: difference in Visual Analog Scale pain scores pre- and post-treatment.

Main Results:

• No statistically significant difference in pain scores on day 1 post-treatment between groups.
• Similar frequencies of sensory disturbances (median nerve issues) in both groups.
• Comparable 12-month outcomes for the Krimmer and DASH scores, indicating no functional disadvantage from omitting reduction.

Conclusions:

• Omitting closed reduction before casting for planned surgical treatment of distal radius fractures results in no disadvantage.
• Routine preoperative closed reduction for these fractures is not clinically warranted.
• This approach simplifies treatment without compromising patient outcomes.