Ultrasound-guided Reduction of Colle’s fracture does not assist in Achieving Better Radiographic Indices - Results of a Randomised Controlled Trial
https://doi.org/10.5704/MOJ.2407.010
- Author:
Bhatt MP
1
;
Nema SK
2
;
Ayyan M
3
Author Information
1. Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
2. Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Raipur, India
3. Department of Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
- Publication Type:Journal Article
- Keywords:
distal radius fracture, Colle’s fracture, ultrasonography, manipulation, and reduction
- From:Malaysian Orthopaedic Journal
2024;18(No.2):71-76
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Ultrasound-guided manipulation and
reduction (M&R) of the distal radius fractures (DRF) is
believed to improve radiographic indices due to real-time
feedback of fracture alignment. The objective of this trial
was to compare volar tilt, radial inclination, and radial height
on radiographs between Ultrasound guided and conventional
(landmark-guided) M&R.
Materials and methods: A total of 79 distal radius
extraarticular fractures in adults were randomised to
Ultrasound guided and conventional (landmark-guided)
M&R. The radiograph parameters described above were
compared before and after M&R in both groups.
Results: Except for volar tilt (P=0.05 difference in
difference), there was no difference in both the groups on
radiograph parameters i.e. radial inclination and radial
height. We estimated a reduction in the incidence of malreduction by 49% (Risk ratio 0.51) and an absolute risk
reduction of 22% through USG-guided reduction. We
evaluated a number needed to treat 4 through USG-directed
M&R of DRF to prevent one unacceptable reduction. There
were 9 (22%) and 18 (46%) (P=0.70) unacceptable
reductions in USG-guided and landmark-guided M&R.
Conclusion: Adding USG guidance to conventional
landmark-based closed reduction methods is not beneficial
for the accuracy of fracture reduction in Colle’s fracture.
However, improved volar tilt in sonographic-directed M&R
needs further studies to determine the clinical significance.
- Full text:202408211733534781816.2024my1375.pdf
