The Effectiveness of Mini–C-Arm Fluoroscopy for the Closed Reduction of Distal Radius Fractures in Adults: A Randomized Controlled Trial

Steven Dailey, Ashley R. Miller, Rafael Kakazu, John D. Wyrick, Peter J. Stern

Research output: Contribution to journalArticle

Abstract

Purpose: Most distal radius (DR) fractures are initially managed with closed reduction and orthosis application. Mini–C-arm fluoroscopy provides assessment of reduction quality in real time. Our null hypothesis was that there would be no difference in the reduction quality of DR fractures in the emergency department when using mini–C-arm fluoroscopy during reduction compared with standard reduction techniques (evaluating reduction quality with orthogonal radiographs taken in an orthosis). Methods: Sixty-three consecutive patients with closed DR fractures requiring reduction between April 2015 and April 2017 were prospectively randomized to standard versus fluoroscopically aided reductions. Reductions were performed by orthopedic surgery residents. The primary outcome measurement was reduction quality (radial height, radial inclination, ulnar variance, and volar tilt) as measured on postreduction radiographs. Results: Standard reductions were performed in 34 patients and fluoroscopically aided reductions in 29 patients. The 2 groups were similar in regards to all potential confounders that were analyzed. No differences in postreduction radial height, radial inclination, ulnar variance, or volar tilt were noted. Overall reduction attempts and subjective difficulty of fracture reduction were increased when using fluoroscopy. The rate of initial operative management did not differ between groups. Conclusions: The use of mini–C-arm fluoroscopy during the initial closed reduction of adult DR fractures results in equivalent postreduction radiographic parameters when compared with conventional reduction techniques. Additional research regarding time spent in the emergency department and overall cost could elucidate potential benefits of fluoroscopically aided DR fracture reduction. Type of study/level of evidence: Therapeutic I.

Original languageEnglish (US)
Pages (from-to)927-931
Number of pages5
JournalJournal of Hand Surgery
Volume43
Issue number10
DOIs
StatePublished - Oct 1 2018
Externally publishedYes

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Radius Fractures
Fluoroscopy
Randomized Controlled Trials
Fracture Fixation
Orthotic Devices
Hospital Emergency Service
Orthopedics
Costs and Cost Analysis
Research

Keywords

  • Closed reduction
  • distal radius fracture
  • fluoroscopy
  • mini–C-arm

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

The Effectiveness of Mini–C-Arm Fluoroscopy for the Closed Reduction of Distal Radius Fractures in Adults : A Randomized Controlled Trial. / Dailey, Steven; Miller, Ashley R.; Kakazu, Rafael; Wyrick, John D.; Stern, Peter J.

In: Journal of Hand Surgery, Vol. 43, No. 10, 01.10.2018, p. 927-931.

Research output: Contribution to journalArticle

Dailey, Steven ; Miller, Ashley R. ; Kakazu, Rafael ; Wyrick, John D. ; Stern, Peter J. / The Effectiveness of Mini–C-Arm Fluoroscopy for the Closed Reduction of Distal Radius Fractures in Adults : A Randomized Controlled Trial. In: Journal of Hand Surgery. 2018 ; Vol. 43, No. 10. pp. 927-931.
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