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Risk factors for fracture redisplacement after reduction and cast immobilization of displaced distal radius fractures in children: a meta-analysis.
- Source :
- European Journal of Trauma & Emergency Surgery; 2020, Vol. 46 Issue 4, p789-800, 12p, 1 Black and White Photograph, 1 Diagram, 2 Charts, 8 Graphs
- Publication Year :
- 2020
-
Abstract
- Purpose: Displaced distal radius fractures in children are common and often reduced if necessary and immobilized in cast. Still, fracture redisplacement frequently occurs. This can be prevented by fixation of fracture fragments with K-wires, but until now, there are no clear guidelines for treatment with primary K-wire fixation. This meta-analysis aimed to identify risk factors for redisplacement after reduction and cast immobilization of displaced distal radius fractures in children, and thereby determine which children will benefit most of primary additional K-wire fixation. Methods: Eight databases were searched to identify studies and extract data on the incidence of and risk factors for redisplacement of distal radius fractures after initial reduction and cast immobilization in children. Results: Twelve studies, including 1256 patients, showed that initial complete displacement (odds ratio [OR] 4.69, 95% confidence interval [CI] 2.98–7.39) and presence of a both-bone fracture (OR 1.95, 95% CI 1.34–2.85) were independent risk factors for redisplacement. Anatomical reduction reduced the redisplacement risk (OR 0.14, 95% CI 0.05–0.40). No significant influence on redisplacement risk could be established for female sex, experience level of the attending surgeon, Cast Index < 0.8, Three-Point Index < 0.8 and patient's age. Conclusions: For children with a displaced distal radius fracture, the presence of a both-bone fracture, complete displacement of the distal radius and non-anatomical reduction are risk factors for redisplacement after reduction of their initially displaced distal radius fracture. Children with one or more of these risk factors probably benefit most of reduction combined with primary K-wire fixation. [ABSTRACT FROM AUTHOR]
- Subjects :
- DISEASE relapse prevention
DISEASE relapse
CINAHL database
CONFIDENCE intervals
JOINT dislocations
FRACTURE fixation
BONE fractures
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
INTERNAL fixation in fractures
MEDLINE
META-analysis
ONLINE information services
PATIENTS
SURGICAL plaster casts
RADIUS bone injuries
RISK assessment
SURGERY
SYSTEMATIC reviews
DESCRIPTIVE statistics
ODDS ratio
DISEASE risk factors
ADOLESCENCE
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 18639933
- Volume :
- 46
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- European Journal of Trauma & Emergency Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 148387493
- Full Text :
- https://doi.org/10.1007/s00068-019-01227-w