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

Authors
  • Dailey, Steven K1
  • Miller, Ashley R2
  • Kakazu, Rafael2
  • Wyrick, John D2
  • Stern, Peter J2
  • 1 Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH. Electronic address: [email protected]
  • 2 Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH.
Type
Published Article
Journal
The Journal of hand surgery
Publication Date
Oct 01, 2018
Volume
43
Issue
10
Pages
927–931
Identifiers
DOI: 10.1016/j.jhsa.2018.02.015
PMID: 29573894
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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). 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. 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. 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. Therapeutic I. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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