Splinting vs reduction prior to fixation of distal radius fractures showed comparable pain scores
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Results showed comparable preoperative pain scores and opioid medication usage between patients who did and those who did not undergo reduction prior to surgical intervention of isolated, closed, neurovascularly intact, displaced distal radius fractures.
Bryan Brown, MD, and colleagues randomly assigned patients with isolated, closed, neurovascularly intact, displaced distal radius fractures to undergo either reduction (n=6) or nonreduction/in situ splinting (n=20) prior to surgical intervention. Researchers recorded standard numeric rating scale score for pain, amount of pain medication administered and time to admission. Researchers also monitored patients for complications and examined the skin for breakdown or necrosis at the time of surgery.
Results showed no preoperative complications in either cohort. Researchers found no significant differences in preoperative pain scores between the two groups, as well as an overall average time to operating room of 20.7 hours. Patients in the reduction group had a preoperative opioid consumption using morphine equivalent dosage of 18.9 mg per day vs. 24.8 mg per day in the nonreduction group, according to results. Researchers also noted an average time from ER presentation to admission order of 344 minutes and 260 minutes in the reduction and nonreduction groups, respectively.
“The preliminary take-home message of this study so far is that patients with closed, isolated, neurovascularly intact and displaced radius fractures can safely be splinted in situ without a preliminary closed reduction prior to operative fixation. These patients have had comparable subjective pain responses with substantially quicker throughput times in the emergency room,” Brown told Healio Orthopedics. “This could have significant implications with regard to both orthopedics and the health care industry, as these patients could forego the potential psychologically traumatic and painful experience of a preliminary closed reduction, be safely taken in and out of the emergency room in a more efficient manner, and limit the direct intervention of a surgical specialist until the time of surgery. All of these factors have the potential to decrease health care cost in a safe manner.” – by Casey Tingle
Reference:
Brown B, et al. ePaper 462. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
Disclosure: Brown reports no relevant financial disclosures.
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Brown B, et al. ePaper 462. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
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