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Evidence-Based Orthopaedics   |    
Indirect Reduction and Percutaneous Fixation Led to a Rapid Recovery and Better Function Than Open Reduction for Intra-Articular Fractures of the Distal End of the Radius

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Kreder HJ, Hanel DP, Agel J, McKee M, Schemitsch EH, Trumble TE, Stephen D. Indirect Reduction and Percutaneous Fixation Versus Open Reduction and Internal Fixation for Displaced Intra-Articular Fractures of the Distal Radius: A Randomised, Controlled Trial.
J Bone Joint Surg Br
. 2005 Jun;87:829-36.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Feb 01;88(2):455-455. doi: 10.2106/JBJS.8802.ebo3
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Question: In patients with displaced intra-articular fractures of the distal end of the radius, how do indirect reduction and percutaneous fixation compare with open reduction and internal fixation?Design: Randomized (allocation concealed), unblinded, controlled trial with 24-month follow-up (only the 6-month follow-up included >80% of patients).Setting: 2 centers in the United States and 1 in Canada.Patients: 179 skeletally mature patients who were 16 to 75 years of age (mean age, 39 y; 61% men) and had displaced intra-articular fractures of the distal end of the radius and a step-off or gap of =2 mm after an initial closed reduction in the emergency department. Exclusion criteria were a history of wrist fracture, a congenital anomaly or severe problem of the wrist, unfitness for surgery, an inability to treat the injury definitively within a week, mental incompetence, an inability to understand or write English, an open fracture, associated injuries of the ipsilateral upper limb, or other systemic injuries. Follow-up at 6 months was 93%.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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