Abstract
Objectives: The aim of this study was to reduce the number of inappropriately managed distal radial fractures with the use of a template.
Methods: A template has been developed to aid junior doctors and emergency nurse practitioners (ENPs) to decide which distal radial fractures require manipulation. Emergency Department (ED) junior doctors and ENPs were asked to review the radiographs of 12 distal radial fractures with and without the template and comment on whether the fracture required manipulation.
Results: There was an improvement in appropriate management with the template of 16.6% for the junior doctors and 22.3% for the ENPs. This was statistically significant for both groups when the results were analysed with a paired t test (p<0.01).
Conclusions: We conclude that the availability of this template in the ED may be helpful to junior doctors and ENPs, and represents a low cost and efficient way of reducing the number of patients who attend a fracture clinic with a distal radial fracture in an unsatisfactory position. This may also reduce the numbers requiring admission and a manipulation under anaesthetic, which spares the patients the risks of general anaesthesia and may possibly be cost saving.
Full Text
The Full Text of this article is available as a PDF (68.3 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Dias J. J., Wray C. C., Jones J. M. The radiological deformity of Colles' fractures. Injury. 1987 Sep;18(5):304–308. doi: 10.1016/0020-1383(87)90047-7. [DOI] [PubMed] [Google Scholar]
- GARTLAND J. J., Jr, WERLEY C. W. Evaluation of healed Colles' fractures. J Bone Joint Surg Am. 1951 Oct;33-A(4):895–907. [PubMed] [Google Scholar]
- GOLDEN G. N. Treatment and prognosis of Colles' fracture. Lancet. 1963 Mar 9;1(7280):511–515. doi: 10.1016/s0140-6736(63)91321-7. [DOI] [PubMed] [Google Scholar]
- Kelly A. J., Warwick D., Crichlow T. P., Bannister G. C. Is manipulation of moderately displaced Colles' fracture worthwhile? A prospective randomized trial. Injury. 1997 May;28(4):283–287. doi: 10.1016/s0020-1383(96)00204-5. [DOI] [PubMed] [Google Scholar]
- LIDSTROM A. Fractures of the distal end of the radius. A clinical and statistical study of end results. Acta Orthop Scand Suppl. 1959;41:1–118. [PubMed] [Google Scholar]
- McQueen M. M., MacLaren A., Chalmers J. The value of remanipulating Colles' fractures. J Bone Joint Surg Br. 1986 Mar;68(2):232–233. doi: 10.1302/0301-620X.68B2.3958009. [DOI] [PubMed] [Google Scholar]
- McQueen M., Caspers J. Colles fracture: does the anatomical result affect the final function? J Bone Joint Surg Br. 1988 Aug;70(4):649–651. doi: 10.1302/0301-620X.70B4.3403617. [DOI] [PubMed] [Google Scholar]
- Pool C. Colles's fracture. A prospective study of treatment. J Bone Joint Surg Br. 1973 Aug;55(3):540–544. [PubMed] [Google Scholar]
- Stewart H. D., Innes A. R., Burke F. D. Factors affecting the outcome of Colles' fracture: an anatomical and functional study. Injury. 1985 Mar;16(5):289–295. doi: 10.1016/0020-1383(85)90126-3. [DOI] [PubMed] [Google Scholar]
- van der Linden W., Ericson R. Colles' fracture. How should its displacement be measured and how should it be immobilized? J Bone Joint Surg Am. 1981 Oct;63(8):1285–1288. [PubMed] [Google Scholar]