Table 3.
Outcomes
| References | Mean FU | Treatment | N | Outcomes | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean TAM (range/SD) | TAM categories | NU | TAM <180° | TAM >240° | Inf. | Failurea | SSPs | Other/statistical outcomes | ||||
| 3A Non-operative treatment | ||||||||||||
| Franz [17] | 12 weeks | LuCa | 20 | 240° (155°–290°) | N.D. | 0 | 0 | 12 | N.A. | 0 | 0 | N.D. |
| Franz [16] | 12 weeks | A: LuCa | 44 | 246.6° (150°–300°) | N.D. | 0 | 1 | 23 | N.A. | 2: loss of reduction | 2: revision surgery (RS) | Mean TAM: NSD, P value N.D. Satisfaction (VAS): A 9.4 vs. B 8.4, P = 0.022* Mean wrist motion: A 128° vs. B 137°, P = 0.074 |
| B: Forearm cast | 30 | 231.6° (145°–300°) | N.D. | 0 | 1 | 14 | N.A. | 0 | 0 | |||
| Held [18] | 7 weeks | Dorsal splint | 23 | N.D. | N.D. | 0 | N.D. | N.D. | N.A. | 2: MU requiring RS | 2: revision surgery (RS) | N.D. |
| 3B Closed Reduction Internal Fixation (CRIF) | ||||||||||||
| Al-Qattan [21] | 30 weeks | A: K-wire, w/o SSTC | 16 | 241.3° (SD 8.5°) | Excellent (≥240°): 10 (63%) Good (210°–240°): 6 (38%) Fair (180°–209°): 0 Poor (<180°): 0 |
0 | 0 | N.D. | 0 | 0 | 0 | Mean TAM: A vs. B, P < 0.001* Mean TTRBTW: A 15.1 weeks (SD ± 1.6) vs. B 26.8 weeks (SD ± 2.0), P < 0.001* |
| B: K-wire with SSTC |
13 | 186.9° (SD 20.7°) |
Excellent (≥240°):0 Good (210°–240°): 3 (23%) Fair (180°–209°): 2 (23%) Poor (<180°): 7 (54%) |
0 | 7 | N.D. | 0 | 0 | 0 | |||
| Faruqui [22] | 8 months | A: K-wires (transarticular) | 25 | 201° | N.D. | 1 | N.D. | N.D. | 1 | 2: loss of reduction | 5: tenolysis 1: capsulotomy |
Mean TAM: NSD, P value N.D. Overall % complications (as defined by authors): A 56% vs. B 48%, NSD, P value N.D. |
| B: K-wires (extra-articular) | 25 | 198° | N.D. | 0 | N.D. | N.D. | 0 | 0 | 1: tenolysis 1: capsulotomy |
|||
| Hornbach [14] | 20 months | K-wires (transarticular) | 12 | 265° (SD 25°) | N.D. | 0 | 0 | 10 | 0 | 1: rotational MU requiring RS | 1: tenolysis | SF-36: NSD compared to standardized values for general population Mean grip strength: compared to contralateral hand, P > 0.05 |
| 3C Open Reduction Internal Fixation (ORIF) | ||||||||||||
| Al-Qattan [23] | 12 weeks | Cerclage wires | 15 | 258° (245°–260°) | Excellent (> 75%): 17 (74%) Good (50–75%): 6 (26%) Fair (25–50%): 0 Poor (<25%): 0 |
0 | 0 | N.D. | 0 | 0 | 2: implant removal | N.D. |
| Başar [13] | 19.2 months | A: Mini plate and screws | N.D. | 212.3° (SD 30.3°) | N.D. | 0 | N.D. | N.D. | 2 | 0 | 0 | Mean TAM, A vs. B, P = 0.022* QuickDASH score: A 6.45 vs. B 2.58, P = 0.022* Loss of grip strength: A 6.1% (SD ± 8.6) vs. B 2.5% (SD ± 4.6), P = 0.1447 Mean TTRBTW: A 33.2 days vs. B 46.0 days, P < 0.05* |
| B: Screws only | N.D. | 235.0° (SD 25.6°) | N.D. | 0 | N.D. | N.D. | 0 | 0 | 0 | |||
| Brei-Thoma [25] | 10 months | Plate and screws, plate | 29 | 213° (100°–285°) | Excellent (>250°): 7 (24%) Good (210°–250°): 11 (38%) Fair (180°–209°): 3 (10%) Poor (<180°): 8 (28%) |
0 | 8 | 8 | 0 | 1: implant failure 2: rotational MU requiring RS |
2: revision surgery (RS) 12: implant removal + tenolysis |
N.D. |
| Nalbantoǧlu [15] | 35 months | Plate and screws, mini screw only | 18 | 200° (160°–260°, SD 39.5°) | Excellent (≥220°): 6 (33%) Good (180°219°): 5 (28%) Fair (130°179°): 7 (39%) Poor (<130°): 0 |
0 | 7 | 4 | 0 | 0 | 4: implant removal + tenolysis | Mean QuickDASH score: 3.4 |
| Pehlivan [27] | 13 months | Tension band wiring | 23 | N.D. | Excellent (> 75%): 17 (74%) Good (50–75%): 6 (26%) Fair (25–50%): 0 Poor (<25%): 0 |
0 | 0 | N.D. | 0 | 0 | 2: implant removal | N.D. |
| Thomas [28] | 28.8 months | Theta fixation | 10 | N.D. | Excellent (> 250°): 9 (90%) Good (> 180°): 1 (10%) Fair (<180°): 0 Poor (no change): 0 |
0 | N.D. | 9b | 0 | 0 | 3: implant removal | N.D. |
| 3D CRIF and/versus ORIF | ||||||||||||
| Al-Qattan [20] | 14 weeks | A: K-wires (transarticular) | 40 | N.D. | Excellent (> 240°): 5 (13%) Good (220–240°): 20 (50%) Fair (180–219°): 10 (25%) Poor (<180°): 5 (13%) |
0 | 5 | 5 | 2 | 2: re-displacement | 1: implant removal | TAM scores: A vs. B, P = 0.03* Mean TTRBTW: A 15 weeks vs. B 14 weeks, NSD, P value N.D. |
| B: Interosseous loop wires | 38 | N.D. | Excellent (> 240°): 15 (39%) Good (220–240°): 16 (42%) Fair (180–219°): 3 (8%) Poor (<180°): 4 (11%) |
0 | 4 | 15 | 0 | 3: re-displacement | 0 | |||
| Al-Qattan [24] | 16 weeks | C: K-wires (extra-articular) | 35c | N.D. | Excellent (> 240°): 15 (43%) Good (220–240°): 10 (29%) Fair (180–219°): 5 (14%) Poor (<180°): 5 (14%) |
0 | 5 | 15 | 4 | 0 | 0 | Comparison with Al-Qattan 2008: TAM scores: A vs. C, P = 0.021* TAM scores: B vs. C, P = 0.599 |
| Horton [19] | 40 months | A: K-wires (transversal) | 15 | N.D. | N.D. | 0 | N.D. | N.D. | 3 | 1: fixation failure | 3: tenolysis 1: release of palmar plate |
Mean (range) flexion PIPJ: A 81° (40–105) vs. B 80° (25–105), NSD, P value N.D. Mean (range) flexion DIPJ: A 55° (25–90) vs. B 49° (0–95), NSD, P value N.D. Median TTRBTW: A 3 weeks vs. B 1 week, NSD, P value N.D. Functional recovery: P = 0.3 Median VAS scores on pain and cold intolerance: NSD, P value N.D. |
| B: Lag screws | 13 | N.D. | N.D. | 0 | N.D. | N.D. | 3 | 1: fixation failure | 0 | |||
| Patankar [26] | ≥6 months | Intra-medullary nailingc | 35d | N.D. | Excellent (≥85%): 35 (100%) Good (70–84%): 6 Fair (50–69%): 0 Poor (<50%): 0 |
0 | 0 | N.D. | 1 | 0 | 0 | N.D. |
FU follow-up, Inf infection, MU malunion, N.A. not applicable, N.D. not described, NSD not significantly different, NU non-union, SSPs secondary surgical procedures, SSTC significant soft tissue crush, TTRBTW time to return back to work
aAs defined by authors
bTAM score of the remaining patient cannot be retrieved
cOf the 35 included patients, 15 were treated with open reduction and 20 patients with closed reduction, no differentiation made