| Methods |
Randomisation by order of hospital admission
Assessor blinding: not stated
Intention‐to‐treat analysis: only for those followed up
Loss to follow‐up: 29 (48%) |
| Participants |
Highland General Hospital, University of California, USA
60 participants. Of 31 analysed: 22 male (71%), mean age 35 years, range 19‐50 years. Transverse, oblique, comminuted, and displaced fractures included.
Inclusion criteria: closed midshaft, or distal isolated ulnar fracture.
Exclusion criteria: proximal ulnar fracture, distal radioulnar fracture. |
| Interventions |
No details of when treatment started. Infer that treatment ended when fracture union confirmed.
1. Ace Wrap ‐ elastic bandage
2. Short arm plaster cast
3. Long arm plaster cast
Allocated: ?/?/? (numbers in each group not stated)
Assessed: 8/14/9 (subjective results: 7/10/5) |
| Outcomes |
Length of follow‐up: until union (mean 20 weeks)
Fracture union (radiographic and pain free)
Treatment failure
Patient evaluation: pain, cosmetic deformity, satisfaction.
Range of motion (wrist, elbow, forearm)
Anatomic: varus and volar/dorsal angulation
Return to previous employment |
| Notes |
Large loss of follow‐up attributed to common violent origin of this fracture.
Six participants did not tolerate Ace wrap due to pain: 3 were changed to short arm plaster casts and 3 to long arm plaster casts. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
High risk |
"Based on order of hospital admission", thus quasi‐randomised. |
| Allocation concealment (selection bias) |
High risk |
Inadequate because "based on order of hospital admission". |
| Blinding (performance bias and detection bias)
Patient‐rated outcomes |
High risk |
There was no report of blinding. |
| Blinding (performance bias and detection bias)
Clinician‐rated outcomes |
Unclear risk |
There was no report of blinding. |
| Incomplete outcome data (attrition bias)
Patient‐rated outcomes |
High risk |
Large loss to follow‐up: 29/60 (48%). Inadequate data available to examine effects. |
| Incomplete outcome data (attrition bias)
Clinician‐rated outcomes |
Unclear risk |
Large loss to follow‐up: 29/60 (48%). Inadequate data available to examine effects. |
| Selective reporting (reporting bias) |
Unclear risk |
Reports on typical set of outcomes for these fractures. |
| Selection bias (baseline imbalances)? |
High risk |
Data not provided for whole study population. Some imbalances in patient characteristics of the 31 followed up (e.g. fracture type). |
| Performance bias (care programme discrepancies)? |
Unclear risk |
Insufficient information. |
