Table 1.
Baseline characteristics of included studies
| Study details | Sample size; n | Study population | Outcomes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First author | Country | Year | Design | Control | Intervention | Injuries studied | Described eligibility criteria for DD | Population | D | L | € | F | S | AO | Period; m |
| Comparative | |||||||||||||||
| Abdelmalek [10] | England | 2015 | RCSPPP | 36 | 27 | 5MC neck Fx | Angulation < 50°, no rotational deformity | A + P | + | + | − | − | − | − | 6 vs. 6 |
| Bansal [11] | England | 2007 | PCSPPP | 40 | 38 | 5MC neck Fx | Angulation < 70°, no rotational deformity, no delay (< 1w) | ≥ 16y | − | + | − | + | + | − | NR |
| Ferguson [12] | Scotland | 2015 | RPPRCS | 279 | 339 | 5MT Fx | Not clearly defined | A + P | + | + | − | − | − | + | 12 vs. 12 |
| Hamilton [13] | England | 2013 | RCT | 158 | 159 | Stable forearm Fx | Torus/greenstick: < 15° angulation; SH I/II: < 5 mm displaced | P ≥ 2y | − | + | + | + | + | − | 34 |
| Kelly [14] | Ireland | 2019 | RPPRCS | NR | 247 | Multiple | Not clearly defined | A + P | + | − | − | − | − | − | 6 vs. 6 |
| Khan [15] | Ireland | 2007 | RCT | 48 | 69 | Torus Fx distal radius | Not clearly defined, described as ‘stable’ | P | − | − | − | − | + | − | 3 |
| Mackenzie [9] | Scotland | 2018 | RPPCS | 108 | 88 | 5MC Fx | Isolated extra-articular Fx | A + P ≥ 13y | − | + | + | + | + | + | 6 vs. 6 |
| 111 | 87 | 5MT Fx | Any | A + P ≥ 13y | − | + | + | + | + | + | 6 vs. 6 | ||||
| 118 | 114 | Radial head/neck Fx | Mason type 1 and 2 | A + P ≥ 13y | − | + | + | + | + | + | 6 vs. 6 | ||||
| Matthews [16] | England | 2014 | RPPCS | 55 | 23 | Clavicle Fx | Isolated single fragment midshaft Fx | P 1-15y | + | − | − | − | + | − | 10 vs. 3 |
| Seewoonarain[17] | England | 2019 | RPPCS | 39 | 44 | Torus Fx distal radius | No associated ulnar styloid Fx | P < 16y | + | + | + | − | − | − | 6. vs 6 |
| Vardy [8] | Scotland | 2014 | RPPCS | 2840 | 6385 | All not requiring immediate inpatient treatment | Not clearly defined, included 5MC neck, paediatric greenstick/torus, clavicle, mallet finger, radial head, 5MT Fx | A + P | + | − | − | − | − | − | 12 vs. 12 |
| Non-comparative | |||||||||||||||
| Bhattacharyya[18] | Scotland | 2017 | RCS | 138 | Clavicle Fx | Not clearly defined, mostly Robinson 2a1 and 3a1 | A + P | + | + | − | + | − | + | 12 | |
| Breathnach [19] | Ireland | 2018 | RCS | 157 | ‘Orthopaedic Fx’ | Not clearly defined, includes buckle Fx/STI of hand, foot, ankle | A + P | + | − | − | − | − | + | 1.5 | |
| Brogan [20] | England | 2017 | CS | 663 | Suspected 5MT Fx | All 5MT Fx, but ‘Jones’ Fx’ based on clinician’s decision | A + P | + | + | − | − | − | + | 24 | |
| Brooksbank[21] | Scotland | 2014 | PCS | 47 | Mallet finger | Not clearly defined | NR | + | + | − | + | + | − | 12 | |
| Callender [22] | Ireland | 2015 | RCS | 119 | Wrist torus Fx | Not clearly defined | P | − | + | + | − | − | + | 12 | |
| Evans [23] | England | 2018 | PCS | 291 | Hand and wrist injuries | ‘Simple tuft, 5MC neck, minor avulsion, volar plate and STI’ | A + P | + | − | − | − | − | + | 4.5 | |
| Gamble [24] | Scotland | 2015 | RCS | 167 | 5MC Fx | Not clearly defined | A | − | + | − | + | + | − | 6 | |
| Gleeson [25]—I | NZ | 2016 | RCS | 61 | Torus Fx radius/ulna; clavicle Fx | Torus: < 15° angulation; Clavicle: isolated Fx with bone contact | P > 1y | − | + | + | - | + | − | 12 | |
| Gleeson [26]—II | NZ | 2016 | RCS | 33 | 5MC neck Fx; 5MT base Fx; Ankle Fx, Weber type A | 5MC: < 60° angulation, no rotation; 5MT: Zone 1 < 2 mm displaced, < 10% angulation; Weber A: < 4 mm displaced, fragment < 5 mm | NR | − | − | + | − | − | − | 9 | |
| Ibrahim [27] | Scotland | 2018 | CS | 100 | Acute closed STI/bony hand injuries | Not clearly defined, but excl. isolated carpal and wrist Fx | NR | + | − | − | − | − | + | 1.5 | |
| Jayaram [28] | Scotland | 2014 | RCS | 182 | Radial head/neck Fx | Unilateral, Mason type 1 or 2 or fatpad sign, no other injuries | NR | + | + | − | − | − | + | 12 | |
| Jenkins [2] | Scotland | 2014 | RCS | 6385 | 5MT, 5MC, distal radius, torus, radial head Fx, mallet finger, child clavicle Fx | Not clearly defined, described as ‘simple, self-limiting stable Fx’ | A + P | + | − | − | − | − | − | 12 | |
| Little [29] | England | 2020 | PCS | 3709 | Hand/wrist injuries | Stable STI/bony injury, no significant swelling or ROM problems | A + P | + | − | − | + | + | − | 21 | |
| O’Reilly [30] | Ireland | 2019 | CS | 2704 | Simple 5MC, 5MT, clavicle, radial head or torus Fx, mallet finger | Not clearly defined: ‘simple injuries’, mallet finger: no bony injury | A + P | + | − | − | − | − | − | 19 | |
| Robinson [31] | England | 2017 | PCS | 229 | MC, phalanx hand, distal radius/ulna, elbow, clavicle, metatarsal, lateral malleolus Fx | Metacarpal: < 60° angulation, no rotational deformity; phalanx: minor avulsion, wrist: undisplaced or torus, elbow: undisplaced/ fatpad (> 5y); clavicle: un/minor displaced, metatarsal: undisplaced; lateral malleolus: undisplaced (> 5y) | P | - | + | − | − | − | + | 6 | |
| White [1] | Scotland | 2017 | RCS | 12,069 | All patients with musculoskeletal injuries | Mallet finger with no bony injury, 5MC neck, radial head/neck Mason type I or II, 5MT base Fx or Fx of lesser toe | A + P | + | − | − | − | − | − | 12 | |
Studies were included if they reported at least one of: D (proportion of patients discharged directly), L (logistic outcomes), € (financial outcomes), F (functional outcomes), S, (satisfaction with treatment); AO (Adverse outcomes)
5MC fifth metacarpal, 5MT fifth metatarsal, A adult, CS cohort study, not mentioned specifically if data were collected retrospectively or prospectively. DD direct discharge, Fx fracture, PCS prospective cohort study, PPP prospective pre-post study, m months, MC metacarpal, mm millimetre, NR not reported, NZ New Zealand, P paediatric, RCS retrospective cohort study; ROM range of motion, RPP retrospective pre-post study, SH Salter-Harris, STI soft-tissue injury