Principles of Evidence-Based Management of Distal Radius Fractures


Key Points

  • Evidence-based management requires combination of the best evidence with patient values and provider preferences to make treatment decisions.

  • The practice of evidence-based management involves question formulation, acquisition of related literature, appraisal of study quality, and the appropriate application of research findings to individual patients.

  • Evidence-based management does not strictly depend on the results of randomized controlled trials, but more accurately involves the informed and effective use of all types of evidence.

Panel 1: Case Scenarios

Case 1

A 75 year-old female trips and fall, landing on her outstretch right hand. She complains of right wrist pain when presenting to fracture clinic a few days later. Initial radiographs show a minimally displaced distal radius fracture ( Fig.1 A–C ).

Fig. 1, (A, B) Initial radiographs showing a minimally displaced distal radius fracture. (C, D) Radiographs following initial reduction and immobilization in the emergency department. (E, F) Radiographs at two weeks demonstrating conversion to fiberglass casting material and mild shortening of the fracture with maintained sagital alignment.

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