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Frank Scott - One of the best experts on this subject based on the ideXlab platform.

  • A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population
    European Journal of Orthopaedic Surgery & Traumatology, 2020
    Co-Authors: Trevor Jackson, Ethan Maulsby, Derek Wilson, Andy Lalka, Frank Scott
    Abstract:

    Introduction Distal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar–dorsal splint versus sugar-tong splint prior to conversion into a short arm Cast. Methods We performed a retrospective study of patients with distal radius fractures placed in a sugar-tong ( n  = 45) and volar–dorsal splint ( n  = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar–dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured. Results The average age was not significantly different between groups (Diff: 1.1 years, P  = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar–dorsal group (17.1 vs. 19, P  = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar–dorsal group (8.4 vs. 9.2, P  = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar–dorsal group ( P  = 0.696). Conclusion Our results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar–dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar–dorsal splint compared to a sugar-tong splint. Level of evidence Therapeutic level III.

Ingrid Kjellin - One of the best experts on this subject based on the ideXlab platform.

  • Does Thumb Immobilization Contribute to Scaphoid Fracture Stability?
    HAND, 2008
    Co-Authors: J. Mark Schramm, Minhthy Nguyen, Montri D. Wongworawat, Ingrid Kjellin
    Abstract:

    Immobilization protocols for nondisplaced scaphoid fractures have included the elbow, wrist, and thumb. This study attempts to demonstrate whether or not immobilization of the thumb makes a difference in preventing motion at the scaphoid fracture site. Using six fresh frozen forearm specimens, a transverse waist scaphoid fracture was created through a dorsal approach. Metallic markers were imbedded on either side of the fracture. Sutures were secured to the flexor pollicus longus (FPL) and extensor pollicus longus (EPL). Each specimen was loaded in extension and flexion by attaching 50-g weights to the EPL and FPL, first with no Casting, then with a short arm Cast, and finally a short arm thumb spica Cast. Angulation and displacement at the fracture site were measured in the coronal, sagittal, and axial planes utilizing image reconstructions from computed tomography. One-way ANOVA with repeated measures and Tukey–Kramer multiple comparison test post hoc analysis were used for statistical evaluation. There was no significant difference in fracture angulation or rotation between spica and short arm Casts. There was a significant difference in angulation and rotation in all three planes when comparing between Casting and no Casting, p  

  • Does Thumb Immobilization Contribute to Scaphoid Fracture Stability
    Hand, 2007
    Co-Authors: J. Mark Schramm, Minhthy Nguyen, Montri D. Wongworawat, Ingrid Kjellin
    Abstract:

    Immobilization protocols for nondisplaced scaphoid fractures have included the elbow, wrist, and thumb. This study attempts to demonstrate whether or not immobilization of the thumb makes a difference in preventing motion at the scaphoid fracture site. Using six fresh frozen forearm specimens, a transverse waist scaphoid fracture was created through a dorsal approach. Metallic markers were imbedded on either side of the fracture. Sutures were secured to the flexor pollicus longus (FPL) and extensor pollicus longus (EPL). Each specimen was loaded in extension and flexion by attaching 50-g weights to the EPL and FPL, first with no Casting, then with a short arm Cast, and finally a short arm thumb spica Cast. Angulation and displacement at the fracture site were measured in the coronal, sagittal, and axial planes utilizing image reconstructions from computed tomography. One-way ANOVA with repeated measures and Tukey–Kramer multiple comparison test post hoc analysis were used for statistical evaluation. There was no significant difference in fracture angulation or rotation between spica and short arm Casts. There was a significant difference in angulation and rotation in all three planes when comparing between Casting and no Casting, p < 0.05. In our cadaveric model, wrist immobilization is crucial for nondisplaced scaphoid waist fractures, and short arm Casting was just as effective as thumb spica Casting in preventing fracture displacement.

Trevor Jackson - One of the best experts on this subject based on the ideXlab platform.

  • A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population
    European Journal of Orthopaedic Surgery & Traumatology, 2020
    Co-Authors: Trevor Jackson, Ethan Maulsby, Derek Wilson, Andy Lalka, Frank Scott
    Abstract:

    Introduction Distal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar–dorsal splint versus sugar-tong splint prior to conversion into a short arm Cast. Methods We performed a retrospective study of patients with distal radius fractures placed in a sugar-tong ( n  = 45) and volar–dorsal splint ( n  = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar–dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured. Results The average age was not significantly different between groups (Diff: 1.1 years, P  = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar–dorsal group (17.1 vs. 19, P  = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar–dorsal group (8.4 vs. 9.2, P  = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar–dorsal group ( P  = 0.696). Conclusion Our results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar–dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar–dorsal splint compared to a sugar-tong splint. Level of evidence Therapeutic level III.

  • A comparison of sugar-tong and volar-dorsal splints for provisional immobilization of distal radius fractures in the adult population.
    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020
    Co-Authors: Trevor Jackson, Ethan Maulsby, Derek Wilson, Andy Lalka, Frank I. Scott
    Abstract:

    INTRODUCTION Distal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar-dorsal splint versus sugar-tong splint prior to conversion into a short arm Cast. METHODS We performed a retrospective study of patients with distal radius fractures placed in a sugar-tong (n = 45) and volar-dorsal splint (n = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar-dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured. RESULTS The average age was not significantly different between groups (Diff: 1.1 years, P = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar-dorsal group (17.1 vs. 19, P = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar-dorsal group (8.4 vs. 9.2, P = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar-dorsal group (P = 0.696). CONCLUSION Our results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar-dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar-dorsal splint compared to a sugar-tong splint. LEVEL OF EVIDENCE Therapeutic level III.

Louis Lawton - One of the best experts on this subject based on the ideXlab platform.

  • A Randomized, Controlled Trial of Removable Splinting Versus Casting for Wrist Buckle Fractures in Children
    Pediatrics, 2006
    Co-Authors: Amy C Plint, Jeffrey J. Perry, Rhonda Correll, Isabelle Gaboury, Louis Lawton
    Abstract:

    OBJECTIVE. Wrist buckle fractures are a frequent reason for emergency department visits. Although textbooks recommend 2 to 4 weeks of immobilization in a short arm Cast, management varies. Treatment with both Casts and splints is common, and length of immobilization varies. The objective was to determine if children with distal radius and/or ulna buckle fractures treated with a removable splint have better physical functioning than those treated with a short arm Cast for 3 weeks. METHODS. This was a randomized, controlled trial in the emergency department of an academic, tertiary care children’s hospital. Participants were children 6 to 15 years of age with distal radius and/or ulna buckle fractures who were randomly assigned to treatment with a short arm Cast for 3 weeks or a removable splint. Cast removal was at 3 weeks. A validated self-reported outcome tool, the Activities Scales for Kids performance version (ASKp), was used to measure physical functioning over a 4-week period. The main outcome was the ASKp score at 14 days postinjury. RESULTS. We randomly assigned 113 patients, and 87 were included in the final analysis: 42 in the splint group and 45 in the Cast group. Study groups were similar in age, gender, bone fractured, and dominant hand injured. There were significant differences in ASKp score at day 14 and change in ASKp from baseline at days 14 and 20, indicating better functioning in the splint group. Splinted children had less difficulty with bathing throughout the entire study. There were no significant differences in pain between groups as measured by visual analog scale. There were no refractures. CONCLUSIONS. Children treated with removable splinting have better physical functioning and less difficulty with activities than those treated with a Cast.

Andy Lalka - One of the best experts on this subject based on the ideXlab platform.

  • A comparison of sugar-tong and volar–dorsal splints for provisional immobilization of distal radius fractures in the adult population
    European Journal of Orthopaedic Surgery & Traumatology, 2020
    Co-Authors: Trevor Jackson, Ethan Maulsby, Derek Wilson, Andy Lalka, Frank Scott
    Abstract:

    Introduction Distal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar–dorsal splint versus sugar-tong splint prior to conversion into a short arm Cast. Methods We performed a retrospective study of patients with distal radius fractures placed in a sugar-tong ( n  = 45) and volar–dorsal splint ( n  = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar–dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured. Results The average age was not significantly different between groups (Diff: 1.1 years, P  = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar–dorsal group (17.1 vs. 19, P  = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar–dorsal group (8.4 vs. 9.2, P  = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar–dorsal group ( P  = 0.696). Conclusion Our results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar–dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar–dorsal splint compared to a sugar-tong splint. Level of evidence Therapeutic level III.

  • A comparison of sugar-tong and volar-dorsal splints for provisional immobilization of distal radius fractures in the adult population.
    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020
    Co-Authors: Trevor Jackson, Ethan Maulsby, Derek Wilson, Andy Lalka, Frank I. Scott
    Abstract:

    INTRODUCTION Distal radius fractures are extremely common injuries affecting a wide range of patient demographics. The purpose of this study was to evaluate the outcomes of distal radius fractures managed initially with closed reduction and immobilization in either a below elbow volar-dorsal splint versus sugar-tong splint prior to conversion into a short arm Cast. METHODS We performed a retrospective study of patients with distal radius fractures placed in a sugar-tong (n = 45) and volar-dorsal splint (n = 36). Anteroposterior and lateral radiographs were evaluated immediately after closed reduction and placement into either a sugar-tong or volar-dorsal splint. The radial inclination, radial length, volar tilt, and intra-articular displacement were measured. RESULTS The average age was not significantly different between groups (Diff: 1.1 years, P = 0.8766). Initial clinic follow-up radiographs illustrated significantly lower radial inclination in the sugar-tong group than volar-dorsal group (17.1 vs. 19, P = 0.0443). Follow-up mean radial length was not significantly lower in the sugar-tong than volar-dorsal group (8.4 vs. 9.2, P = 0.0858). Palmar tilt and articular step-off was not significantly different between splint types. The loss of reduction was 28.8% for the sugar-tong and 25.0% for the volar-dorsal group (P = 0.696). CONCLUSION Our results did not demonstrate a significant difference in loss of reduction rates between the two splint groups. There was no significant difference between the sugar-tong and volar-dorsal groups in terms of loss of radial length and volar tilt. Loss of reduction was similar between groups suggesting no advantage of a volar-dorsal splint compared to a sugar-tong splint. LEVEL OF EVIDENCE Therapeutic level III.