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Intramedullary Nailing for
Distal Radius Fractures: A
Systematic Review
RW Jordan, A Saithna
Southport and Ormskirk Hospit...
Introduction
 Distal radius fractures are common injuries
 No clear consensus regarding optimal
management of unstable f...
Methods
 Systematic review of the literature using the
online databases Medline and EMBASE
performed on the 1st of August...
Results
 16 studies were included for review
 The biomechanical studies concluded that
intramedullary nails had at least...
Conclusion
 IM nailing can give comparable clinical results to
current treatment modalities in extra-articular
and simple...
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Intramedullary nailing vs volar plating for distal radius fractures

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European Orthopaedic Research Society, Bristol, September 2015

Published in: Health & Medicine
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Intramedullary nailing vs volar plating for distal radius fractures

  1. 1. Intramedullary Nailing for Distal Radius Fractures: A Systematic Review RW Jordan, A Saithna Southport and Ormskirk Hospitals NHS Trust, Merseyside, UK
  2. 2. Introduction  Distal radius fractures are common injuries  No clear consensus regarding optimal management of unstable fractures  Open reduction and internal fixation with volar plates had become increasingly popular  Recent studies suggested K-wires as effective as plate fixation  Intramedullary nails are an alternative  Reduced risk of tendon injury  Reduced risk of intra-articular screw penetration  This article systematically reviews the biomechanics, outcomes and complications of intramedullary nails
  3. 3. Methods  Systematic review of the literature using the online databases Medline and EMBASE performed on the 1st of August 2014  All studies assessed adults who had sustained any type of distal radius fracture treated with an IM nail  Data regarding clinical outcomes and complications were extracted  These studies were appraised independently by both authors using a validated quality assessment scale
  4. 4. Results  16 studies were included for review  The biomechanical studies concluded that intramedullary nails had at least comparable strength to locking plates  The clinical studies reported that IM nailing was associated with comparable ROM, functional outcome and grip strength to alternative fixation techniques.  However, the mean complication rate was 17.6% (range 0 to 50%) with the most common complication being neurapraxia of the superficial radial nerve in 9.5%.
  5. 5. Conclusion  IM nailing can give comparable clinical results to current treatment modalities in extra-articular and simple intra-articular distal radius fractures.  However the evidence is insufficient to determine whether IM nailing has any clinically important advantage over well-established alternatives.  The complication rate reported is higher than that in contemporary studies for volar plating  Further adequately powered RCTs comparing the technique to volar plates and K-wire fixation are required

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