Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jan 23;2008(1):CD006522.
doi: 10.1002/14651858.CD006522.pub2.

Different methods of external fixation for treating distal radial fractures in adults

H H G Handoll  1 , J S Huntley, R Madhok
Affiliations

Different methods of external fixation for treating distal radial fractures in adults

H H G Handoll et al. Cochrane Database Syst Rev. .

Abstract

Background: Fracture of the distal radius is a common injury. A surgical treatment is external fixation, where metal pins inserted into bone on either side of the fracture are then fixed to an external frame.

Objectives: To evaluate the evidence from randomised controlled trials comparing different methods of external fixation for distal radial fractures in adults.

Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and other databases, conference proceedings and reference lists of articles. No language restrictions were applied.

Selection criteria: Randomised or quasi-randomised controlled clinical trials which compared different methods of external fixation in adults with a distal radial fracture.

Data collection and analysis: All review authors independently performed study selection. Two authors independently assessed the included trials and performed data extraction.

Main results: Nine small trials involving 510 adults with potentially or evidently unstable fractures, were grouped into five comparisons. The interventional, clinical and methodological heterogeneity of trials precluded data pooling. Only one trial had secure allocation concealment. Two trials comparing a bridging (of the wrist) external fixator versus pins and plaster external fixation found no significant differences in function or deformity. One trial found tendencies for more serious complications but less subsequent discomfort and deformity in the fixator group. Three trials compared non-bridging versus bridging fixation. Of the two trials testing uni-planar non-bridging fixation, one found no significant differences in functional or clinical outcomes; the other found non-bridging fixation significantly improved grip strength, wrist flexion and anatomical outcome. The third trial found no significant findings in favour of multi-planar non-bridging fixation of complex intra-articular fractures. One trial using a bridging external fixator found that deploying an extra external fixator pin to fix the 'floating' distal fragment gave superior functional and anatomical results. One trial found no evidence of differences in clinical outcomes for hydroxyapatite coated pins compared with standard uncoated pins. Two trials compared dynamic versus static external fixation. One trial found no significant effects from early dynamism of an external fixator. The poor quality of the other trial undermines its findings of poorer functional and anatomical outcomes for dynamic fixation.

Authors' conclusions: There is insufficient robust evidence to determine the relative effects of different methods of external fixation. Adequately powered studies could provide better evidence.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 External fixator versus pins and plaster external fixation, Outcome 1 Functional grading: fair (or poor).
1.2
1.2. Analysis
Comparison 1 External fixator versus pins and plaster external fixation, Outcome 2 Subjective assessment of function.
1.3
1.3. Analysis
Comparison 1 External fixator versus pins and plaster external fixation, Outcome 3 Grip strength (% or normal side).
1.4
1.4. Analysis
Comparison 1 External fixator versus pins and plaster external fixation, Outcome 4 Complications.
1.5
1.5. Analysis
Comparison 1 External fixator versus pins and plaster external fixation, Outcome 5 Patient dissatisfaction with outcome.
1.6
1.6. Analysis
Comparison 1 External fixator versus pins and plaster external fixation, Outcome 6 Anatomical grading: fair or poor.
2.1
2.1. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 1 DASH scores (0 to 100: most disability).
2.2
2.2. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 2 SF‐12 physical domain scores (0 onwards; higher better: population mean = 50).
2.3
2.3. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 3 Grip strength (kg).
2.4
2.4. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 4 Mass grip strength (% of normal side).
2.5
2.5. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 5 Residual pain.
2.6
2.6. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 6 Pain (VAS 0 to 100: worst).
2.7
2.7. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 7 Range of motion (degrees).
2.8
2.8. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 8 Range of motion (% of normal side).
2.9
2.9. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 9 Complications.
2.10
2.10. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 10 Patient dissatisfaction with outcome.
2.11
2.11. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 11 Anatomical displacement.
2.12
2.12. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 12 Anatomical measurements.
2.13
2.13. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 13 Deformity (structural).
2.14
2.14. Analysis
Comparison 2 Non‐bridging versus bridging external fixation, Outcome 14 Length of surgery (minutes).
3.1
3.1. Analysis
Comparison 3 Supplementary percutanous pinning of distal radial fracture fragment, Outcome 1 Functional gradings.
3.2
3.2. Analysis
Comparison 3 Supplementary percutanous pinning of distal radial fracture fragment, Outcome 2 Grip strength (% of normal side).
3.3
3.3. Analysis
Comparison 3 Supplementary percutanous pinning of distal radial fracture fragment, Outcome 3 Range of motion (% of normal side).
3.4
3.4. Analysis
Comparison 3 Supplementary percutanous pinning of distal radial fracture fragment, Outcome 4 Complications.
3.5
3.5. Analysis
Comparison 3 Supplementary percutanous pinning of distal radial fracture fragment, Outcome 5 Ulnar plus variance.
3.6
3.6. Analysis
Comparison 3 Supplementary percutanous pinning of distal radial fracture fragment, Outcome 6 Length of surgery (minutes).
4.1
4.1. Analysis
Comparison 4 Hydroxyapatite coated versus standard pins, Outcome 1 Complications.
4.2
4.2. Analysis
Comparison 4 Hydroxyapatite coated versus standard pins, Outcome 2 Torque for insertion and removal of pins (Nmm).
5.1
5.1. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 1 Functional gradings.
5.2
5.2. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 2 Mass grip strength (% of normal side).
5.3
5.3. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 3 Range of movement (% of normal side).
5.4
5.4. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 4 Complications.
5.5
5.5. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 5 Anatomical displacement.
5.6
5.6. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 6 Anatomical measurements.
5.7
5.7. Analysis
Comparison 5 Dynamic versus static fixation, Outcome 7 Deformity (structural).
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD006522

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Atroshi 2006 {published and unpublished data}
    1. Atroshi I. personal communication March 7 2007.
    1. Atroshi I, Brogren E, Larsson G‐U, Kloow J, Hofer M, Berggren A‐M. Wrist‐bridging versus non‐bridging external fixation for displaced distal radius fractures: A randomized assessor‐blind clinical trial of 38 patients followed for 1 year. Acta Orthopaedica 2006;77(3):445‐53. - PubMed
Hutchinson 1995 {published and unpublished data}
    1. Hutchinson DT, Ewert GO. Pins and plaster versus external fixation in the treatment of unstable distal radius fractures: A randomized, prospective study [abstract]. Orthopaedic Transactions 1990;14(3):588‐9.
    1. Hutchinson DT, Strenz GO, Cautilli RA. Pins and plaster vs external fixation in the treatment of unstable distal radial fractures. A randomized prospective study. Journal of Hand Surgery ‐ British Volume 1995;20(3):365‐72. - PubMed
Krishnan 2003 {published and unpublished data}
    1. Krishnan J, Wigg AER, Walker RW, Slavotinek J. Intra‐articular fractures of the distal radius: a prospective randomised controlled trial comparing static bridging and dynamic non‐bridging external fixation. Journal of Hand Surgery ‐ British Volume 2003; Vol. 28, issue 5:417‐21. - PubMed
    1. Walker R, Wigg A, Krishnan J, Slavotinek J. Intra‐articular fractures of the distal radius: A prospective randomised trial comparing bridging and non‐bridging external fixation [abstract]. Journal of Bone & Joint Surgery ‐ British Volume 2003;85 Suppl 1:27‐8. - PubMed
    1. Wigg A, Walker R, Krishnan J. Intra‐articular fractures of the distal radius: Bridging vs non‐bridging external fixation [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2001;83 Suppl 3:334‐5.
    1. Wigg A, Walker R, Krishnan J. Intra‐articular fractures of the distal radius: Bridging vs non‐bridging external fixation [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2001;83 Suppl 4:405.
    1. Wigg A, Walker R, Krishnan J. Intra‐articular fractures of the distal radius: Bridging vs non‐bridging external fixation [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2002;84 Suppl 3:214.
McQueen 1996 {published data only}
    1. McQueen MM, Court‐Brown CM. Unstable fractures of the distal radius: a prospective randomized comparison of four treatment methods [abstract]. Orthopaedic Transactions 1997;21(2):595‐6.
    1. McQueen MM, Hajducka C, Court‐Brown CM. Redisplaced unstable fractures of the distal radius. A prospective randomised comparison of four methods of treatment. Journal of Bone and Joint Surgery ‐ British Volume 1996;78(3):404‐9. - PubMed
McQueen 1998 {published data only}
    1. Casteleyn PP. Redisplaced unstable fractures of the distal radius [letter]. Journal of Bone and Joint Surgery ‐ British Volume 1999;81(2):368. - PubMed
    1. McQueen MM. Non‐bridging external fixation of the distal radius [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 1999;81 Suppl 2:126. - PubMed
    1. McQueen MM. Redisplaced unstable fractures of the distal radius. A randomised, prospective study of bridging versus non‐bridging external fixation. Journal of Bone and Joint Surgery ‐ British Volume 1998;80(4):665‐9. - PubMed
    1. McQueen MM, Hajducka C, Court‐Brown CM. Unstable fractures of the distal radius: metaphyseal versus bridging external fixation [abstract]. Orthopaedic Transactions 1997;21(2):622‐3.
Moroni 2001 {published data only}
    1. Moroni A, Faldini C, Marchetti S, Manca M, Consoli V, Giannini S. Fixation in osteoporotic bone using hydroxyapatite‐coated tapered external fixation pins ‐ a prospective randomized study in wrist fractures [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2001;83 Suppl 2:228. - PubMed
    1. Moroni A, Faldini C, Marchetti S, Manca M, Consoli V, Giannini S. Improvement of the bone pin interface in osteoporotic bone using hydroxyaptite‐coated tapered external fixation pins. A prospective randomized clinical study in wrist. 67th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2000 Mar 15‐19; Orlando (FL). AAOS On‐Line Service, 2000:http://www.aaos.org/wordhtml/anmt2000/sciprog/099.htm (accessed 31/08/2000).
    1. Moroni A, Faldini C, Marchetti S, Manca M, Consoli V, Giannini S. Improvement of the bone‐pin interface strength in osteoporotic bone with use of hydroxyapatite‐coated tapered external‐fixation pins. A prospective, randomized clinical study of wrist fractures. Journal of Bone and Joint Surgery ‐ American Volume 2001;83‐A(5):717‐21. - PubMed
    1. Moroni A, Marchetti S, Manca M, Consoli V, Giannini S. Fixation improvement in osteoporotic bone using hydroxyapatite‐coated tapered external fixation pins: A prospective randomized study in wrist fractures [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2001;83 Suppl 2:229. - PubMed
Raskin 1993 {published data only}
    1. Raskin KB, Melone CP. Unstable articular fractures of the distal radius. Comparative techniques of ligamentotaxis. Orthopedic Clinics of North America 1993;24(2):275‐86. - PubMed
Sommerkamp 1994 {published data only}
    1. Sommerkamp TG. Unstable distal radius fractures: A prospective randomized comparison of static versus dynamic external fixation [abstract]. Orthopaedic Transactions 1990;14(1):97‐8.
    1. Sommerkamp TG, Seeman M, Silliman J, Jones A, Patterson S, Walker J, et al. Dynamic external fixation of unstable fractures of the distal part of the radius. A prospective, randomized comparison with static external fixation. Journal of Bone and Joint Surgery ‐ American Volume 1994;76(8):1149‐61. - PubMed
Werber 2003 {published data only}
    1. Werber KD, Brauer R. New management in treatment of distal radius fractures using external fixation with five pins instead of four pins [abstract]. Journal of Hand Surgery ‐ British Volume 1999;24 Suppl 1:18.
    1. Werber KD, Brauer RB, Raeder F. New management in treatment of distal radius fracture using external fixation with five pins instead of four pins [abstract]. Journal of Hand Surgery ‐ British Volume 1997;22 Suppl 1:58.
    1. Werber KD, Raeder F, Brauer RB, Weiss S. External fixation of distal radial fractures: four compared with five pins: a randomized prospective study. Journal of Bone and Joint Surgery ‐ American Volume 2003;85‐A(4):660‐6. - PubMed

References to studies excluded from this review

Asche 1995 {published data only}
    1. Asche G. Treatment of radius fractures with a newly developed dynamic external fixator [Die Behandlung von Speichenbruchen mit einem neu entwickelten dynamischen Bewegungsfixateur]. Zentralblatt fur Chirurgie 1995;120(12):952‐8. - PubMed
    1. Asche G, Rader L, Jung K. The treatment of distal radius fractures with a newly developed movement fixator [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 1995;77 Suppl 2:149.
Auge 2000 {published data only}
    1. Auge WK 2nd, Velazquez PA. The application of indirect reduction techniques in the distal radius: The role of adjuvant arthroscopy. Arthroscopy 2000;16(8):830‐5. - PubMed
Cardone 2006 {published data only}
    1. Cardone L, Simpson H, McQueen M, Ekrol I, Muir A, McGeough J. Technique to assess the rigidity of callus bone during external fixation of distal radial fractures [abstract]. Journal of Bone & Joint Surgery ‐ British Volume 2006;88 Suppl 3:396.
Hutchinson 2000 {published data only}
    1. Hutchinson DT, Bachus KN, Higgenbotham T. External fixation of the distal radius: To predrill or not to predrill. Journal of Hand Surgery ‐ American Volume 2000;25(6):1064‐8. - PubMed
Rawes 1995 {published and unpublished data}
    1. Rawes ML, Richardson JB, Hardy JRW, Dias JJ. Dynamic versus static external fixation of distal radial fractures: a prospective randomized controlled trial [abstract]. Injury 1995;26(2):140.
Stoffelen 1999 {published data only}
    1. Stoffelen D, Broos P. The value of wrist arthroscopy in distal radius fractures [abstract]. Journal of Bone and Joint Surgery ‐ British Volume 1999;81 Suppl 2:166.
Stokes 1998 {published data only}
    1. Stokes H, George E. Extraarticular versus transarticular external fixation of distal radius fractures [abstract]. Orthopaedic Transactions 1998;22(2):436‐7.
Tortosa 1995 {published data only}
    1. Tortosa RD, Chambers T. Distal radial fractures ‐ uni‐planer or multi‐planer ligamentotaxis [abstract]. Orthopaedic Transactions 1995;19(3):817.

References to studies awaiting assessment

Basdekis 2005 {published and unpublished data}
    1. Basdekis G, Varitimidis S, Dailiana Z, Bargiotas K, Hantes M, Malizos KN, Jones AL, Schmidt AH. Intra‐articular distal radius fractures: fluoroscopic or arthroscopic reduction? [abstract]. Annual Meeting of the American Academy of Orthopaedic Surgeons; 2006 March 22‐26: Chicago (IL). AAOS On‐Line Service, 2006:http://www3.aaos.org/education/anmeet/anmt2006/podium/podium.cfm?Pevent=075 (accessed 13/09/06).
    1. Basdekis G, Varitimidis S, Dailiana Z, Hantes M, Bargiotas K, Malizos K. Intraarticular distal radius fractures: fluoroscopic or arthroscopic reduction? [abstract]. Journal of Hand Surgery ‐ British Volume 2005;30 Suppl 1:7. - PubMed
    1. Basdekis GK, Varitimidis S, Dailiana ZH, Hantes ME, Bargiotas K, Malizos KN. Intra‐articular distal radius fractures: fluoroscopic or arthroscopic reduction? [abstract]. Journal of Bone & Joint Surgery ‐ British Volume 2006;88 Suppl 1:187. - PubMed
Hove 2005 {published data only}
    1. Hove LM, Helland P, Finsen V, Revheim K, Molster AO. Dynamic versus static external fixation of fractures of the distal radius. A prospective, randomized, multicentre study [abstract]. Journal of Hand Surgery ‐ British Volume 2005;30 Suppl 1:8‐9.
    1. Hove LM, Helland P, Molster AO. Dynamic traction for unstable fractures of the distal radius. Journal of Hand Surgery ‐ British Volume 1999;24(2):210‐4. - PubMed
McQueen 2006 {unpublished data only}
    1. McQueen M. External fixation with percutaneous pinning versus non‐spanning external fixation verus open reduction with locked volar plate fixation for unstable distal radius fractures ‐ a prospective randomised study. In: The National Research Register, Issue 3, 2006. Oxford: Update Software.
Tornetta 2005 {published data only}
    1. Einhorn TA, Creevy WR, Levin R, Siegel J, Sung J, Tornetta PI. Reuse of external fixation components: A prospective randomized trial [abstract]. Annual Meeting of the American Academy of Orthopaedic Surgeons; 2006 March 22‐26: Chicago (IL). AAOS On‐Line Service, 2006:http://www3.aaos.org/education/anmeet/anmt2006/podium/podium.cfm?Pevent=... (accessed 13/09/06).
    1. Tornetta P. personal correspondence March 13 2007.
    1. Tornetta PI, Einhorn TA, Creevy WR, Levin R, Siegel J, Sung J. Reuse of external fixation components: A prospective randomized trial [abstract]. Orthopaedic Trauma Association Annual Meeting Oct 20‐25 2005, Ottawa, Ontario. 2005:http://www.hwbf.org/ota/am/ota05/otapa/OTA050306.htm (accessed 25/01/2006).

Additional references

Altissimi 1986
    1. Altissimi M, Antenucci R, Fiacca C, Mancini GB. Long‐term results of conservative treatment of fractures of the distal radius. Clinical Orthopaedics and Related Research 1986;(206):202‐10. - PubMed
Altman 2003
    1. Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ 2003;326(7382):219. - PMC - PubMed
Amadio 2001
    1. Amadio PC. Outcome assessment in hand surgery and hand therapy: an update. Journal of Hand Therapy 2001;14(2):63‐7. - PubMed
Andersen 1996
    1. Andersen DJ, Blair WF, Steyers CM Jr, Adams BD, Khouri GY, Brandser EA. Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility. Journal of Hand Surgery ‐ American Volume 1996;21(4):574‐82. - PubMed
Atkins 1989
    1. Atkins RM, Duckworth T, Kanis JA. Algodystrophy following Colles' fracture. Journal of Hand Surgery ‐ British Volume 1989;14(2):161‐4. - PubMed
Atkins 2004
    1. Atkins RM. Aspects of current management: Complex regional pain syndome. Journal of Bone & Joint Surgery ‐ British Volume 2004;85(8):1100‐6. - PubMed
Belsole 1993
    1. Belsole RJ, Hess AV. Concomitant skeletal and soft tissue injuries. Orthopedic Clinics of North America 1993;24(2):327‐31. - PubMed
BMJ 2006
    1. A guide to the text. Clinical Evidence Online http://www.clinicalevidence.com/ceweb/about/guide.jsp (accessed 24 March 2006).
Capo 2006
    1. Capo JT, Swan KG Jr, Tan V. External fixation techniques for distal radius fractures. Clinical Orthopaedics and Related Research 2006;445:30‐41. - PubMed
Chitnavis 1999
    1. Chitnavis J. The wrist. In: Pynsent PB, Fairbank JC, Carr AJ editor(s). Classification of musculoskeletal trauma. Oxford: Butterworth Heinemann, 1999:146‐70.
Cooney 1980
    1. Cooney WP 3rd, Dobyns JH, Linscheid RL. Complications of Colles' fractures. Journal of Bone and Joint Surgery ‐ American Volume 1980;62(4):613‐9. - PubMed
Cooney 1993
    1. Cooney WP. Fractures of the distal radius. A modern treatment‐based classification. Orthopedic Clinics of North America 1993;24(2):211‐6. - PubMed
Cummings 1985
    1. Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiologic Reviews 1985;7:178‐208. - PubMed
Fernandez 1996
    1. Fernandez DL, Jupiter JB. Fractures of the distal radius. A practical approach to management. 1st Edition. New York: Springer‐Verlag, 1996.
Fernandez 1999
    1. Fernandez DL, Palmer AK. Fractures of the distal radius. In: Green DP, Hotchkiss RN, Pederson WC editor(s). Green's Operative Hand Surgery. 4th Edition. New York: Churchill Livingstone, 1999:929‐85.
Flinkkila 1998
    1. Flinkkila T, Raatikainen T, Hamalainen M. AO and Frykman's classifications of Colles' fracture. No prognostic value in 652 patients evaluated after 5 years. Acta Orthopaedica Scandinavica 1998;69(1):77‐81. - PubMed
Frykman 1967
    1. Frykman G. Fracture of the distal radius including sequelae‐‐shoulder‐hand‐finger syndrome, disturbance in the distal radio‐ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthopaedica Scandinavica Supplementum 1967;108:3‐153. - PubMed
Gartland 1951
    1. Gartland JJ, Werley CW. Evaluation of healed Colles' fractures. Journal of Bone and Joint Surgery ‐ American Volume 1951;33(4):895‐910. - PubMed
Handoll 2003a
    1. Handoll HH, Madhok R. Surgical interventions for treating distal radial fractures in adults (Cochrane review). Cochrane Database of Systematic Reviews 2003, Issue 3. - PubMed
Handoll 2003b
    1. Handoll HH, Madhok R. Conservative interventions for treating distal radial fractures in adults. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD000314] - DOI - PubMed
Handoll 2003c
    1. Handoll HHG, Madhok R. From evidence to best practice in the management of fractures of the distal radius in adults: working towards a research agenda. BMC Musculoskeletal Disorders 2003;4(27). - PMC - PubMed
Handoll 2007
    1. Handoll HHG, Huntley JS, Madhok R. External fixation versus conservative treatment for distal radial fractures in adults. Cochrane Database of Systematic Reviews 2007, Issue 3. [DOI: 10.1002/14651858.CD006194.pub2] - DOI - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2005
    1. Higgins JPT, Green S, editors. Highly sensitive search strategies for identifying reports of randomized controlled trials in MEDLINE. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]; Appendix 5b. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd.
Jupiter 1997
    1. Jupiter JB, Fernandez DL. Comparative classification for fractures of the distal end of the radius. Journal of Hand Surgery ‐ American Volume 1997;22(4):563‐71. - PubMed
Kapandji 1988
    1. Kapandji IA, Epinette J‐A. Colles' fracture: treatment by double intrafocal wire fixation. In: Razemon JP, Fisk GR editor(s). The wrist. Edinburgh: Churchill Livingstone, 1988:65‐73.
Knirk 1986
    1. Knirk JL, Jupiter JB. Intra‐articular fractures of the distal end of the radius in young adults. Journal of Bone and Joint Surgery ‐ American Volume 1986;68(5):647‐59. - PubMed
Kreder 1996a
    1. Kreder HJ, Hanel DP, McKee M, Jupiter J, McGillivary G, Swiontkowski MF. X‐ray film measurements for healed distal radius fractures [published erratum appears in J Hand Surg [Am] 1996 May;21(3):532]. Journal of Hand Surgery ‐ American Volume 1996;21(1):31‐9. - PubMed
Kreder 1996b
    1. Kreder HJ, Hanel DP, McKee M, Jupiter J, McGillivary G, Swiontkowski MF. Consistency of AO fracture classification for the distal radius. Journal of Bone & Joint Surgery ‐ British Volume 1996;78(5):726‐31. - PubMed
Lidstrom 1959
    1. Lidstrom A. Fractures of the distal end of the radius. Acta Orthopaedica Scandinavica Supplementum 1959;41:5‐118. - PubMed
MacDermid 2000
    1. MacDermid JC, Richards RS, Donner A, Bellamy N, Roth JH. Responsiveness of the short form‐36, disability of the arm, shoulder, and hand questionnaire, patient‐rated wrist evaluation, and physical impairment measurements in evaluating recovery after a distal radius fracture. Journal of Hand Surgery ‐ American Volume 2000;25(2):330‐40. - PubMed
McKay 2001
    1. McKay SD, MacDermid JC, Roth JH, Richards RS. Assessment of complications of distal radius fractures and development of a complication checklist. Journal of Hand Surgery ‐ American Volume 2001;26(5):916‐22. - PubMed
Melone 1993
    1. Melone CPJr. Distal radius fractures: patterns of articular fragmentation. Orthopedic Clinics of North America 1993;24(2):239‐53. - PubMed
Muller 1991
    1. Muller M, Allgower M, Schneider R, Willenegger H. Manual of internal fixation: techniques recommended by the AO‐ASIF Group. 3rd Edition. Berlin: Springer‐Verlag, 1991.
O'Neill 2001
    1. O'Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, et al. Incidence of distal forearm fracture in British men and women. Osteoporosis International 2001;12(7):555‐8. - PubMed
Older 1965
    1. Older TM, Stabler EV, Cassebaum WH. Colles fracture: Evaluation and selection of therapy. Journal of Trauma 1965;5(4):469‐76. - PubMed
Pennig 1996
    1. Pennig D, Gausepohl T. External fixation of the wrist. Injury 1996;27(1):1‐15. - PubMed
Sahlin 1990
    1. Sahlin Y. Occurrence of fractures in a defined population: a 1‐year study. Injury 1990;21(3):158‐60. - PubMed
Singer 1998
    1. Singer BR, McLauchlan GJ, Robinson CM, Christie J. Epidemiology of fractures in 15,000 adults: the influence of age and gender. Journal of Bone and Joint Surgery ‐ British Volume 1998;80(2):243‐8. - PubMed
Smith 1988
    1. Smith RJ, Floyd WE. Smith's and Barton's fractures. In: Barton N editor(s). Fractures of the hand and wrist. Edinburgh: Churchill Livingstone, 1988:252‐66.
Taleisnik 1984
    1. Taleisnik J, Watson HK. Midcarpal instability caused by malunited fractures of the distal radius. Journal of Hand Surgery ‐ American Volume 1984;9(3):350‐7. - PubMed
Temple 2004
    1. Temple J, Santy J. Pin site care for preventing infections associated with external bone fixators and pins (Cochrane Review). Cochrane Database of Systematic Reviews 2004, Issue 1. - PubMed
Van Staa 2001
    1. Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001;29(6):517‐22. - PubMed

Publication types