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
Meta-Analysis
. 2008 Apr 16;2008(2):CD006836.
doi: 10.1002/14651858.CD006836.pub2.

Bone grafts and bone substitutes for treating distal radial fractures in adults

H H G Handoll  1 , A C Watts
Affiliations
Meta-Analysis

Bone grafts and bone substitutes for treating distal radial fractures in adults

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

Abstract

Background: Surgical treatment of fractures of the distal radius can involve the implantation of bone scaffolding materials (bone grafts and substitutes) into bony defects that frequently arise after fracture reduction.

Objectives: To review the evidence from randomised controlled trials evaluating the implanting of bone scaffolding materials for treating 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. No language restrictions were applied.

Selection criteria: Randomised or quasi-randomised controlled clinical trials evaluating the use of bone scaffolding for treating distal radial fracture in adults.

Data collection and analysis: Two people independently selected studies and undertook assessment and data collection.

Main results: Ten heterogenous trials involving 874 adults with generally unstable fractures were grouped into six comparisons. No trial had proven allocation concealment. Four trials (239 participants) found implantation of bone scaffolding (autogenous bone graft (one trial); Norian SRS - a bone substitute (two trials); methylmethacrylate cement (one trial)) improved anatomical outcomes compared with plaster cast alone; and two found it improved function. Reported complications of bone scaffolding were transient discomfort resulting from extraosseous deposits of Norian SRS; with surgical removal of one intra-articular deposit. One trial (323 participants) comparing bone substitute (Norian SRS) versus plaster cast or external fixation found no difference in functional or anatomical outcomes at one year. Statistically significant complications in the respective groups were extraosseous Norian SRS deposits and pin track infection. One trial (48 participants with external fixation) found that autogenous bone graft did not significantly change outcome. There was one serious donor-site complication. One trial (21 participants) found some indication of worse outcomes for hydroxyapatite bone cement compared with Kapandji's intrafocal pinning. Three trials (180 participants) found bone scaffolding (autogenous bone graft (one trial); Norian SRS (one trial); methylmethacrylate cement (one trial)) gave no significant difference in functional outcomes but some indication of better anatomical outcomes compared with external fixation. Most reported complications were associated with external fixation; extraosseous deposits of Norian SRS occurred in one trial. One trial (93 participants with dorsal plate fixation) found autografts slightly improved wrist function compared with allogenic bone material but with an excess of donor site complications.

Authors' conclusions: Bone scaffolding may improve anatomical outcome compared with plaster cast alone but there is insufficient evidence to conclude on functional outcome and safety; or for other comparisons.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 1 Functional gradings.
1.2
1.2. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 2 Non recovery of full grip strength.
1.3
1.3. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 3 Mass grip strength (% of normal side).
1.4
1.4. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 4 Pain at 6 months (VAS: 0 (none) to 100 mm (unbearable)).
1.5
1.5. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 5 Long term pain.
1.6
1.6. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 6 Non‐recovery of full range of movement.
1.7
1.7. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 7 Range of movement (% of normal side).
1.8
1.8. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 8 Complications.
1.9
1.9. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 9 Anatomical displacement.
1.10
1.10. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 10 Anatomical measurements.
1.11
1.11. Analysis
Comparison 1 Bone scaffolding (graft/substitute) versus plaster cast, Outcome 11 Deformity (cosmetic and structural).
2.1
2.1. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 1 Unsuccessful functional outcome.
2.2
2.2. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 2 Grip strength (% or normal side).
2.3
2.3. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 3 Pain.
2.4
2.4. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 4 Range of movement (% of normal side).
2.5
2.5. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 5 10% or more deficit in range of motion compared with normal side.
2.6
2.6. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 6 Complications.
2.7
2.7. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 7 Anatomical measurements.
2.8
2.8. Analysis
Comparison 2 Bone substitute versus control (plaster or external fixation), Outcome 8 Unsuccessful radiographic outcome measures.
3.1
3.1. Analysis
Comparison 3 Bone graft, external fixation then plaster cast versus external fixation, Outcome 1 Poor function and grip strength (at 1 year).
3.2
3.2. Analysis
Comparison 3 Bone graft, external fixation then plaster cast versus external fixation, Outcome 2 Mass grip strength (% of normal side).
3.3
3.3. Analysis
Comparison 3 Bone graft, external fixation then plaster cast versus external fixation, Outcome 3 Range of movement (% of normal side).
3.4
3.4. Analysis
Comparison 3 Bone graft, external fixation then plaster cast versus external fixation, Outcome 4 Complications.
3.5
3.5. Analysis
Comparison 3 Bone graft, external fixation then plaster cast versus external fixation, Outcome 5 Anatomical measurements.
3.6
3.6. Analysis
Comparison 3 Bone graft, external fixation then plaster cast versus external fixation, Outcome 6 Deformity (severe malunion).
4.1
4.1. Analysis
Comparison 4 Bone substitute versus percutaneous pinning, Outcome 1 Palmar flexion (degrees).
4.2
4.2. Analysis
Comparison 4 Bone substitute versus percutaneous pinning, Outcome 2 Complications.
5.1
5.1. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 1 Functional gradings.
5.2
5.2. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 2 Non recovery of full grip strength.
5.3
5.3. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 3 Mass grip strength (% of normal side).
5.4
5.4. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 4 Persistent pain (during carrying or lifting).
5.5
5.5. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 5 Non‐recovery of full range of movement.
5.6
5.6. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 6 Range of movement (% of normal side).
5.7
5.7. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 7 Complications.
5.8
5.8. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 8 Anatomical displacement.
5.9
5.9. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 9 Anatomical measurements.
5.10
5.10. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 10 Long term redisplacement.
5.11
5.11. Analysis
Comparison 5 Bone scaffolding (graft/substitute) versus external fixation, Outcome 11 Deformity (cosmetic and structural).
6.1
6.1. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 1 Moderate or severe restrictions in everyday life.
6.2
6.2. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 2 Functional gradings.
6.3
6.3. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 3 Grip strength (% of normal hand).
6.4
6.4. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 4 Discomforting or worse wrist pain.
6.5
6.5. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 5 Range of movement (degrees).
6.6
6.6. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 6 Complications.
6.7
6.7. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 7 Dissatisfaction (only poor or fair rating of treatment outcome).
6.8
6.8. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 8 Anatomical measurements (1 year).
6.9
6.9. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 9 Anatomical outcomes.
6.10
6.10. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 10 Length of operating (minutes).
6.11
6.11. Analysis
Comparison 6 Bone allograft versus autograft, Outcome 11 Length of hospital stay (days).
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD006836

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Cassidy 2003 {published and unpublished data}
    1. Cassidy C, Jupiter JB, Cohen M, Delli‐Santi M, Fennell C, Leinberry C, et al. Norian SRS cement compared with conventional fixation in distal radial fractures. Journal of Bone & Joint Surgery ‐ American Volume 2003;85(11):2127‐37. - PubMed
    1. Cohen MS, Whitman K. Calcium phosphate bone cement‐‐the Norian skeletal repair system in orthopedic surgery. AORN Journal 1997;65(5):958‐62. - PubMed
    1. Fennell CW, Husband JB, Cassidy C, Leinberry C, Cohen MS, Jupiter J. Norian SRS versus conventional therapy in distal radius fracture treatment [Abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2000;82 Suppl 2:170. - PubMed
    1. Husband JB, Cassidy C, Leinberry C, Cohen MS, Jupiter JB. Multicenter clinical trial of Norian SRS vs conventional therapy in the treatment of distal radius fractures: preliminary results [Abstract]. Orthopaedic Transactions 1997;21(1):140‐1.
    1. McQueen M. The use of Norian SRS in fractures of the distal radius. Poster displayed in Department of Orthopaedic Surgery, Edinburgh University, UK 1996.
Jeyam 2002 {published and unpublished data}
    1. Andrew JG. A study to compare the efficacy of "Bone Source" hydroxyapatite paste with that of Kapandji wiring in the treatment of displaced fractures of the distal radius in elderly patients. In: The National Research Register, Issue 2, 2000. Oxford: Update Software.
    1. Jeyam M. personal communication March 11 2003.
    1. Jeyam M, Andrew JG, Muir LTSW, McGovern A. Controlled trial of distal radial fractures treated with a resorbable bone mineral substitute. Journal of Hand Surgery ‐ British Volume 2002;27(2):146‐9. - PubMed
    1. McKee MD. Hydroxyapatite cement was not as effective as intrafocal Kirschner‐wire fixation for acute fractures of the distal part of the radius (commentary). Journal of Bone & Joint Surgery ‐ American Volume 2003;85(2):386. - PubMed
Kopylov 1999 {published and unpublished data}
    1. Kopylov P. personal communication July 2007.
    1. Kopylov P, Aspenberg P, Yuan X, Ryd L. Radiostereometric analysis of distal radial fracture displacement during treatment. A randomized study comparing Norian SRS and external fixation in 23 patients. Acta Orthopaedica Scandinavica 2001;72(1):57‐61. - PubMed
    1. Kopylov P, Jonsson K, Aspenberg P. Resorption of the ulnar styloid in distal radial fractures ‐ a possible explanation to the pain at ulnar border of the wrist [Abstract]. Journal of Bone and Joint Surgery ‐ British Volume 2001;83 Suppl 2:259.
    1. Kopylov P, Jonsson K, Runnquist K, Aspenberg P. Norian SRS, an injectable calcium phosphate, compared to external fixation in the treatment of unstable distal radius fractures [Abstract]. Orthopaedic Transactions 1997;21(1):141.
    1. Kopylov P, Jonsson K, Runnquist K, Aspenberg P. Norian SRS; an injectable calcium phosphate, compared to external fixation in the treatment of unstable distal radial fractures [Abstract]. Journal of Hand Surgery ‐ British Volume 1997;22 Suppl 1:21.
Kopylov 2002 {published and unpublished data}
    1. Kopylov P. personal communication July 18 2007.
    1. Kopylov P, Adalberth K, Jonsson K, Aspenberg P. Norian SRS versus functional treatment in redisplaced distal radial fractures: a randomised study in 20 patients. Journal of Hand Surgery ‐ British Volume 2002;27(6):538‐41. - PubMed
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
Rajan 2006 {published and unpublished data}
    1. Fornaro J, Zellweger R, Sommer C, Trentz O. Repair of comminuted distal radius fractures: Allogenic versus autogeneic transplants. Orthopaedic Trauma Association; Combined meeting with the American Association for the Surgery of Trauma. 2000 Oct 12; San Antonio, Texas. Monroe, NY: HWB Foundation, 2000:http://www.hwbf.org/ota/am/ota00/otapa/OTA00319.htm (accessed 15/12/2000).
    1. Rajan GP, Fornaro J, Trentz O, Zellweger R. Cancellous allograft versus autologous bone grafting for repair of comminuted distal radius fractures: a prospective, randomized trial. Journal of Trauma‐Injury Infection & Critical Care 2006;60(6):1322‐9. - PubMed
Sanchez‐Sotelo 2000 {published data only}
    1. McKee MD. The Norian skeletal repair system was effective for fractures of the distal radius (Commentary). Journal of Bone & Joint Surgery ‐ American Volume 2001;83(2):302.
    1. Sanchez‐Sotelo J, Munuera L. Norian SRS for the treatment of distal radius fractures: a prospective randomized study [Abstract]. Journal of Bone and Joint Surgery ‐ British Volume 1999;81 Suppl 2:166. - PubMed
    1. Sanchez‐Sotelo J, Munuera L, Madero R. Treatment of fractures of the distal radius with a remodellable bone cement. A prospective, randomised study using Norian SRS. Journal of Bone and Joint Surgery ‐ British Volume 2000;82(6):856‐63. - PubMed
Schmalholz 1989 {published data only}
    1. Schmalholz A. personal communication August 27 2007.
    1. Schmalholz A. Bone cement for redislocated Colles' fracture. A prospective comparison with closed treatment. Acta Orthopaedica Scandinavica 1989;60(2):212‐7. - PubMed
Schmalholz 1990 {published data only}
    1. Schmalholz A. personal communication August 27 2007.
    1. Schmalholz A. External skeletal fixation versus cement fixation in the treatment of redislocated Colles' fracture. Clinical Orthopaedics & Related Research 1990;(254):236‐41. - PubMed
Widman 2002 {published data only}
    1. Widman J, Isacson J. Primary bone grafting does not improve the results in severely displaced distal radius fractures. International Orthopaedics 2002;26(1):20‐2. - PMC - PubMed

References to studies excluded from this review

Chapman 1997 {published data only}
    1. Chapman MW, Bucholz R, Cornell C. Treatment of acute fractures with a collagen‐calcium phosphate graft material ‐ A randomized clinical trial. Journal of Bone & Joint Surgery ‐ American Volume 1997;79(4):495‐502. - PubMed
    1. Moran CG. Treatment of acute fractures with a collagen‐calcium phosphate graft material ‐ A randomized clinical trial [letter]. Journal of Bone and Joint Surgery ‐ American Volume 1998;80(3):454. - PubMed
Dickson 2002 {published data only}
    1. Dickson KF, Friedman J, Buchholz JG, Flandry FD. The use of BoneSource hydroxyapatite cement for traumatic metaphyseal bone void filling. Journal of Trauma‐Injury Infection & Critical Care 2002;53(6):1103‐8. - PubMed
McQueen 2001 {unpublished data only}
    1. McQueen M. A comparison of external fixation alone versus external fixation with bone source for the treatment of unstable distal radial fractures. In: The National Research Register, Issue 4, 2000. Oxford: Update Software.
    1. McQueen MM. personal communication April 30 2002.
Schmalholz 1988 {published data only}
    1. Schmalholz A, Alberts KA. A scintimetric study of Colles' fracture. Comparison between cementation and closed treatment. Acta Radiologica 1988;29(6):715‐7. - PubMed
Wyrick 1999 {unpublished data only}
    1. Wyrick J, Spieles C, Ansari I. A prospective, randomised comparison of corraline hydroxyapatite and autogenous bone graft in the treatment of distal radius fractures (commentary on paper presented at the American Society for Surgery of the Hand 54th Annual Meeting, Sept 2‐4 1999, Boston, USA). commentary in http://www.eradius.com/research.htm (accessed 10/03/2002).
Zimmermann 2003 {published data only}
    1. Zimmermann R, Gabl M, Lutz M, Angermann P, Gschwentner M, Pechlaner S. Injectable calcium phosphate bone cement Norian SRS for the treatment of intra‐articular compression fractures of the distal radius in osteoporotic women. Archives of Orthopaedic & Trauma Surgery 2003;123(1):22‐7. - PubMed

References to ongoing studies

Barbier 2008 {unpublished data only}
    1. Barbier O. Allomatrix injectable putty in distal radius fractures. Protocol for a randomised, controlled clinical study in unstable fractures of the distal radius. Controlled Clinical Trials: http://clinicaltrials.gov/show/NCT00274378 (assessed 13/09/06).

Additional references

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
Arrington 1996
    1. Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA. Complications of iliac crest bone graft harvesting. Clinical Orthopaedics and Related Research 1996;(329):300‐9. - PubMed
Atkins 2003
    1. Atkins RM. Aspects of current management: Complex regional pain syndrome. Journal of Bone and Joint Surgery ‐ British Volume 2003;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).
Carson 2007
    1. Carson JS, Bostrom MP. Synthetic bone scaffolds and fracture repair. Injury 2007;38(Suppl 1):S33‐S37. - 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 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
FDA 1998
    1. U.S. Food and Drug Administration ‐ Center for Devices and Radiological Health. Norian(R) SRS(R) Cement. P970010. Issued 23‐12‐1998. FDA Web site: http://www.fda.gov/cdrh/pdf/p970010.html (accessed 31/08/2000).
Fernandez 1996
    1. Fernandez DL, Jupiter JB. Fractures of the distal radius. A practical approach to management. 1st Edition. New York: Springer‐Verlag, 1996.
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. [DOI: 10.1002/14651858.CD003209] - DOI - PubMed
Handoll 2003b
    1. Handoll HH, Madhok R. Conservative interventions for treating distal radial fractures in adults (Cochrane Review). 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):1‐15. - PMC - PubMed
Handoll 2007
    1. Percutaneous pinning for treating distal radial fractures in adults. Handoll HHG, Vaghela MV, Madhok R. Cochrane Database of Systematic Reviews 2007, Issue 3. [DOI: 10.1002/14651858.CD006080.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. www.cochrane.org/resources/handbook/hbook.htm (accessed 31 July 2007)..
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
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 1996
    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
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
McKee 2003
    1. McKee MD. Hydroxyapatite cement was not as effective as intrafocal Kirschner‐wire fixation for acute fractures of the distal part of the radius (commentary). Journal of Bone & Joint Surgery ‐ American Volume 2003;85(2):386. - PubMed
Melone 1993
    1. Melone CPJr. Distal radius fractures: patterns of articular fragmentation. Orthopedic Clinics of North America 1993;24(2):239‐53. - PubMed
Mjoberg 1984
    1. Mjoberg B, Pettersson H, Rosenqvist R, Rydholm A. Bone cement, thermal injury and the radiolucent zone. Acta Orthopaedica Scandinavica 1984;55(6):597‐600. - 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‐Injury Infection & Critical Care 1965;5(4):469‐76. - 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
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
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

Substances