AAOS, ASSH provide updated guidelines for treatment of distal radius fractures
The American Academy of Orthopaedic Surgeons and the American Society for Surgery of the Hand released updated clinical practice guidelines for the diagnosis and treatment of distal radius fractures in adult patients.
Serving as a reference point and educational tool for both primary care physicians and orthopedic surgeons, the guidelines are limited to the treatment of acute distal radius fractures and do not address distal radius malunion, according to a press release.
Suggestions offered with strong or moderate evidence by the clinical practice guidelines include no difference in outcomes between use of arthroscopic assistance and no arthroscopic assistance in treatment of distal radius fractures as well as no significant difference in radiographic or patient-reported outcomes between fixation techniques for complete articular or unstable distal radius fractures. The guidelines also suggest improved radiographic and patient reported outcomes with operative treatment for fractures with post-reduction radial shortening greater than 3mm, dorsal tilt greater than 10° or intraarticular displacement or step off greater than 2mm among patients younger than 65 years. However, the guidelines suggest no long-term improvements in patient reported outcomes with operative treatment in patients 65 years and older compared with nonoperative treatment.
“In the absence of sufficient evidence specific to distal radius fractures, the [clinical practice guideline CPG workgroup notes that opioid sparing and multimodal pain management strategies should be considered for patients undergoing treatment for distal radius fractures,” according to the press release. “Further, limited evidence suggests no difference in outcomes based on frequency of radiographic evaluation for patients treated for distal radius fractures.”