Posted on 01/20/2022 7:49:34 PM PST by ConservativeMind
Using metal K-wires (commonly known as 'pins') to hold broken wrist bones in place while they heal are no better than a traditional moulded plaster cast.
Surgery is expensive and carries risk for the patient, whereas a moulded plaster cast is cheaper but may not provide the same functional outcome.
To find out which of these treatments is superior, researchers tracked the progress of 500 adults with a displaced wrist fracture at 36 NHS hospitals between January 2017 and March 2019.
Other (secondary) outcomes were PRWE score at three and six months, quality of life, and complications, including the need for later surgery.
A total of 395 (79%) patients completed the follow-up. While both groups showed improvement over the 12-month period, no statistically significant difference was seen in the PRWE score at three, six or 12 months (average score 21.2 in the cast group compared with 20.7 in the K-wire group).
Health related quality of life also showed a similar pattern of recovery in both groups over time, and again the difference was not significant.
However, one in eight patients treated with a moulded cast needed later surgery for loss of fracture position in the first six weeks after their injury compared with just one patient in the K-wire group.
As such, they conclude: "Surgical fixation with K-wires did not provide better wrist function at 12 months compared with a moulded cast, indicating that a cast is an acceptable first line treatment following manipulation of a dorsally displaced fracture of the distal radius."
They add: "Cast treatment avoids the expense and risks of surgical fixation for seven out of eight patients. However, careful follow-up is needed as one in eight patients treated with a cast required subsequent surgical intervention as the fracture reduction could not be maintained."
(Excerpt) Read more at medicalxpress.com ...
“Looks like a cast is the best way to go, “
For 7 of 8.
I broke a leg once. Compound fracture of the Tibia(big shin bone) and shattered fibula(small muscle anchor mainly) and I had good insurance at the time. They told me I’d be able to walk in half the time if I had a rod inserted in the tibia as opposed to a cast. Wonder if it was all about money?
Never had a problem with metal detectors.
I got a “Colles Fracture” about 20 years ago by falling off a fence (it’s a typical “high energy” fracture common to motorcyclists and snowboarders). No pins; they set it and casted it. Never did get the full range of motion back (maybe 10 degrees short), it’s a bit arthritic, and it’s for weird slight twist to it (that only I see). When the cast is on, you don’t see these things forming. When the cast comes off, it’s “Oh!”
I have a friend who broke a hip and had to have temporary ‘pins’ put in.
When they came out, she had them worked into jewelry- apparently in the hospital she learned of an artisan who specialized in that.
Seems weird to me, like ‘cremation jewelry’; but whatever, it turned into a nice pendant.
How dare you!
Well, that 1 out of 8 that needs surgery is simply the same as the wire operations that all required surgery.
I wonder if you could now get the surgery to correct it.
You are like the 1 out of 8 in this study.
I thought about that when the cast was removed, but decided to just live with it. It hasn’t caused any serious problems...or minor problems for that matter. Just a few minor annoyances.
Perhaps so. I have to wonder if we will see a downgrade of medical care /procedures for the sake of saving $ and call it equal/superior. Perhaps saying ‘there’s nothing else we can do’, when there is.
Not saying that is happening here. But, I’m almost expecting to see it soon.
Titanium rod? That is a non-magnetic metal that isn’t rejected by biology..
Yeah I think so.
I had surgery to correct a 90-degree twist of my R index finger (tobogganing accident). They put a tiny pin in the joint, and it's been there for over 40 years now. It's only detectable in an x-ray of my hand.
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