Ultrasound Directed Reduction of Colles Type Distal Radial Fractures in ED (UDiReCT)

Launched by ROYAL DEVON AND EXETER NHS FOUNDATION TRUST · Mar 6, 2019

Keywords

ClinConnect Summary

Wrist fractures are one of the most common fractures encountered in the Emergency Department (ED). These injuries most frequently happen in people who have fallen onto an outstretched hand and can result in deformity ('displacement') of the broken bone. These 'displaced' (Colles' types of distal radial) fractures can result in long term deformity and problems using the wrist. To prevent this, patients with displaced fractures often undergo manipulation of their fractures, to straighten the wrist, using local anaesthetic or sedation techniques in ED before a plaster cast is applied.

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Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adults with Colles' type fractures of the distal radius undergoing fracture manipulation in the ED
• • UDiReCT Trial trained staff available
• Exclusion Criteria:
• • Age under 18
• • Volar displaced (Smith's) type fractures (well established as being unstable and requiring surgical treatment)
• • Unable or unwilling to give informed consent
• • Unable or unwilling to be followed up (e.g. orthopaedic follow up in another region)
• • Major trauma with other injuries and ISS (Injury Severity Score) \>16
• • Urgent manipulation required due to neurovascular or skin compromise
• • Open fractures or those with associated nerve or tendon involvement (affect functional outcome)
• • Prisoners