Wrist injury practice guideline, winter sports safety tips

More than 261,000 persons visited an emergency department in 2007 because they had a distal radius fracture, according to the American Academy of Orthopaedic Surgeons (AAOS). To improve patient care for those who sustain this injury, the AAOS released an evidence-based clinical practice guideline, The Treatment of Distal Radius Fractures.

The new guideline serves as a point of reference and educational tool for primary care physicians as well as orthopedic surgeons, the AAOS noted. The patient-oriented guideline contains 29 evidence-based recommendations, including the following:
•If the fracture was displaced, a rigid cast is a better option than a splint.
•If the fracture was not displaced, as in a hairline crack, a removable splint may be worn.
•If a fracture has a tendency to fall back the way it was before the physician repaired it, surgery may be a better treatment option than a cast.

The guideline offered consensus recommendations (the current studies lacked evidence-based support), including the following:
•For distal radius fractures managed without surgery, repeated x-ray films should be obtained for 3 weeks and when the use of a splint or cast is discontinued.
•Patients should perform active finger motion exercises after a diagnosis of distal radius fracture has been made.
•Physicians should promptly reevaluate patients who have distal radius fractures and unremitting pain.

The guideline work group noted that better studies are needed to determine precisely which current treatments work the best under different clinical circumstances. For example, they identified a key research question, whether surgeons should perform the same procedures with older patients as they do with younger patients.

With the arrival of the 2010 Winter Olympic Games, the AAOS also offered a variety of winter sport injury prevention tips. They include the following:
•Because cold muscles, tendons, and ligaments are more susceptible to injury, perform light exercises for at least 3 to 5 minutes, then slowly and gently stretch the muscles to be exercised, holding each stretch for at least 30 seconds.
•Take frequent water breaks to prevent dehydration and overheating.
•Avoid participating in sports when experiencing pain or exhaustion.
•When falling, try to fall on your side or buttocks. Roll over naturally, turning your head in the direction of the roll.
•Be prepared for emergency situations and have a plan to reach medical personnel to manage injuries.

For more information, visit the AAOS Web site at http://aaos.org. Or, contact the organization at American Academy of Orthopaedic Surgeons, 6300 North River Road, Rosemont, IL 60018-4262; telephone: (847) 823-7186; fax (847) 823-8125.