000			02760na a2200229 4500
003			H12O
005			20180417112611.0
008			130622s2012 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_9878 _aPretell Mazzini, Juan _eCirugía Ortopédica y Traumatología
245	0	0	_aDistal metaphyseal radius fractures in children following closed reduction and casting: can loss of reduction be predicted?. _h[artículo]
260			_bInternational Orthopaedics, _c2012
300			_a36(7):1435-40.
500			_aFormato Vancouver: Pretell Mazzini J, Beck N, Brewer J, Baldwin K, Sankar W, Flynn J. Distal metaphyseal radius fractures in children following closed reduction and casting: can loss of reduction be predicted? Int Orthop. 2012 Jul;36(7):1435-40.
501			_aPMID: 22307559
504			_aContiene 25 referencias
520			_aPURPOSE: The aim of this study was to identify factors which contribute to loss of reduction (LOR). METHODS: Outpatient records and initial, post-reduction (PR) and follow-up radiographs of patients with a distal radial metaphyseal fracture were reviewed to determine demographic factors; fracture characteristics (obliquity, comminution, intact ulna); three-point cast index (3PI); and initial, PR, and follow-up displacement (angulation and translation in the sagittal and coronal planes). Univariate and multivariate regression were used to identify significant risk factors for LOR. RESULTS: A total of 161 patients were included in our series (119 boys and 42 girls). Fifty-seven (35%) patients met the criteria for LOR. Multivariate logistic regression revealed that patients over 14 years old were 4.8 times more likely (p=0.01) to lose reduction, and those with more than 10% PR translation in the sagittal plane were four times more likely (p=0.03) to lose reduction. In younger patients, initial coronal translation and PR sagittal translation were independent risk factors. Patients with over 10% initial translation in the coronal plane were 2.4 times more likely (p=0.01) to lose reduction, and those with over 10% PR translation in the sagittal plane were 2.7 times more likely (p=0.03) to lose reduction. Three point cast index was not found to be a significant risk factor (1.64 vs. 1.57, p=0.43). CONCLUSION: Our study, the largest dedicated series of distal radial metaphyseal fractures, indicates that loss of reduction is common. Our analysis suggests that an anatomical reduction, which minimises residual translation, is the most important variable in preventing a loss of reduction.
710			_9371 _aServicio de Cirugía Ortopédica y Traumatología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/6/pc6042.pdf _ySolicitar documento
942			_n0 _2ddc _cART
999			_c6042 _d6042