Ultrasonography Assisted Reduction Vs Blind Manipulation in Closed Reduction of Colles Fractures - A Comparative Study

Abstract

BACKGROUND Colles fracture is the most common wrist fracture in adults, predominantly affecting elderly women. Our study intends to reinforce the role of ultrasonography assisted reduction of Colles fractures as a suitable alternative to blind manipulation, as it can verify the adequacy of reduction in a single sitting in real time, and avoid multiple reduction sessions. METHODS 20 adult patients diagnosed with Colles fracture were enrolled in this case control study. Patients were divided into two groups of 10 each, study and control groups. The sample size was limited due to the Covid-19 pandemic of 2020. Study group was subjected to ultrasonography assisted reduction. Control group was subjected to blind manipulation and reduction. RESULTS Baseline characteristics between two groups were similar. The rate of repeat reduction was reduced in the ultrasound group (20 % VS 40 %; P =.329). The post reduction radiographic indices were similar between the two groups, although the ultrasound group had improved volar tilt (mean, 2.80 VS 1.60; P =.394). The operative rate was reduced in the ultrasound groups (10 % VS 30 %; P =.263). These results, though similar to existing studies into the topic, were not statistically significant, probably due to low sample size. CONCLUSIONS Despite the inability of our study to arrive at statistically significant results, we have positive findings for the parameters of volar tilt, number of multiple reduction attempts and number of cases proceeding to surgery. These findings are in line with other studies that were successful in establishing statistical significance for the above parameters. In view of this, a recommendation can be made to prefer ultrasonography assisted reduction over blind manipulation in initial management of Colles fractures, where the facility is available. KEY WORDS Colles Fractures, Ultrasonography, Blind Manipulation, Reduction, Volar Tilt, Operative Rate