XXXX : comparison of manual manipulation and finger-trap traction: a prospective, randomized study.

@entity1 @entity174 @entity7719
BACKGROUND: An optimal outcome of closed treatment of a @entity7719 may depend on accurate reduction and adequate immobilization. It has been suggested that the use of finger-trap traction results in a better reduction and a lower rate of redisplacement than manual manipulation does, but to our knowledge these concepts have never been evaluated scientifically. We compared these two methods in a prospective, randomized controlled trial. METHODS: Two hundred and twenty-three @entity1 with 225 displaced @entity7719 were randomized to treatment with closed reduction with either finger-trap traction (112 @entity1 ) or manual manipulation (111 @entity1 ). The @entity174 were assessed radiographically by measurement of the radial angle, dorsal tilt, and radial shortening before reduction, immediately after reduction, and at one and five weeks after reduction. RESULTS: The groups were comparable with regard to age, sex, side of injury, @entity174 grade, and amount of displacement at presentation. No significant differences were found between the alignment of the @entity174 in the two treatment groups at any time. With dorsal tilt of <10 degrees and radial shortening of <5 mm considered acceptable, the two techniques both produced an 87% rate of satisfactory reductions. However, the percentages of @entity174 in an acceptable alignment were only 57% and 50% at one week after finger-trap traction and manual manipulation, respectively, and only 27% and 32% at five weeks. The failure rates did not differ significantly between the two groups. CONCLUSIONS: The two methods of @entity174 reduction did not differ with regard to the eventual position of the @entity174 or the rate of failure. Although closed reduction was successful for the majority of @entity174 , most redisplaced substantially during the period of cast immobilization.
