Kotnis R, Waites M D, Fayomi O, Dega R
Oxford Trauma and Orthopaedic Rotation, UK.
Emerg Med J. 2005 Aug;22(8):544-7. doi: 10.1136/emj.2004.016360.
The aim of this study was to reduce the number of inappropriately managed distal radial fractures with the use of a template.
A template has been developed to aid junior doctors and emergency nurse practitioners (ENPs) to decide which distal radial fractures require manipulation. Emergency Department (ED) junior doctors and ENPs were asked to review the radiographs of 12 distal radial fractures with and without the template and comment on whether the fracture required manipulation.
There was an improvement in appropriate management with the template of 16.6% for the junior doctors and 22.3% for the ENPs. This was statistically significant for both groups when the results were analysed with a paired t test (p<0.01).
We conclude that the availability of this template in the ED may be helpful to junior doctors and ENPs, and represents a low cost and efficient way of reducing the number of patients who attend a fracture clinic with a distal radial fracture in an unsatisfactory position. This may also reduce the numbers requiring admission and a manipulation under anaesthetic, which spares the patients the risks of general anaesthesia and may possibly be cost saving.
本研究的目的是通过使用模板减少桡骨远端骨折处理不当的数量。
已开发出一种模板，以帮助初级医生和急诊护士从业者（ENP）确定哪些桡骨远端骨折需要手法复位。要求急诊科（ED）初级医生和ENP在有或没有模板的情况下查看12例桡骨远端骨折的X线片，并对骨折是否需要手法复位发表意见。
使用模板后，初级医生的正确处理率提高了16.6%，ENP的正确处理率提高了22.3%。当用配对t检验分析结果时，两组的这一结果均具有统计学意义（p<0.01）。
我们得出结论，在急诊科提供这种模板可能对初级医生和ENP有帮助，并且是一种低成本、高效率的方法，可减少因桡骨远端骨折位置不理想而前往骨折诊所就诊的患者数量。这也可能减少需要住院和在麻醉下进行手法复位的人数，从而使患者避免全身麻醉的风险，并可能节省成本。
