A systematic review 1 including 33 studies with a total of 1 876 subjects was abstracted in DARE. For the nonsurgical treatments, the average time to union was 7.1 weeks for early mobilisation, 8.6 weeks for above elbow plaster cast (AEPOP), 9.1 weeks for below elbow plaster cast (BEPOP), and 9.7 weeks for functional bracing. Nonunion rates ranged from 2 to 4%. Excellent or good functional results were achieved in 88% of AEPOP, 90% of BEPOP, 95% of early mobilisation, and 96% of functional bracing patients. Complication rates ranged from 0 to 4%.
In the surgical group, time to union was 15.5 weeks for unlocked Kuntscher nail, and 10.4 weeks for locked Lefevre nails. Compression plates, Mennen plates and Rush pins had an average union time of 12.1 to 12.4 weeks. Nonunion rates were: for the Lefevre nail and Mennen plate, 0%; compression plates, 2%; unlocked Kuntscher nail, 5%; and Rush pins, 13%. Functional outcome was excellent or good in 72% of patients following locked intramedullary nailing, and in 79% following unlocked intramedullary nailing; it was 83 to 86% following other forms of surgery. Complication rates ranged from 6 to 16%.
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