BMJ  2007;335:612-613 (22 September), doi:10.1136/bmj.39272.565810.80

Practice

Evidence Based Case Report

Do all fractures need full immobilisation?

Paul Glasziou, professor of evidence based medicine

Centre for Evidence-based Medicine, Department of Primary Health Care, University of Oxford, Oxford OX3 7LF

paul.glasziou@dphpc.ox.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

As I was about to start my morning general practice clinic, the receptionist told me of a patient who was coming in with an injury and handed me a faxed report from radiology, which stated: "possible fracture of the radial head." The "possible" suggested it was undisplaced or minimally displaced, so I wondered if it needed treating at all. While waiting for the first patient to arrive and sipping my tea, I checked the orthopaedics texts in my room and did a PubMed search.

Searching for the evidence

I went to the Clinical Queries section of PubMed Central (which is bookmarked on my Firefox toolbar) and used the narrow version of the "therapy" filter (which filters for randomised trials). I entered search terms to describe the condition "fracture and radial and head," which brought up seven studies. Two of these studies were not trials and three were not relevant (two looked at different types . . . [Full text of this article]

Assessing the evidence

Outcome for the patient


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Rapid Responses:

Read all Rapid Responses

Community treatment of fractures
Mr Peter John Kenyon
bmj.com, 25 Sep 2007 [Full text]
Immobilisation as Appropriate
Hussain A Kazi
bmj.com, 26 Sep 2007 [Full text]
A total red herring
peter j mahaffey
bmj.com, 28 Sep 2007 [Full text]
dumbing down?
ben dean
bmj.com, 30 Sep 2007 [Full text]
Expertise and evidence must learn to work together
Paul Glasziou
bmj.com, 1 Oct 2007 [Full text]
The case for specialist treatment
Margaret M McQueen
bmj.com, 3 Oct 2007 [Full text]
evidence
ben dean
bmj.com, 8 Oct 2007 [Full text]
The use of Evidence Based Medicine in clinical practice
Emma Stapleton
bmj.com, 8 Oct 2007 [Full text]
Appropriate, no universal, referal please
Paul P Glasziou
bmj.com, 11 Oct 2007 [Full text]
Join the dots
ben dean
bmj.com, 26 Oct 2007 [Full text]
Factures and Immobilization
Mehdi Tofighi, et al.
bmj.com, 16 Apr 2008 [Full text]
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