Do all fractures need full immobilisation?

doi:10.1136/bmj.39272.565810.80

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ education articles:

From

Limit by

The BMJ iPad app brings you the best of print and online, including live links to the latest news, blogs, video, and podcasts. Get the BMJ iPad app.
You can use bmj.com to help you with your continuing medical education. Find out about CME/CPD credits for BMJ articles
Keep up to date with cardiology: Access the latest cardiovascular medicine resources from across BMJ Group.
Countdown to London 2012: BMJ Group's Olympics portal highlights latest Olympics and sports medicine-themed research, comment and learning

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

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{at}dphpc.ox.ac.uk

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 of internal fixation, and one looked at different methods of reduction), which left two that were relevant. I used the most …