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Table 5 Modified extract from the document presenting the responses from individuals

From: From evidence to best practice in the management of fractures of the distal radius in adults: working towards a research agenda

Q3.1 When should definitive treatment begin?

(Person number: Comments)

2: If treatment is ineffective, delay doesn't matter. Is manipulation the right treatment? What is the outcome of interest? Alignment, function, etc?

4: Within extended working day, immediate referral to orthopaedics for assessment/ treatment. Out of extended working hours, mild to moderate displacement, volar slab, sling, analgesic, review orthopaedics 9 am. Significant displacement, immediate orthopaedic involvement.

5: Day of injury or within 48 hours. Research: Early reduction prevents complications.

7: ASAP to keep in line with physiology of bone healing.

8: ASAP. Research: More high volume RCTs. This is an important element in practice.

9: Most delays in surgery for emergencies result in increased morbidity – e.g. in RSD?

11: This depends on extent of displacement and/or soft tissue injury. Optimally fracture reduction best done within 24 hours. Research: Regardless of whether fracture equally reducible later it is better for patient comfort and economically better to do at time of presentation.

14: Immediate.

17: In practice undertaken ASAP. Don't see any advantage in delaying manipulation.

19: In 24–48 hours, provided no neurovascular damage is present.

23: I believe treatment should be immediate to avoid problems with nerve damage, stiffness etc. Research: Immediate treatment must be proven to be beneficial.

25: At first reasonable opportunity given resource and personnel.

27: Research: previous trial of unknown effectiveness but I'm not sure you would be granted ethics committee approval to conduct similar trial.

N

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

R

 

1

  

2

0

0

2

  

1

  

0

2

 

0

 

2

0

  

2

 

0

 

1

 
  1. N = Person number; R = Research rating (see 'Appendix 4 [see Additional file 4]')