Treatment of one case of adult forearm traumatic bowing via an evidence-based medicine approach

Abstract

Objective To find the best therapy plan for an adult patient with forearm traumatic bowing who sought medical help in our department. Methods We searched Cochrane Library(Issue 4,2007),MEDLINE(1976 to October 2009),ACP Journal Club(1991 to October 2008),and CBMDisc (1979 to January 2009)for meta analyses,systematic reviews,randomized controlled trials (RCTs),casecontrol studies.reviews and case reports concerning adult forearm traumatic bowing.The quality of the included studies was assessed. Results We did not find any systematic reviews or large-scale RCTs involving a comparison between manipulative reduction and open reduction and internal fixation in the treatment of traumatic bowing.Five clinical retrospective studies and one case report closely related to our clinical questions were found and assessed.These studies concluded that manipulative reduction of the forearm with the patient under general anesthesia was the preferred method for early treatment,and osteotomy misht have to be performed at a late stage to regain appropriate limb function.Since the patient Was at a late stage,we performed osteotomy conscquently and the patient regained appropriate functions. Conclusion The present successful treatment of a rare cage benefits from the evidence-based medicine approach,but high quality large-scale randomized controlled trials are still required to support a good treatment. Key words: Forearm; Wounds and injures; Traumatic bowing; Adult