Robert Jones bandage versus cast in the treatment of distal radius fracture in children: A randomized controlled trial.

PURPOSE: The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones (RJ) bandage. The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence, child comfortability, and family satisfaction. METHODS: The study was a randomized controlled non-inferiority clinical trial including children with recent (less than 5 days) fractures at the distal end of the radius OTA/AO 23-A2, which is usually treated conservatively. Those with open fractures, pathological fracture, severely displaced fracture that needs reduction or multiple injuries were excluded. The participants were divided randomly into 2 groups according to the treatment modalities. Group 1 was treated by plaster of Paris cast (the control group), and Group 2 by modified RJ bandage (the trial group). The difference between the 2 groups was found by the Chi-squared test. The difference was considered statistically significant when the p value was less than 0.05. RESULTS: There were 150 children (aged 2 - 12 years, any gender) included in the study, 75 in each group. The complications occured in 5 (3.3%) cases only, pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2. There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment (p = 0.649). Children treated by RJ bandages were more comfortable than those treated by the cast (97.3% vs. 73.3%, p < 0.001) with a statistically significant difference between them. Contrary to that, the families were more satisfied with the cast than RJ bandage (88.0% vs. 81.3%), but without a statistically significant difference (p = 0.257). CONCLUSION: RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.

The efficacy and safety of modified Robert Jones bandage in total knee arthroplasty: A meta-analysis of randomized-controlled trials.

BACKGROUND: The efficacy of modified Robert Jones bandage in primary total knee arthroplasty (TKA) is controversial. On the basis of randomized controlled trials (RCTs), this systematic review and meta-analysis was conducted to evaluate the modified Robert Jones bandage in TKA. METHODS: The electronic databases of EMBASE, PubMed, Web of Science and Cochrane Library were searched from the inception to November 2018 for all relevant English studies. The outcome measurements consisted of total blood loss, hemoglobin decline, transfusion rates, pain score, range of motion, length of hospitalization, knee circumference difference, and adverse effects. Data were analyzed using STATA 14.0 software (The Cochrane Collaboration, Oxford, United Kingdom).Quality assessment was conducted according to the Cochrane Handbook for systematic review of interventions. RESULTS: A total of 5 randomized controlled trials (RCTs) were included in the systematic review and meta-analysis. The present meta-analysis indicated that there were no significant differences in terms of total blood loss, hemoglobin decline, transfusion rates, pain score, range of motion, length of hospitalization, knee circumference difference, or adverse effects. CONCLUSIONS: Although published articles have shown improved outcome of blood loss, pain, and knee swelling after application of a modified Robert Jones bandage, our study suggest the use of modified Robert Jones bandage may not be necessary after primary TKA.

Modified Robert Jones bandage can not reduce postoperative swelling in enhanced-recovery after primary total knee arthroplasty without intraoperative tourniquet: a randomized controlled trial.

BACKGROUND: Compression therapy is commonly used to reduce lower limb swelling and blood loss after knee surgery. This study was performed to investigate whether modified Robert Jones bandage (MRJB) as a postoperative compression therapy is necessary for enhanced-recovery primary total knee arthroplasty without the tourniquet application. METHODS: In this prospective randomized controlled trial, 90 patients were grouped into 2 groups randomly. The experimental group received compression therapy with MRJB from toes to thigh for 24 h and the control group received no compression therapy. Knee swelling, blood loss, range of motion (ROM), pain, patient reported comfort level and complications were recorded. RESULTS: No significant differences were observed between the two groups when we compared knee swelling. Similarly, no significant difference on postoperative blood loss, pain, ROM, complications was found. However, patients in control group had significantly higher comfort ratings than compression group during the first 24 h. CONCLUSIONS: MRJB is not routinely indicated in enhanced-recovery primary total knee arthroplasty without tourniquet application. TRIAL REGISTRATION: The trial was registered in the Chinese Clinical Trial Registry ( ChiCTR-INR-16010177 ) dated 18th December 2016.

Relative stiffness of 3 bandage/splint constructs for stabilization of equine midmetacarpal fractures.

OBJECTIVE: Determine the relative stiffness of 3 bandage/splint constructs intended for emergency fracture stabilization. DESIGN: Experimental model. A single plane free end deflection model was developed to simulate the forces placed on a bandage/splint construct during stabilization of a complete mid-metacarpal bone fracture. The total deflection of the model in one plane was measured following application of 3 different bandage/splint combinations including a classic, 3 layered Robert Jones Bandage (RJB) with a splint placed on the outside of the bandage (RJB-3), an RJB with splint placed after the first of 3 bandage layers (RJB-1), and a single layer full limb bandage with external splint (SS). Comparisons were made between the deflections of the model with each bandage/splint combinations in an effort to determine the most effective method for field fracture stabilization. SETTING: Laboratory. ANIMALS: No animals were utilized in data collection for this study. Two live horses were utilized during the pilot study. INTERVENTIONS: Application of bandage and splint to a model intended to simulate the bending force on a lower forelimb fracture in a horse MEASUREMENTS AND MAIN RESULTS: Deflection was determined by the difference between the height of the model's supported free end before application of a 4.5 kg weight and at the conclusion of the deflection test. There was no significant difference in the amount of deflection between bandage/splint combinations (78 ± 32 mm (RJB-1), 94 ± 44 mm (RJB-3), and 93 ± 33 mm (SS)) CONCLUSIONS: The one-layer bandage with splint was equivalent to either RJB configuration in the mean amount of deflection in the simple model of a fracture.