title: A scoping review of applications and outcomes of traction orthoses and constructs for the management of intra-articular fractures and fracture dislocations in the hand.
abstract: BACKGROUND
  Intra-articular hand fractures can have devastating consequences for movement and function. The unique nature of the injury and diverse management strategies are a challenge for conducting trials.
  
  
  OBJECTIVE
  To conduct a scoping review of traction constructs for the management of intra-articular hand fractures.
  
  
  METHODS
  We conducted a systematic search of the literature, extracting data on the scope and nature of the evidence for traction constructs.
  
  
  RESULTS
  Our search yielded 87 articles addressing 3 traction constructs: (1) static traction (n = 17), (2) dynamic external fixation (n = 53), and (3) dynamic orthoses (n = 17). Active range of motion of the target joint was the most frequently reported outcome. Study designs included 36 cohorts, 21 case series, and 9 case studies: 24% contained only technical information.
  
  
  CONCLUSIONS
  The current literature addressing traction constructs consists primarily of small and low-quality studies. Evidence synthesis could improve the estimation of range of motion outcomes but would not be able to identify the best treatment. Consensus on classification of fracture patterns, routine use of outcome measures, and randomized trials are needed to compare different traction constructs and inform evidence-based care.
  
  
  METHODS
  Scoping review.
  
  
  METHODS
  N/A.
authors: Hand Therapy Clinic, Department of Rehabilitation Services, Neurosciences and Trauma Program, Hamilton Health Sciences, Hamilton, Ontario, Canada; School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address: packhamt@hhsc.ca.
authors: Tara L
authors: TL
authors: Packham
authors: Hand Therapy Clinic, Department of Rehabilitation Services, Neurosciences and Trauma Program, Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors: Pamela D
authors: PD
authors: Ball
authors: School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors: Joy C
authors: JC
authors: MacDermid
authors: Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, Department of Surgery and Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors: James R
authors: JR
authors: Bain
authors: Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, Department of Surgery and Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada.
authors: Arianna
authors: A
authors: DalCin
mesh_terms: D019468:Disease Management; D019317:Evidence-Based Medicine; D016267:External Fixators; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis / Q000601:surgery*; D000072039:Fracture Dislocation / Q000175:diagnosis / Q000601:surgery*; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D018737:Hand Strength; D006801:Humans; D015601:Injury Severity Score; D057072:Intra-Articular Fractures / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D013165:Splints; D014143:Traction
keywords: Orthoses; Outcomes; Scoping review; Traction