{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:09:05Z","timestamp":1790291345070,"version":"4.1.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009767","name":"Landstinget V\u00e4sternorrland","doi-asserted-by":"publisher","award":["LVNFOU921951"],"award-info":[{"award-number":["LVNFOU921951"]}],"id":[{"id":"10.13039\/501100009767","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background and purpose<\/jats:title>\n<jats:p>National guidelines for treatment of distal radius fractures (DRFs) were presented in Sweden in 2021. In the guidelines, a fast-track is recommended for 4 subgroups of highly unstable DRFs. Regardless of the results of the closed reduction these are recommended for surgery within 1 week of injury. This study aims to evaluate the potential consequences of the newly presented national guidelines on incidence of surgical interventions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Patients and methods<\/jats:title>\n<jats:p>In all, 1,609 patients (1,635 DRFs) with primary radiographs after a DRF between 2014 and 2017 at two Swedish hospitals were included in a retrospective cohort study. An estimation was made of the percentage of patients in the historical pre-guidelines cohort, that would have been recommended early primary surgery according to the new national guidelines compared to treatment implemented without the support of these guidelines.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>On a strict radiological basis, 32% (516 out of 1635) of DRFs were classified into one of the 4 defined subgroups. At 9\u201313 days follow-up, cast treatment was converted into delayed primary surgery in 201 cases. Out of these, 56% (112 out of 201) fulfilled the fast-track criteria and would with the new guidelines have been subject to early primary surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Interpretation<\/jats:title>\n<jats:p>The fast-track regimen in the new guidelines, has a high likelihood of identifying the unstable fractures benefitting from early primary surgery. If the proposed Swedish national guidelines for DRF treatment are implemented, a greater proportion of fractures would be treated with early primary surgery, and a delayed surgery avoided in the majority of cases. The potential benefits in relation to possible costs when using the fast-track criteria in every day practice are still unknown.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0260296","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T18:31:41Z","timestamp":1644517901000},"page":"e0260296","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Forecasting effects of \u201cfast-tracks\u201d for surgery in the Swedish national guidelines for distal radius fractures"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8727-9555","authenticated-orcid":true,"given":"Viktor","family":"Schmidt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Mellstrand Navarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Ottosson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"T\u00e4gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Christersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Engquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arkan","family":"Sayed-Noor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Mukka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Wadsten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"key":"pone.0260296.ref001","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S8756-3282(01)00614-7","article-title":"Epidemiology of fractures in England and Wales","volume":"29","author":"TP van Staa","year":"2001","journal-title":"Bone"},{"key":"pone.0260296.ref002","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.hcl.2012.02.001","article-title":"The Epidemiology of Distal Radius Fractures","volume":"28","author":"KW Nellans","year":"2012","journal-title":"Hand Clinics"},{"key":"pone.0260296.ref003","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jht.2016.03.003","article-title":"Epidemiology of distal radius fractures and factors predicting risk and prognosis","volume":"29","author":"NJ MacIntyre","year":"2016","journal-title":"J Hand Ther"},{"key":"pone.0260296.ref004","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1097\/BOT.0000000000000199","article-title":"Complications after distal radius fracture surgery: results from a Swedish nationwide registry study","volume":"29","author":"CM Navarro","year":"2015","journal-title":"J Orthop Trauma"},{"key":"pone.0260296.ref005","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1302\/0301-620X.101B8.BJJ-2018-1285.R1","article-title":"Percutaneous fixation with Kirschner wires versus volar locking-plate fixation in adults with dorsally displaced fracture of distal radius: five-year follow-up of a randomized controlled trial","volume":"101-B","author":"ML Costa","year":"2019","journal-title":"Bone Joint J"},{"key":"pone.0260296.ref006","doi-asserted-by":"crossref","first-page":"787","DOI":"10.2106\/JBJS.18.00693","article-title":"VIPER Trial Collaborators. 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