Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis.

Abstract:

BACKGROUND:This systematic review and meta-analysis assessed the role of nonoperative treatment and volar locking plate (VLP) fixation in elderly patients with distal radial fracture. METHODS:The systematic literature review identified randomized controlled trials (RCTs) and observational studies using VLP and nonoperative treatment for distal radial fractures in the elderly. Two investigators independently extracted data and evaluated the quality of the studies. A meta-analysis was performed using RevMan version 5.3. RESULTS:The five RCTs and six observational studies included 585 and 604 patients in the VLP and nonoperation groups, respectively. The quality of these 11 studies was moderate. Compared to nonoperation treatment, VLP did not improve the disabilities of the arm, shoulder and hand (DASH) score (weighted mean difference [WMD] = -1.67; 95% confidence interval [CI], -3.58--0.24; P = 0.09), decrease complications (odds ratio = 1.05; 95% CI, 0.51-2.19; P = 0.89), or improve range of motion in flexion, extension, pronation, supination, and radial deviation. The VLP group had better grip strength (WMD = 10.52; 95% CI, 6.19-14.86; P < 0.0001) and radiographic assessment than the nonoperation group. CONCLUSIONS:Although insufficient, the study evidence shows that VLP does not improve DASH scores, complications, or range of motion, but it might provide better grip strength and radiographic assessment than nonoperation treatment.

journal_name

J Orthop Surg Res

authors

Li Q,Ke C,Han S,Xu X,Cong YX,Shang K,Liang JD,Zhang BF

doi

10.1186/s13018-020-01734-2

subject

Has Abstract

pub_date

2020-07-14 00:00:00

pages

263

issue

1

issn

1749-799X

pii

10.1186/s13018-020-01734-2

journal_volume

15

pub_type

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