J Wang1, Y Yang, J Ma, D Xing, S Zhu, B Ma, Y Chen, X Ma. 1. Department of Orthopaedics, Tianjin Medical University General Hospital, 154, Anshan Street, Heping District, 300052 Tianjin, China.
Abstract
PURPOSE: To compare the clinical outcomes of open reduction and internal fixation (ORIF) versus the ones of closed reduction and external fixation (EF) in the treatment of distal radial fractures. METHODS: We performed a meta-analysis of randomized controlled trials that compared the clinical results of ORIF to EF in the treatment of distal radial fractures. A systemic retrieve from PubMed, EMBASE, OVID and Cochrane Collaboration CENTRAL database resulted in 11 studies with 824 patients. We thus performed data synthesis using RevMan (version 5.1). RESULTS: Superior statistical differences were observed for DASH scores (at 3, 6 and 12 months follow-up) grip strength (at 3 months follow-up), volar tilt (at 12 months follow-up), flexion and supination (at 3 months follow-up), and extension (at 3 and 6 months follow-up) in ORIF patients group, compared with those in EF group. We also found a significantly higher risk of infection associated with EF. There was no significant difference in the incidence of malunion and median nerve dysfunction. CONCLUSION: Regarding surgical fixation of unstable distal radius fractures, ORIF yields significantly better subjective outcome (DASH scores) the first year after operation, restoration of anatomic volar tilt, and forearm flexion and extension at the end of the follow-up period. However, EF results in higher incidence of infection compared to ORIF. ORIF is equal to EF for either grip strength, or range of motion of the injured wrist, or incidence of malunion or median nerve dysfunction at the end of the follow-up period. LEVEL OF EVIDENCE: Level II. Therapeutic study. Crown
PURPOSE: To compare the clinical outcomes of open reduction and internal fixation (ORIF) versus the ones of closed reduction and external fixation (EF) in the treatment of distal radial fractures. METHODS: We performed a meta-analysis of randomized controlled trials that compared the clinical results of ORIF to EF in the treatment of distal radial fractures. A systemic retrieve from PubMed, EMBASE, OVID and Cochrane Collaboration CENTRAL database resulted in 11 studies with 824 patients. We thus performed data synthesis using RevMan (version 5.1). RESULTS: Superior statistical differences were observed for DASH scores (at 3, 6 and 12 months follow-up) grip strength (at 3 months follow-up), volar tilt (at 12 months follow-up), flexion and supination (at 3 months follow-up), and extension (at 3 and 6 months follow-up) in ORIF patients group, compared with those in EF group. We also found a significantly higher risk of infection associated with EF. There was no significant difference in the incidence of malunion and median nerve dysfunction. CONCLUSION: Regarding surgical fixation of unstable distal radius fractures, ORIF yields significantly better subjective outcome (DASH scores) the first year after operation, restoration of anatomic volar tilt, and forearm flexion and extension at the end of the follow-up period. However, EF results in higher incidence of infection compared to ORIF. ORIF is equal to EF for either grip strength, or range of motion of the injured wrist, or incidence of malunion or median nerve dysfunction at the end of the follow-up period. LEVEL OF EVIDENCE: Level II. Therapeutic study. Crown
Authors: Ahmadreza Zarifian; Hassan Rahimi Shoorin; Mohammad Hallaj Moghaddam; Meysam Fathi Vavsari; Mohammad Gharedaghi; Ali Moradi Journal: Arch Bone Jt Surg Date: 2018-09
Authors: Taylor Woolnough; Daniel Axelrod; Anthony Bozzo; Alex Koziarz; Frank Koziarz; Colby Oitment; Lauren Gyemi; Jessica Gormley; Kyle Gouveia; Herman Johal Journal: Clin Orthop Relat Res Date: 2021-02-01 Impact factor: 4.755