Comparison of Conservative and Operative Treatment for Distal Radius Fracture: a Meta-analysis of Randomized Controlled Trials

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2016 Jan 16

PMID 26770293

Citations 18

Authors

Jian Song

Ai-Xi Yu

Zong-Huan Li

Affiliations

Soon will be listed here.

Abstract

Background: The authors conducted a meta-analysis to compare the effectiveness and safety of conservative and operative treatment for distal radius fracture.

Methods: PubMed, EMBASE, and the Cochrane Library were searched to identify the relevant studies published up to February of 2015. All randomized controlled trials published to compare the conservative and operative treatment were included in the study. Results were pooled using meta-analysis to compare the efficacy and safety of conservative and operative treatment for distal radius fracture.

Results: The databases were derived from seven qualified studies that included a total of 523 patients in which 269 cases adopted conservative treatment while 253 cases adopted operative treatment. Overall, compared with the conservative treatment- treated the distal radius fracture, operative therapies resulted in significantly better radiographic (P<0.05), however, no significant differences of the functional outcomes and complication rate were observed between the two methods (P>0.05).

Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were deteched in the functional outcomes and complication rate.

Citing Articles

Functional Outcomes in the Distal End of Radius Fracture: A Prospective Study in a Tertiary Care Center.

Thusoo V, Chakrapani A, Nehru A, Kudyar S, Nagpal B, Kv A Cureus. 2024; 16(11):e74226.

PMID: 39712799 PMC: 11663396. DOI: 10.7759/cureus.74226.

Protocol for a prospective randomized trial of surgical versus conservative management for unstable fractures of the distal radius in patients aged 65 years and older.

Bell K, Oliver W, White T, Molyneux S, Graham C, Clement N Bone Jt Open. 2024; 5(10):920-928.

PMID: 39428945 PMC: 11491869. DOI: 10.1302/2633-1462.510.BJO-2024-0044.

Intrafocal Pinning in Distal Extraarticular Radius Fracture: A Retrospective Study Based on Patient Age.

Asiry A, De Villeneuve Bargemon J, Delclaux S, Mansat P, Gandolfi S, Lupon E Plast Reconstr Surg Glob Open. 2024; 12(10):e6229.

PMID: 39410975 PMC: 11479484. DOI: 10.1097/GOX.0000000000006229.

Peri-operative Antibiotic Prophylaxis in K-Wire Fixation: A Systematic Review and Meta-analysis.

Abul A, Karam M, Al-Shammari S, Giannoudis P, Pandit H, Nisar S Indian J Orthop. 2023; 57(7):1000-1007.

PMID: 37384006 PMC: 10293142. DOI: 10.1007/s43465-023-00879-6.

Association of Open Reduction and Internal Fixation With Volar Locking Plate for Distal Radius Fractures With Patient-Reported Outcomes in Older Adults: A Network Meta-analysis.

Jayaram M, Wood S, Kane R, Yang L, Chung K JAMA Netw Open. 2023; 6(6):e2318715.

PMID: 37326988 PMC: 10276304. DOI: 10.1001/jamanetworkopen.2023.18715.

References

Lutz K, Yeoh K, MacDermid J, Symonette C, Grewal R . Complications associated with operative versus nonsurgical treatment of distal radius fractures in patients aged 65 years and older. J Hand Surg Am. 2014; 39(7):1280-6. DOI: 10.1016/j.jhsa.2014.04.018. View

McQueen M, Caspers J . Colles fracture: does the anatomical result affect the final function?. J Bone Joint Surg Br. 1988; 70(4):649-51. DOI: 10.1302/0301-620X.70B4.3403617. View

Azzopardi T, Ehrendorfer S, Coulton T, Abela M . Unstable extra-articular fractures of the distal radius: a prospective, randomised study of immobilisation in a cast versus supplementary percutaneous pinning. J Bone Joint Surg Br. 2005; 87(6):837-40. DOI: 10.1302/0301-620X.87B6.15608. View

Handoll H, Vaghela M, Madhok R . Percutaneous pinning for treating distal radial fractures in adults. Cochrane Database Syst Rev. 2007; (3):CD006080. DOI: 10.1002/14651858.CD006080.pub2. View

Margaliot Z, Haase S, Kotsis S, Kim H, Chung K . A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures. J Hand Surg Am. 2005; 30(6):1185-99. DOI: 10.1016/j.jhsa.2005.08.009. View

Porter M, Stockley I . Fractures of the distal radius. Intermediate and end results in relation to radiologic parameters. Clin Orthop Relat Res. 1987; (220):241-52. View

Diaz-Garcia R, Oda T, Shauver M, Chung K . A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am. 2011; 36(5):824-35.e2. PMC: 3093102. DOI: 10.1016/j.jhsa.2011.02.005. View

Sharma H, Khare G, Singh S, Ramaswamy A, Kumaraswamy V, Singh A . Outcomes and complications of fractures of distal radius (AO type B and C): volar plating versus nonoperative treatment. J Orthop Sci. 2014; 19(4):537-44. DOI: 10.1007/s00776-014-0560-0. View

Bartl C, Stengel D, Bruckner T, Gebhard F . The treatment of displaced intra-articular distal radius fractures in elderly patients. Dtsch Arztebl Int. 2014; 111(46):779-87. PMC: 4263909. DOI: 10.3238/arztebl.2014.0779. View

10.

Horne J, Devane P, Purdie G . A prospective randomized trial of external fixation and plaster cast immobilization in the treatment of distal radial fractures. J Orthop Trauma. 1990; 4(1):30-4. DOI: 10.1097/00005131-199003000-00005. View

11.

Knirk J, Jupiter J . Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986; 68(5):647-59. View

12.

SINGER B, McLauchlan G, Robinson C, Christie J . Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg Br. 1998; 80(2):243-8. DOI: 10.1302/0301-620x.80b2.7762. View

13.

Howard P, Stewart H, Hind R, Burke F . External fixation or plaster for severely displaced comminuted Colles' fractures? A prospective study of anatomical and functional results. J Bone Joint Surg Br. 1989; 71(1):68-73. DOI: 10.1302/0301-620X.71B1.2915010. View

14.

Vargaonkar G . Distal end radius fractures: evaluation of results of various treatments and assessment of treatment choice. Chin J Traumatol. 2014; 17(4):214-9. View

15.

Siripakarn Y, Niempoog S, Boontanapibul K . The comparative study of reliability and reproducibility of distal radius' fracture classification among: AO frykman and Fernandez classification systems. J Med Assoc Thai. 2013; 96(1):52-7. View

16.

Marcheix P, Dotzis A, Benko P, Siegler J, Arnaud J, Charissoux J . Extension fractures of the distal radius in patients older than 50: a prospective randomized study comparing fixation using mixed pins or a palmar fixed-angle plate. J Hand Surg Eur Vol. 2010; 35(8):646-51. DOI: 10.1177/1753193410364179. View

17.

Owen R, Melton 3rd L, Johnson K, Ilstrup D, Riggs B . Incidence of Colles' fracture in a North American community. Am J Public Health. 1982; 72(6):605-7. PMC: 1650126. DOI: 10.2105/ajph.72.6.605. View

18.

Arora R, Lutz M, Deml C, Krappinger D, Haug L, Gabl M . A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am. 2011; 93(23):2146-53. DOI: 10.2106/JBJS.J.01597. View

19.

Wong T, Chiu Y, Tsang W, Leung W, Yam S, Yeung S . Casting versus percutaneous pinning for extra-articular fractures of the distal radius in an elderly Chinese population: a prospective randomised controlled trial. J Hand Surg Eur Vol. 2009; 35(3):202-8. DOI: 10.1177/1753193409339941. View

20.

Hattori Y, Doi K, Estrella E, Chen G . Arthroscopically assisted reduction with volar plating or external fixation for displaced intra-articular fractures of the distal radius in the elderly patients. Hand Surg. 2007; 12(1):1-12. DOI: 10.1142/S021881040700333X. View