Is Volar Locking Plate Superior to External Fixation for Distal Radius Fractures? A Comprehensive Meta-analysis

Overview

Journal Acta Orthop Traumatol Turc

Specialties Emergency Medicine
Orthopedics

Date 2018 Dec 1

PMID 30497657

Citations 11

Authors

Jie Wang

Yandong Lu

Yujie Cui

Xuelei Wei

Jie Sun

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this meta-analysis of randomized controlled trials (RCT) and retrospective cohort studies (CS) regarding the use of volar locking plate (VLP) and external fixation (EF) in distal radius fractures was to determine whether there was any evidence that one treatment was superior to the other.

Methods: The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electrical databases (PubMed, EMBASE and the Cochrane library) were retrieved to find RCTs and CSs met the eligibility criteria. Two reviewers screened the studies, extracted the data and evaluated the methodological quality, and performed data analysis with RevMan 5.1. The publication bias was test by Stata 14.0. The Begg's and Egger's test were performed by Stata 14.0. The quality of evidence was graded according to the criteria of GRADE. We ultimately included ten RCTs and eleven CSs.

Results: A total of 1590 subjects were reported. Publication bias was detected by funnel plot in RCTs. VLP could provide better results such as DASH scores (RCT: MD = -6.12, 95%CI = -12.07-0.17; CS: MD = -6.43, 95%CI = -12.53-0.3), ulnar variance (RCT: MD = -0.81, 95%CI = -1.25-0.37) and infection rate (RCT: RR = 0.25, 95%CI = 0.10-0.65; CS: RR = 0.15, 95%CI = 0.06-0.40). There were no significant differences for G-W scores, VAS and grip strength between the VLP group and EF group. There was significantly greater loss of volar tilt (P = 0.01) and radial inclination (P = 0.02) in patients receiving EF, basing on the CSs.

Conclusions: VLP could provide better results, such as DASH scores, ulnar variance, volar tilt, radial inclination and infection rate. The use of VLP appear to be associated with better results of ROM (flexion, pronation, supination and radial deviation), radiographic parameters (volar tilt and radial inclination) and lower total complication rate and CRPS rate in CSs.

Level Of Evidence: Level 1, Therapeutic study.

Citing Articles

Outcomes of the Management of Distal Radius Fractures in the Last 5 Years: A Meta-analysis of Randomized Controlled Trials.

Asmara A, Karna M, Meregawa P, Deslivia M Rev Bras Ortop (Sao Paulo). 2022; 57(6):899-910.

PMID: 36540735 PMC: 9757966. DOI: 10.1055/s-0042-1754379.

Are external fixators as effective as volar plates in multi-fragmented radius distal intra-articular fractures (AO type C)?.

Dogan N, Buyukdogan H, Caliskan G, Genc Y, Sahin A, Erturk C Eur J Orthop Surg Traumatol. 2022; 33(5):1757-1765.

PMID: 35945390 DOI: 10.1007/s00590-022-03351-7.

Good functional recovery after bilateral elbow dislocation associated with bilateral distal radius and ulna fractures.

Bobovec D, Rajacic D, Zigman T, Dobric I Clin Case Rep. 2022; 10(3):e05439.

PMID: 35356162 PMC: 8948378. DOI: 10.1002/ccr3.5439.

Classification and Visualisation of Normal and Abnormal Radiographs; A Comparison between Eleven Convolutional Neural Network Architectures.

Ananda A, Ngan K, Karabag C, Ter-Sarkisov A, Alonso E, Reyes-Aldasoro C Sensors (Basel). 2021; 21(16).

PMID: 34450821 PMC: 8400172. DOI: 10.3390/s21165381.

The external fixation can be a good alternative to plate-screw treatment in the surgical treatment of bilateral distal radius fractures: A retrospective cohort study.

Dagtas M, Unal O Jt Dis Relat Surg. 2021; 32(2):406-413.

PMID: 34145818 PMC: 8343847. DOI: 10.52312/jdrs.2021.151.

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