Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis

Abstract

Purpose This systematic literature review aimed to make a detailed overview on the clinical and functional outcomes and to get insight into the possible superiority of a treatment method for extra-articular distal radius fractures. Methods Embase, Medline, Cochrane Library, Web of Science, and Google Scholar were searched for studies describing treatment results. Five treatment modalities were compared: plaster cast immobilization, K-wire fixation, volar plating, external fixation, and intramedullary fixation. Results Out of 7,054 screened studies, 109 were included in the analysis. Overall complication rate ranged from 9% after plaster cast treatment to 18.5% after K-wire fixation. For radiographic outcomes, only volar tilt in the plaster cast group was lower than in the other groups. Apart from better grip strength after volar plating, no clear functional differences were found across treatment groups. Conclusion Current literature does not provide uniform evidence to prove superiority of a particular treatment method when looking at complications, re-interventions, and long-term functional outcomes.

Comparison between closed reduction plaster casting and percutaneous Kirschner wire pinning in the management of distal radius fractures in patients aged 65 years and older

“…Results are summarized in Table 5. immobilization and several surgical techniques (32). While volar locking plates were found to be superior in terms of DASH scores, this superiority is minimal and does not have clinical importance (33).…”

Diagnostics, incidence and treatment of the distal radius fractures: an area for many studies, opinions and treatment options

“…Certainly, an extensive literature review could be sought here [ 10 ]. Guidelines as noted earlier may be helpful and timesaving.…”

“…The discussion continues, if an adequate conservative therapy is not possible, about the various options for stabilisation and/or postoperative care [ 10 , 17 , 18 ]. Publications all around the world should be appreciated since some expensive implants are not everywhere available.…”

“…The influence of concomitate injuries (ligaments, ulna, etc.) is much more difficult to adjust in studies dealing with complex fractures [ 10 , 17 , 18 ].…”

“…guidelines of the German Orthopaedics and Trauma Surgery Society (DGOU) or the British Orthopaedic Association (BOA) and British Society for Surgery of the Hand (BSSH). These are validated with respect to the indication for surgical therapy according to the given "thresholds for intervention" like summarised in such publications [5][6][7][8][9]. Following such measures, some authors conclude for themselves, that surgical therapy was chosen too often [5].…”