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 s...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01734-2 |
| _version_ | 1818015937821933568 |
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| author | Qiang Li Chao Ke Shuang Han Xin Xu Yu-Xuan Cong Kun Shang Ji-Dong Liang Bin-Fei Zhang |
| author_facet | Qiang Li Chao Ke Shuang Han Xin Xu Yu-Xuan Cong Kun Shang Ji-Dong Liang Bin-Fei Zhang |
| author_sort | Qiang Li |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-14T07:04:54Z |
| format | Article |
| id | doaj.art-9175cb9994754b6d8ae26395f923f0cf |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T07:04:54Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-9175cb9994754b6d8ae26395f923f0cf2022-12-22T02:06:35ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-07-011511910.1186/s13018-020-01734-2Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysisQiang Li0Chao Ke1Shuang Han2Xin Xu3Yu-Xuan Cong4Kun Shang5Ji-Dong Liang6Bin-Fei Zhang7Department of Hand Surgery, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Hand Surgery, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong UniversityAbstract 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.http://link.springer.com/article/10.1186/s13018-020-01734-2Volar locking plateNonoperationDistal radial fracturesSystematic review, Meta-analysis |
| spellingShingle | Qiang Li Chao Ke Shuang Han Xin Xu Yu-Xuan Cong Kun Shang Ji-Dong Liang Bin-Fei Zhang Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Volar locking plate Nonoperation Distal radial fractures Systematic review, Meta-analysis |
| title | Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis |
| title_full | Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis |
| title_fullStr | Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis |
| title_full_unstemmed | Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis |
| title_short | Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis |
| title_sort | nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture a systematic review and meta analysis |
| topic | Volar locking plate Nonoperation Distal radial fractures Systematic review, Meta-analysis |
| url | http://link.springer.com/article/10.1186/s13018-020-01734-2 |
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