Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
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...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
AVES
2018-09-01
|
| Series: | Acta Orthopaedica et Traumatologica Turcica |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1017995X1830066X |
| _version_ | 1797919814740606976 |
|---|---|
| author | Jie Wang Yandong Lu Yujie Cui Xuelei Wei Jie Sun |
| author_facet | Jie Wang Yandong Lu Yujie Cui Xuelei Wei Jie Sun |
| author_sort | Jie Wang |
| collection | DOAJ |
| description | 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. Keywords: Distal radial fractures, Volar locking plate, External fixation, Meta-analysis, GRADE analysis |
| first_indexed | 2024-04-10T13:52:36Z |
| format | Article |
| id | doaj.art-e8d976068a6b418ab85433535f661cd9 |
| institution | Directory Open Access Journal |
| issn | 1017-995X |
| language | English |
| last_indexed | 2024-04-10T13:52:36Z |
| publishDate | 2018-09-01 |
| publisher | AVES |
| record_format | Article |
| series | Acta Orthopaedica et Traumatologica Turcica |
| spelling | doaj.art-e8d976068a6b418ab85433535f661cd92023-02-15T16:10:39ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2018-09-01525334342Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysisJie Wang0Yandong Lu1Yujie Cui2Xuelei Wei3Jie Sun4Department of Orthopaedic Traumatology, Tianjin Hospital, Tianjin, ChinaDepartment of Orthopaedic Traumatology, Tianjin Hospital, Tianjin, ChinaDepartment of Orthopaedic Traumatology, Tianjin Hospital, Tianjin, ChinaDepartment of Orthopaedic Traumatology, Tianjin Hospital, Tianjin, ChinaCorresponding author. Tel.: +86 60911000.; Department of Orthopaedic Traumatology, Tianjin Hospital, Tianjin, ChinaObjective: 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. Keywords: Distal radial fractures, Volar locking plate, External fixation, Meta-analysis, GRADE analysishttp://www.sciencedirect.com/science/article/pii/S1017995X1830066X |
| spellingShingle | Jie Wang Yandong Lu Yujie Cui Xuelei Wei Jie Sun Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis Acta Orthopaedica et Traumatologica Turcica |
| title | Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis |
| title_full | Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis |
| title_fullStr | Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis |
| title_full_unstemmed | Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis |
| title_short | Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis |
| title_sort | is volar locking plate superior to external fixation for distal radius fractures a comprehensive meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1017995X1830066X |
| work_keys_str_mv | AT jiewang isvolarlockingplatesuperiortoexternalfixationfordistalradiusfracturesacomprehensivemetaanalysis AT yandonglu isvolarlockingplatesuperiortoexternalfixationfordistalradiusfracturesacomprehensivemetaanalysis AT yujiecui isvolarlockingplatesuperiortoexternalfixationfordistalradiusfracturesacomprehensivemetaanalysis AT xueleiwei isvolarlockingplatesuperiortoexternalfixationfordistalradiusfracturesacomprehensivemetaanalysis AT jiesun isvolarlockingplatesuperiortoexternalfixationfordistalradiusfracturesacomprehensivemetaanalysis |