Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Sep;35(9):1333-41.
doi: 10.1007/s00264-011-1300-0. Epub 2011 Jun 23.

Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis

Zhuang Cui  1 , Jianhong Pan, Bin Yu, Kairui Zhang, Xiaolong Xiong
Affiliations
Meta-Analysis

Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis

Zhuang Cui et al. Int Orthop. 2011 Sep.

Abstract

Purpose: Our aim was to compare the effect of internal vs external fixation for unstable distal radius fractures regarding postoperative complications, clinical results and radiological outcomes.

Methods: We selected PubMed; Cochrane Library; EMBASE; BIOSIS; Ovid and the relevant English orthopaedic journals and pooled data from ten eligible randomised controlled trials containing 738 patients to conduct a subgroup analysis according to different periods of follow-up. Our aim was to summarise the best available evidence.

Results: Results showed that compared with external fixation, internal fixation led to significantly fewer total surgical complications [95% confidence interval (CI) 0.39-0.81, P = 0.002] and reduced the incidence of pin-track infections (95% CI 0.08-0.46, P = 0.0002) after a one year follow-up. For clinical results, grip strength (95% CI 1.59-8.25, P = 0.004), supination (95% CI 13.99-48.83, P = 0.0004) and pronation (95% CI 5.61-26.09, P = 0.002) were superior in the internal fixation group six weeks postoperatively, and the same results were obtained three months postoperatively for grip strength (95% CI 3.21-13.47, P = 0.001) and supination (95% CI 3.61-16.01, P = 0.002). Meanwhile, the Disabilities of the Arm, Shoulder and Hand (DASH) score was superior in the internal fixation group at three months (95% CI -20.62 to -2.07, P = 0.02) and after one year (95% CI -14.37 to -2.32, P = 0.007) follow-up.

Conclusions: We suggest that the final results are significant and there is some evidence supporting the use of open reduction and internal fixation.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart of study selection process
Fig. 2
Fig. 2
Total surgical complications reported after 1-year follow-up
Fig. 3
Fig. 3
Pin-track infection reported after 1-year follow-up
Fig. 4
Fig. 4
Grip strength at 6 weeks, 3 months and 1-year follow-up
Fig. 5
Fig. 5
Disabilities of the Arm, Shoulder and Hand (DASH) score 3 months and 1-year follow-up
Fig. 6
Fig. 6
Funnel plot based on studies with data on total complications
See this image and copyright information in PMC

References

    1. Kotnis R, Waites TD, Fayomi O, Dega R. The use of a template to improve the managemeng of distal radial fractures. Emerg Med J. 2005;22:544–547. doi: 10.1136/emj.2004.016360. - DOI - PMC - PubMed
    1. Xu GG, Chan SP, Puhaindran ME, Chew WY. Prospective randomised study of intra-articular fractures of the distal radius: comparison between external fixation and plate fixation. Ann Acad Med Singapore. 2009;38:600–606. - PubMed
    1. Abramo A, Kopylov P, Geijer M, Tagil M. Open reduction and internal fixation compared to closed reduction and external fixation in distal radius fractures: A randomized study of 50 patients. Acta Orthop. 2009;80:478–485. doi: 10.3109/17453670903171875. - DOI - PMC - PubMed
    1. Rozental TD, Blazar PE, Franko OI, Chacko AT, Earp BE, Day CS. Functional outcomes for unstable distal fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation: a prospective randomized trial. J Bone Joint Surg Am. 2009;91:1837–1846. doi: 10.2106/JBJS.H.01478. - DOI - PubMed
    1. Wei DH, Raizman NM, Bottino CJ, Jobin CM, Strauch RJ, Rosenwasser MP. Unstable distal radial fractrures treated with external fixation, a radial column plate, or a volar plate. A prospective randomized trial. J Bone Joint Surg Am. 2009;91:1568–1577. doi: 10.2106/JBJS.H.00722. - DOI - PubMed

Publication types

LinkOut - more resources