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Meta-Analysis
. 2020 Jul 14;15(1):263.
doi: 10.1186/s13018-020-01734-2.

Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis

Qiang Li  1 , Chao Ke  2 , Shuang Han  2 , Xin Xu  2 , Yu-Xuan Cong  2 , Kun Shang  2 , Ji-Dong Liang  3 , Bin-Fei Zhang  4
Affiliations
Meta-Analysis

Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis

Qiang Li et al. J Orthop Surg Res. .

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.

Keywords: Distal radial fractures; Nonoperation; Systematic review, Meta-analysis; Volar locking plate.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the studies included in the meta-analysis
Fig. 2
Fig. 2
Forest plot comparing DASH scores between the VLP and nonoperation groups
Fig. 3
Fig. 3
Forest plot comparing grip strength between the VLP and nonoperation groups
Fig. 4
Fig. 4
Forest plot comparing complications between the VLP and nonoperation groups
Fig. 5
Fig. 5
Funnel plot comparing complications between the VLP and nonoperation groups. The y-axis represents the standard error (SE) (log [OR]), while the x-axis represents the odds ratio (OR). The sloped lines represent the 95% CI boundaries and the circles indicate the 11 studies
See this image and copyright information in PMC

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