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Meta-Analysis
. 2021 May 12;22(1):433.
doi: 10.1186/s12891-021-04312-7.

Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials

Qi Gou #  1 , Xiong Xiong #  1 , Dan Cao  2 , Yuanliang He  3 , Xu Li  4
Affiliations
Meta-Analysis

Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials

Qi Gou et al. BMC Musculoskelet Disord. .

Abstract

Background: The outcomes for volar locking plate (VLP) and external fixation (EF) in distal radius fracture cases remain controversial. The current study of randomized controlled trials (RCTs) aimed to assess VLP and EF, which might benefit distal radius fracture cases.

Methods: RCTs comparing VLP and EF in distal radius fracture cases, until 18 March 2020, were systematically reviewed and summarized. The functional and radiographic outcomes, together with complications, for distal radius fracture cases, were evaluated.

Results: In total, 12 studies comprising 1205 distal radius fracture cases were included. The VLP group had observed lower disability in the arm shoulder and hand score (DASH) at 3rd, 6th, and 12th -month post-operation, with the mean differences (MDs) of - 10.43 (95 % CI = - 15.77 to - 5.08, P < 0.01), - 3.48 (95 % CI = - 6.37 to - 0.59, P = 0.02), and - 4.13 (95 % CI = - 6.94 to - 1.33, P < 0.01), respectively. The VLP group also had lower visual analog scale scores (VAS) compared to the EF group, with MDs of - 0.10 (95 % CI = - 0.18 to - 0.03, P < 0.01) for the former at 6th -month post-operation. Also, the EF group exhibited better grip strength than that in the VLP group, with MD of 12.48 (95 % CI = 7.00-17.95, P < 0.01) at the 3rd month and 4.54 (95 % CI = 0.31-8.76, P = 0.04) at 6th month. No significant differences in radiographic outcomes were observed between the VLP and EF groups (P > 0.05). The VLP group had a lower complication rate than that in the EF group.

Conclusions: VLP had a lower DASH score and VAS score but with lower grip strength. No significant differences in radiographic outcomes were observed. VLP had a lower complication rate than that of EF.

Keywords: Distal radius fractures; External fixation; Meta-analysis; Putcome; RCTs; Volar locking plates.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study selection process
Fig. 2
Fig. 2
Risk of bias assessment of the included studies
Fig. 3
Fig. 3
Summarized disabilities of the arm shoulder and hand score
Fig. 4
Fig. 4
Summarized visual analog scale scores
Fig. 5
Fig. 5
Summarized grip strength results
Fig. 6
Fig. 6
Summarized wrist range of motion results after 3 months
Fig. 7
Fig. 7
Summarized wrist range of motion results after 6 months
Fig. 8
Fig. 8
Summarized wrist range of motion results after 12 months
Fig. 9
Fig. 9
Summarized radiological measurement results
Fig. 10
Fig. 10
Summarized complications
See this image and copyright information in PMC

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