title: Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis.
abstract: OBJECTIVE
  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.
authors.affiliation: Southern Medical University, Guangzhou, China.
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Cui
authors.forename: Jianhong
authors.initials: J
authors.lastname: Pan
authors.forename: Bin
authors.initials: B
authors.lastname: Yu
authors.forename: Kairui
authors.initials: K
authors.lastname: Zhang
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Xiong
mesh_terms: D017760:Bone Malalignment / Q000209:etiology / Q000517:prevention & control; D003100:Colles' Fracture / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D011884:Radius / Q000293:injuries / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome