title: Comparison of internal and external fixation of distal radius fractures.
abstract: OBJECTIVE
  There is no consensus on the difference in effects of internal fixation (IF) and external fixation (EF) on outcomes for the treatment of distal radius fractures. We performed a meta-analysis of randomized clinical studies.
  
  
  METHODS
  We searched the literature and included studies that compared the effects of IF and EF on the treatment of distal radius fractures. Statistically, we pooled patient data using standard meta-analytic methods. For the continuous variables, the weighted mean difference (WMD) was used. For dichotomous data, the relative risk (RR) was calculated.
  
  
  RESULTS
  10 studies were eligible for data extraction. The pooled data showed that compared with EF, IF led to statistically significantly better Disabilities of the Arm, Shoulder, and Hand (DASH) scores at 12 months postoperatively, recovery of forearm supination at 3 months, and restoration of volar tilt and radial inclination. IF using volar locking plates resulted in better DASH scores than EF at 3 and 6 months, but the trend diminished over time; at 12 months postoperatively, the scores were not statistically significant. Compared with EF, IF led to fewer minor surgical complications.
  
  
  CONCLUSIONS
  For surgical treatment of distal radius fractures, IF yields better functional outcomes, forearm supination, restoration of anatomic volar tilt and radial inclination, and fewer minor complications. The patients who received IF using volar locking plates for the treatment of distal radius recovered more quickly than did patients who received EF.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai PR China.
authors.forename: Xuetao
authors.initials: X
authors.lastname: Xie
authors.forename: Xiaoxing
authors.initials: X
authors.lastname: Xie
authors.forename: Hui
authors.initials: H
authors.lastname: Qin
authors.forename: Longxiang
authors.initials: L
authors.lastname: Shen
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhang
mesh_terms: D001860:Bone Plates; D016267:External Fixators; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006801:Humans; D011885:Radius Fractures / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function