title: Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The choice between volar locking plates (VLP) and external fixation (EF) for unstable distal radius fractures have not reached a consensus. The meta-analysis of randomized controlled trials was performed to compare VLP with EF to determine the dominant strategy.
  
  
  METHODS
  Meta-analysis was performed with a systematic search of studies conducted by using the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. The randomized controlled trials that compared VLP with EF was identified. Characteristics, functional outcomes, radiological results, and complications were manually extracted from all the selected studies.
  
  
  RESULTS
  Six studies encompassing 445 patients met the inclusion criteria. There was significant difference between two procedures in disabilities of the arm shoulder and hand scores at 3,6, and 12 mo, visual analogue scale at 6 mo, grip strength at 3 mo, supination at 3 and 6 mo, extension at 3 mo, ulnar variance at 12 mo, and reoperation rate at 12 mo, postoperatively. However, there was no significant difference between flexion, pronation, radial deviation, and ulnar deviation at all follow-up points postoperatively and overall complications at 12 mo, postoperatively.
  
  
  CONCLUSIONS
  EF had less reoperative rate due to complications, however, VLP had advantages in functional recovery in the early period after surgery, but two methods had similar functional recovery at 12 mo, postoperatively. Clinician should make the treatment decision with great caution for the patients who sustained unstable distal radial fractures.
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing, P.R. China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Li-hai
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing, P.R. China; School of Medicine, Nankai University, Tianjin, P.R. China.
authors.forename: Wang
authors.initials: W
authors.lastname: Ya-nan
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing, P.R. China.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhi
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing, P.R. China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Li-cheng
authors.affiliation: School of Medicine, Nankai University, Tianjin, P.R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Hong-da
authors.affiliation: School of Medicine, Nankai University, Tianjin, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Huan
authors.affiliation: Rehabilitation Medicine Center, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xiao-xie
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing, P.R. China. Electronic address: pftang301@sina.com.
authors.forename: Tang
authors.initials: T
authors.lastname: Pei-fu
mesh_terms: D001860:Bone Plates; D004185:Disability Evaluation; D016267:External Fixators; D006801:Humans; D053401:Palmar Plate / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function
keywords: External fixation; Meta-Analysis; Randomized controlled trials; Unstable distal radial fractures; Volar locking plate