title: Predictors of unstable distal radius fractures: a systematic review and meta-analysis.
abstract: The aim of this study was to perform a systematic review in order to identify predictors of secondary displacement in distal radius fractures. We performed a systematic review and identified all studies that reported secondary displacement following distal radius fractures. Where possible, we pooled the odds ratios of predictors. The initial search yielded 3178 studies of which 27 were included. Multiple studies found that age, shortening, volar comminution, loss of radial inclination, the presence of a volar hook, AO type 3 fractures (A3, B3, C3) and the Older classification were significant predictors of secondary displacement. Pooling revealed a significantly increased risk of secondary displacement in fractures with dorsal comminution, in women and in patients aged >60 years. An associated ulna fracture or intra-articular involvement does not result in an increased risk of secondary displacement. The overview provided in this study can help surgeons to inform patients of the chances of success of closed treatment regarding the radiological outcome and facilitate shared decision making.
  
  
  METHODS
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authors.affiliation: Trauma Unit, University of Amsterdam, Amsterdam, The Netherlands m.m.walenkamp@amc.nl.
authors.forename: M M J
authors.initials: MM
authors.lastname: Walenkamp
authors.affiliation: Trauma Unit, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Aydin
authors.affiliation: Trauma Unit, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M A M
authors.initials: MA
authors.lastname: Mulders
authors.affiliation: Trauma Unit, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
authors.affiliation: Trauma Unit, University of Amsterdam, Amsterdam, The Netherlands Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
authors.forename: N W L
authors.initials: NW
authors.lastname: Schep
mesh_terms: D000367:Age Factors; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D018460:Fractures, Comminuted / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology*; D007593:Joint Instability / Q000503:physiopathology*; D011183:Postoperative Complications / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011885:Radius Fractures / Q000503:physiopathology* / Q000601:surgery*; D012307:Risk Factors; D012737:Sex Factors
keywords: Distal radius fracture; displacement; instability; loss of position; loss or reduction; predictors; unstable