Internal fixation vs conservative treatment for displaced distal radius fractures: a meta-analysis of randomized controlled trials.
BACKGROUND
The aim of the present study was to compare clinical outcomes of internal fixation and conservative approach in the treatment of displaced distal radius fractures.


METHODS
Reports of studies were retrieved from the PubMed, Cochrane Library, EMBASE, BIOSIS, Ovid, CNKI, and Wanfang Data databases, as well as other sources. Methodological quality of the trials was critically assessed, and relevant data were extracted. Review Manager (RevMan) meta-analysis software (version 5.0; Cochrane Collaboration, London, UK) was used for data analysis.


RESULTS
A total of 10 randomized controlled trials, which included 653 patients, were eligible for inclusion in the present meta-analysis, 7 of which were in English, and 3 of which were in Chinese. The trials had medium risk of bias. Results of meta-analysis showed that patients undergoing conservative treatment for distal radius fractures had better restoration of pronation (MD=1.80, 95% confidence interval [CI]=0.18-3.42, p=0.03; heterogeneity p=0.17, I2=43%), but shorter restoration of radial length (MD=2.62, 95% CI=1.47-3.76, p<0.00001; heterogeneity p=0.02, I2=73%). Wrist range of motion other than pronation, grip strength, radiographic parameters other than radial length, and rates of complications were not significantly different between the 2 treatments.


CONCLUSIONS
Very few clinical differences were found between results of internal fixation and conservative treatment for displaced distal radius fractures. Best course of of treatment must be determined based on concrete conditions.
Department of Orthopaedics and Traumatology, Fuzhou The 2nd Hospital of Xia Men University, Fu Zhou, Fujian-China.
Guang Shu
GS
Yu
Department of Orthopaedics and Traumatology, Fuzhou The 2nd Hospital of Xia Men University, Fu Zhou, Fujian-China. 812953900@qq.com.
Yan Bin
YB
Lin
Department of Orthopaedics and Traumatology, Mawei Branch of Fuzhou The 2nd Hospital, Fu Zhou, Fujian-China.
Li Sheng
LS
Le
Department of Orthopaedics and Traumatology, Luoyuan County Hospital, Luo Yuan, Fujian-China.
Mei Feng
MF
Zhan
Graduate School, Fujian University of Traditional Chinese Medicine, Fu Zhou, Fujian-China.
Xiao Xiang
XX
Jiang
D000072700:Conservative Treatment; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D011885:Radius Fractures / Q000473:pathology / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D015599:Trauma Severity Indices; D016896:Treatment Outcome