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Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis

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Abstract

Purpose

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.

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Authors and Affiliations

  1. Orthopaedics and trauma, NanFang Hospital,Southern Medical University, Guangzhou, China

    Zhuang Cui, Bin Yu, Kairui Zhang & Xiaolong Xiong

  2. Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China

    Jianhong Pan

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  1. Zhuang Cui
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Correspondence to Bin Yu.

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Cui, Z., Pan, J., Yu, B. et al. Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis. International Orthopaedics (SICOT) 35, 1333–1341 (2011). https://doi.org/10.1007/s00264-011-1300-0

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