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Langenbeck's Archives of Surgery

, Volume 400, Issue 7, pp 767–779 | Cite as

Comparison of treatment outcomes between nonsurgical and surgical treatment of distal radius fracture in elderly: a systematic review and meta-analysis

  • Ji-Hui Ju
  • Guang-Zhe Jin
  • Guan-Xing Li
  • Hai-Yang Hu
  • Rui-Xing Hou
Systematic Review and Meta-analysis

Abstract

Purpose

The best treatment of distal radius fractures (DRFs) in the elderly is uncertain. The purpose of this meta-analysis was to compare the outcomes of surgical and nonsurgical management of DRFs in persons 65 years of age or older.

Methods

Medline, Cochrane, EMBASE, and Google Scholar databases were searched until April 27, 2015 using the following search terms: distal radius fracture, conservative treatment, nonoperative treatment, nonsurgical treatment, surgical treatment, operative, elderly, and older. The primary outcome measure was DASH score, and secondary outcomes were functional and radiological assessments. The standard difference in post-treatment means was calculated for the outcomes to compare the two groups.

Results

Of 59 articles identified, eight studies with a total of 440 patients in the surgical groups and 449 in the control groups were included in the analysis. No significant differences in DASH score, VAS pain score, grip strength, wrist extension, pronation, or supination, and ulnar deviation were noted between the groups. The nonsurgical group had significantly greater wrist flexion, radial deviation, and ulnar variance and less radial inclination than the surgical group.

Conclusions

Surgical and nonsurgical methods produce similar results in the treatment of DRFS in the elderly, and minor objective functional differences did not result an impact on subjective function outcome and quality of life.

Keywords

Distal radius fracture Elderly Internal fixation Meta-analysis Nonsurgical Open reduction 

Notes

Conflicts of interest

None.

Author contribution

Jihui Ju: study design, literature research, clinical studies, data acquisition, statistical analysis, manuscript preparation

Guangzhe Jin: literature research, clinical studies, data acquisition

Guanxing Li: literature research, clinical studies, data acquisition

Haiyang Hu: literature research, clinical studies, data acquisition

Ruixing Hou: guarantor of integrity of the entire study, study design, manuscript review

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ji-Hui Ju
    • 1
  • Guang-Zhe Jin
    • 1
  • Guan-Xing Li
    • 1
  • Hai-Yang Hu
    • 1
  • Rui-Xing Hou
    • 1
  1. 1.Department of Hand SurgeryRuihua Affiliated Hospital of Soochow UniversitySuzhouChina

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