Complications following open reduction and internal fixation versus external fixation in treating unstable distal radius fractures: Grading the evidence through a meta-analysis.
Orthop Traumatol Surg Res
; 104(1): 95-103, 2018 02.
Article
en En
| MEDLINE
| ID: mdl-29031702
BACKGROUND: The common fixation techniques for unstable distal radius fractures include open reduction and internal fixation (ORIF) with plates and closed reduction and external fixation (EF). There is controversy over the choice of surgical approach in treating unstable distal radius fractures. HYPOTHESIS: This meta-analysis was performed to compare complication rates in patients treated with ORIF or EF for unstable distal radius fractures and to develop GRADE (grading of recommendations, assessment, development, and evaluation)-based recommendations for using the procedures to treat unstable distal radius fractures. MATERIALS AND METHODS: A systematic search of all the studies published was conducted using the Pubmed, ScienceDirect, Embase, BIOSIS, Springer, Cochrane Library databases. The randomized controlled trials (RCTs) that compared ORIF with EF in treating adult patients with unstable distal radius fractures and provided data regarding the complication were identified. The demographic characteristics and adverse events were manually extracted from all of the included studies. RevMan 5.1 was used for data analysis. PRISMA guidelines were followed. RESULTS: Sixteen studies that included a total of 1280 patients met the inclusion criteria. Compared with ORIF, EF results in higher incidence of total complications, infection and malunion. The overall GRADE system evidence quality was very low, which reduces our confidence in the recommendations of this system. DISCUSSION: This meta-analysis indicates that ORIF and EF are both effective procedures for treating unstable distal radius fractures. ORIF may be superior to EF in the treatment of unstable distal radius fractures. Because of the low quality evidence currently available, high-quality RCTs are required. LEVEL OF EVIDENCE: Level II: low-powered prospective randomized trial meta-analysis.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fracturas del Radio
/
Fijación de Fractura
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Orthop Traumatol Surg Res
Año:
2018
Tipo del documento:
Article
País de afiliación:
China
Pais de publicación:
Francia