Dergiler / Acta Orthopaedica et Traumatologica Turcica / 2021 / Cilt: 55 - Sayı: 2

Comparison of treatment results between surgical and conservative treatment of distal radius fractures in adults: A meta-analysis of randomized controlled trials

Sayfa
118–126
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Although similar complication rates can be encountered with both treatment modalities, it should be taken into account that the rate of infection may be higher in surgical treatment.Level of Evidence: Level I, Therapeutic Study

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Objective: This meta-analysis study aims to determine the efficacy and safety of surgical and conservative treatments for distal radiusfractures (DRFs) in adults.Methods: Reports of randomized controlled trials were retrieved from the Web of Science, Pubmed, Google Scholar, EMBASE, CochraneLibrary, Medline, Ovid, and BIOSIS for studies that met the eligibility criteria.
📊
Temel Bulgular & Veri:The search strategy was check by two independent reviewers.
💡
Sonuç & Katkı:Although similar complication rates can be encountered with both treatment modalities, it should be taken into account that the rate of infection may be higher in surgical treatment.Level of Evidence: Level I, Therapeutic Study
🔬Tür:Laboratuvar & Saha Deneyi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: This meta-analysis study aims to determine the efficacy and safety of surgical and conservative treatments for distal radiusfractures (DRFs) in adults.Methods: Reports of randomized controlled trials were retrieved from the Web of Science, Pubmed, Google Scholar, EMBASE, CochraneLibrary, Medline, Ovid, and BIOSIS for studies that met the eligibility criteria. The search was limited to human subjects and had nolanguage limits. The search strategy was check by two independent reviewers. If there was any dispute, a third reviewer was consulted.Primary outcomes were: (1) the active wrist range of motion including flexion, extension, pronation, supination, radial, and ulnar deviation; (2) the Disabilities of the Arm, Shoulder, and Hand (DASH) score; and (3) radiological outcomes including radial inclination andulnar variance. Secondary outcomes were the number of complications including non-infectious and infectious. Quality assessment wasperformed using the Cochrane Risk of Bias Tool provided by the Cochrane Review Manager 5.3.Results: A total of 10 randomized controlled trials were included. The meta-analysis detected no statistically significant difference inpooled data for complications not included infection (MD 0.64, CI: 0.33 to 1.23, Z=1.34, p=0.18). Surgical treatment achieved a better rangeof motion (MD 3.76, CI: 1.58 to 5.95, Z=3.37, p=0.0007), DASH score (MD -6.57, CI: -9.08 to -4.06, Z=5.12, p<0.00001), and radiographicoutcomes (MD 3.75, CI: 2.75 to 4.74, Z=7.37, p<0.00001) compared with conservative treatment. In contrast, the conservative treatmentachieved less infection rate compared with surgical treatment (MD 4.09, CI: 1.18 to 14.21, Z=2.21, p=0.03).Conclusion: Findings of this study reveal that when compared with conservative treatment, surgical treatment can ensure better clinical andradiological results for the treatment of DRFs in adults. Although similar complication rates can be encountered with both treatment modalities, it should be taken into account that the rate of infection may be higher in surgical treatment.Level of Evidence: Level I, Therapeutic Study

🔖

Bu Makaleye Atıf Yap

CHEN, Y., LIN, C., HUANG, X., LIN, F., LUO, X. (2021). Comparison of treatment results between surgical and conservative treatment of distal radius fractures in adults: A meta-analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica, Cilt: 55 - Sayı: 2, 118–126. https://ajindex.com/articles/353415

Kaynakça (14)

  1. Körner D, Gonser CE, Bahrs C, Hemmann P. Change in paediatric upper extremity fracture incidences in German hospitals from 2002 to 2017: An epidemiological study. Arch Orthop Trauma Surg 2020; 140: 887-94
  2. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002; 359; 1761-7
  3. Nguyen ND, Ahlborg HG, Center JR, Eisman JA, Nguyen TV. Residual lifetime risk of fractures in women and men. J Bone Miner Res 2007; 22: 781-8
  4. Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury 1989; 20: 208-10
  5. Armstrong KA, von Schroeder HP, Baxter NN, Zhong T, Huang A, McCabe SJ. Stable rates of operative treatment of distal radius fractures in Ontario, Canada: a population-based retrospective cohort study (2004-2013). Can J Surg 2019; 62: 386-92
  6. Trevisan C, Klumpp R, Nava V, Riccardi D, Recalcati W. Surgical versus conservative treatment of distal radius fractures in elderly. Aging Clin Exp Res 2013; 25 Suppl 1: S83-4
  7. Arora R, Lutz M, Deml C, Krappinger D, Haug L, Gabl M. A Prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am 2011; 93: 2146-53
  8. Mattila VM, Huttunen TT, Sillanpää P, Niemi S, Pihlajamäki H, Kannus P. Significant change in the surgical treatment of distal radius fractures: A nationwide study between 1998 and 2008 in Finland. J Trauma 2011; 71: 939-43
  9. Wilcke MKT, Hammarberg H, Adolphson PY. Epidemiology and changed surgical treatment methods for fractures of the distal radius A registry analysis of 42,583 patients in Stockholm County, Sweden, 2004-2010. Acta Orthop 2013; 84: 292-6
  10. Mellstrand-Navarro C, Pettersson HJ, Tornqvist H, Ponzer S. The operative treatment of fractures of the distal radius is increasing results from a nationwide Swedish study. Bone Joint J 2014; 96-B: 963-9
  11. Schneppendahl J, Windolf J, Kaufmann RA. Distal Radius Fractures: Current Concepts. J Hand Surg Am 2012; 37: 1718-25
  12. Handoll HHG, Huntley JS, Madhok R. External fixation versus conservative treatment for distal radial fractures in adults. Cochrane Database Syst Rev 2007; (3): CD006194
  13. Hoaglin DC. Misunderstandings about Q and ‘Cochran’s Q test’ in meta-analysis. Stat Med 2016; 35: 485-95
  14. Gupta R, Raheja A, Modi U. Colles’ fracture: Management by percutaneous crossed-pin fixation versus plaster of Paris cast