External fixation versus plate internal fixation in the treatment of unstable distal radius fractures：a Meta-analysis
LE Li-sheng
YU Guang-shu
JIANG Xiao-xiang
WANG Yu
Abstract：Objective To compare clinical outcomes of external fixation versus internal fixation in the treatment of unstable distal radius fractures. Methods Reports of studies, including Chinese and English, using randomized controlled trials ( RCT ) to compare external fixation with internal fixation in the management of unstable distal radius fractures were retrieved ( from January 1st, 1990 to September 1st, 2014 ) from the PubMed, Cochrane Library, EMBASE, BIOSIS, Ovid databases, CNKI, Vip Database, Wanfang Database, and manually. Methodological quality of the trials was critically assessed. Relevant data were extracted. Statistical software Revman 5.1.0 was used for data-analysis. Results A total of 14 randomized controlled trials, 656 cases in external fixation and 644 cases in internal fixation, were included with ten in English and four in Chinese. There were 8 studies that were qualified as level A and 6 studies as level B. Risk-of-bias analysis revealed that all the trials were of medium risk of bias. The results of meta-analysis showed that there were no significant differences on postoperative nerve deficit ( RR=1.14, 95% CI: 0.08 to 16.63, P=0.16 ), reflex sympathetic dystrophy ( RR=0.71, 95% CI: 0.24 to 2.08, P=0.53 ), deformity ( RR=1.22, 95% CI: 0.82 to 1.82, P=0.33 ), and further surgrery ( RR=1.12, 95% CI: 0.29 to 4.37, P=0.87 ) between external fixation and internal fixation. The postoperative Disability of Arm Shoulder and Hand ( DASH ) scores of plate internal fixation was higher than external fixation ( MD=3.76, 95% CI: 0.13 to 7.40, P=0.04 ). The wrist function recovery rate of external fixation was higher than internal fixation ( RR=0.88, 95% CI: 0.79 to 4.73, P=0.98 ). The incidence of infections was lower at external fixation group ( RR=2.53, 95% CI: 1.36 to 4.73, P=0.004 ). Conclusions Both advantages and disadvantages exist in external fixation and internal fixation in the treatment of unstable distal radius fractures. The best treatment option should be decided according to different clinical status.
Keywords：External fixatorsFracture fixationinternalRadius fracturesMeta-analysis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 950-956 )