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Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis

OBJECTIVE: The aim of this meta-analysis of randomized controlled trials (RCT) and retrospective cohort studies (CS) regarding the use of volar locking plate (VLP) and external fixation (EF) in distal radius fractures was to determine whether there was any evidence that one treatment was superior to...

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Autores principales: Wang, Jie, Lu, Yandong, Cui, Yujie, Wei, Xuelei, Sun, Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Association of Orthopaedics and Traumatology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204453/
https://www.ncbi.nlm.nih.gov/pubmed/30497657
http://dx.doi.org/10.1016/j.aott.2018.06.001
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author Wang, Jie
Lu, Yandong
Cui, Yujie
Wei, Xuelei
Sun, Jie
author_facet Wang, Jie
Lu, Yandong
Cui, Yujie
Wei, Xuelei
Sun, Jie
author_sort Wang, Jie
collection PubMed
description OBJECTIVE: The aim of this meta-analysis of randomized controlled trials (RCT) and retrospective cohort studies (CS) regarding the use of volar locking plate (VLP) and external fixation (EF) in distal radius fractures was to determine whether there was any evidence that one treatment was superior to the other. METHODS: The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electrical databases (PubMed, EMBASE and the Cochrane library) were retrieved to find RCTs and CSs met the eligibility criteria. Two reviewers screened the studies, extracted the data and evaluated the methodological quality, and performed data analysis with RevMan 5.1. The publication bias was test by Stata 14.0. The Begg's and Egger's test were performed by Stata 14.0. The quality of evidence was graded according to the criteria of GRADE. We ultimately included ten RCTs and eleven CSs. RESULTS: A total of 1590 subjects were reported. Publication bias was detected by funnel plot in RCTs. VLP could provide better results such as DASH scores (RCT: MD = −6.12, 95%CI = −12.07–0.17; CS: MD = −6.43, 95%CI = −12.53–0.3), ulnar variance (RCT: MD = −0.81, 95%CI = −1.25–0.37) and infection rate (RCT: RR = 0.25, 95%CI = 0.10–0.65; CS: RR = 0.15, 95%CI = 0.06–0.40). There were no significant differences for G-W scores, VAS and grip strength between the VLP group and EF group. There was significantly greater loss of volar tilt (P = 0.01) and radial inclination (P = 0.02) in patients receiving EF, basing on the CSs. CONCLUSIONS: VLP could provide better results, such as DASH scores, ulnar variance, volar tilt, radial inclination and infection rate. The use of VLP appear to be associated with better results of ROM (flexion, pronation, supination and radial deviation), radiographic parameters (volar tilt and radial inclination) and lower total complication rate and CRPS rate in CSs. LEVEL OF EVIDENCE: Level 1, Therapeutic study.
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spelling pubmed-62044532018-11-05 Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis Wang, Jie Lu, Yandong Cui, Yujie Wei, Xuelei Sun, Jie Acta Orthop Traumatol Turc Research Paper OBJECTIVE: The aim of this meta-analysis of randomized controlled trials (RCT) and retrospective cohort studies (CS) regarding the use of volar locking plate (VLP) and external fixation (EF) in distal radius fractures was to determine whether there was any evidence that one treatment was superior to the other. METHODS: The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electrical databases (PubMed, EMBASE and the Cochrane library) were retrieved to find RCTs and CSs met the eligibility criteria. Two reviewers screened the studies, extracted the data and evaluated the methodological quality, and performed data analysis with RevMan 5.1. The publication bias was test by Stata 14.0. The Begg's and Egger's test were performed by Stata 14.0. The quality of evidence was graded according to the criteria of GRADE. We ultimately included ten RCTs and eleven CSs. RESULTS: A total of 1590 subjects were reported. Publication bias was detected by funnel plot in RCTs. VLP could provide better results such as DASH scores (RCT: MD = −6.12, 95%CI = −12.07–0.17; CS: MD = −6.43, 95%CI = −12.53–0.3), ulnar variance (RCT: MD = −0.81, 95%CI = −1.25–0.37) and infection rate (RCT: RR = 0.25, 95%CI = 0.10–0.65; CS: RR = 0.15, 95%CI = 0.06–0.40). There were no significant differences for G-W scores, VAS and grip strength between the VLP group and EF group. There was significantly greater loss of volar tilt (P = 0.01) and radial inclination (P = 0.02) in patients receiving EF, basing on the CSs. CONCLUSIONS: VLP could provide better results, such as DASH scores, ulnar variance, volar tilt, radial inclination and infection rate. The use of VLP appear to be associated with better results of ROM (flexion, pronation, supination and radial deviation), radiographic parameters (volar tilt and radial inclination) and lower total complication rate and CRPS rate in CSs. LEVEL OF EVIDENCE: Level 1, Therapeutic study. Turkish Association of Orthopaedics and Traumatology 2018-09 2018-06-29 /pmc/articles/PMC6204453/ /pubmed/30497657 http://dx.doi.org/10.1016/j.aott.2018.06.001 Text en © 2018 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Wang, Jie
Lu, Yandong
Cui, Yujie
Wei, Xuelei
Sun, Jie
Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
title Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
title_full Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
title_fullStr Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
title_full_unstemmed Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
title_short Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis
title_sort is volar locking plate superior to external fixation for distal radius fractures? a comprehensive meta-analysis
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204453/
https://www.ncbi.nlm.nih.gov/pubmed/30497657
http://dx.doi.org/10.1016/j.aott.2018.06.001
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