Dynamic and static external fixation for distal radius fractures--a systematic review

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomedical Engineering

Background:

• External fixation for distal radius fractures includes static (wrist-bridging) and dynamic (mobile hinge or non-bridging) methods.
• Unstable distal radius fractures require effective stabilization techniques.

Purpose of the Study:

• To systematically review and compare the effectiveness of different external fixation methods for unstable distal radius fractures.
• To evaluate functional and radiological outcomes associated with static, dynamic, and non-bridging external fixators.

Main Methods:

• A systematic literature search was conducted on the Medline database.
• Included studies comprised meta-analyses, randomized controlled trials (RCTs), and comparative studies, critically appraised for quality.
• Eight high-quality studies (six RCTs, two comparative studies) were included in the review.

Main Results:

• Dynamic wrist-bridging external fixators showed no functional or radiological superiority over static wrist-bridging fixators.
• Non-bridging fixation demonstrated functional and radiological benefits over static wrist-bridging fixation in patients of all ages.
• No significant benefits were observed for non-bridging fixation over static fixation in older patients.

Conclusions:

• Both dynamic and static external fixators yield comparable outcomes and complication rates for unstable distal radius fractures.
• Non-bridging fixation may offer improved functional and radiological results and earlier return to function for most patients.
• While not showing superior outcomes in older patients, non-bridging fixation may offer practical advantages in mobility and independence, warranting cost-effectiveness analysis.