Is percutaneous pinning an outdated technique for distal radius fractures?

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomedical Engineering

Background:

• Distal radius fractures are common ER visits, accounting for 17.5% of all fractures.
• Treatment remains debated, with a shift towards volar locking plates over traditional pinning.
• Recent advancements have introduced significant changes in surgical management.

Purpose of the Study:

• To compare clinical and radiological outcomes of volar locking plate fixation versus closed reduction and percutaneous pinning for distal radius fractures.
• To analyze factors influencing the choice of surgical treatment.
• To evaluate the long-term efficacy and complication rates of both methods.

Main Methods:

• Systematic review and meta-analysis of clinical studies comparing volar locking plates and percutaneous pinning.
• Assessment of early functional recovery, radiological outcomes, and complication rates.
• Analysis of surgeon and clinic characteristics influencing treatment decisions.

Main Results:

• Volar locking plate fixation demonstrates superior early functional recovery, improved radiological outcomes, and fewer minor complications.
• Long-term functional and radiological results are comparable between the two methods.
• Minor complications and worse radiological outcomes with pinning are not clinically significant.
• Volar locking plate fixation is increasingly preferred over percutaneous pinning.
• Surgeon and clinic factors significantly influence treatment choice, while implant cost is a minor factor.

Conclusions:

• Volar locking plate fixation is a dominant treatment for distal radius fractures due to better short-term outcomes.
• Despite similar long-term results, the preference for plating persists.
• Treatment decisions are influenced by surgeon and institutional factors more than implant cost.