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TCM splints versus internal fixation for distal radius fractures: A systematic review and meta-analysis of randomized
Wantao Xiong1, Xin Cui2, Junchen Li3
1Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Background:
The optimal treatment of distal radius fractures (DRFs) remains unclear. This study aimed to compare the clinical outcomes of traditional Chinese medicine (TCM) splints and internal fixation in the treatment of DRFs.
Methods:
A comprehensive search was conducted for randomized controlled trials comparing TCM splints with internal fixation for DRFs using databases such as PubMed, Web of Science, EMBASE, Cochrane Library, SinoMed, the Chinese National Knowledge Infrastructure Database, Wanfang Database, and VIP Database. Following literature screening, data extraction, and evaluation of the risk of bias, data analysis was performed using RevMan 5.3 and Stata 14.2 software. The quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system.
Results:
Eighteen studies comprising 1682 patients with DRFs were included in this analysis. No significant differences were observed in clinical effective rate, volar tilt, radial inclination, radial height, visual analog scale score, or complication rate between the treatment of TCM splints and internal fixation for DRFs. In addition, for clinical effective rate, subgroup analysis based on different evaluation criteria showed no significant difference between the groups. TCM splints demonstrated advantages in fracture healing time.
Conclusion:
TCM splints and internal fixation methods are similar in most clinical outcomes in the treatment of DRFs. However, TCM splints exhibited superior performance in terms of fracture healing time, making them a preferable option. Nonetheless, TCM splints are not a replacement for internal fixation, and internal fixation should still be performed when there are surgical indications. When considering internal fixation surgery, it is critical to thoroughly evaluate the risks and benefits. The optimal treatment plan should be tailored based on the patient's specific needs, individual circumstances, and available clinical expertise.
