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Treatment Outcomes for Distal Radius Fractures: A Meta-Analysis.

Ki Woong Yoon1, Jiayong Liu2, Martin Skie2

  • 1University of Toledo College of Medicine and Life Sciences, Ohio.

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PubMed
Summary
This summary is machine-generated.

Comparing distal radius fracture treatments, percutaneous pinning offers the best function but higher infection risk. Volar locking plates (VLP) improve function over bracing, while splinting and bracing provide comparable outcomes to VLP in some measures.

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Area of Science:

  • Orthopedics
  • Traumatology
  • Evidence-based medicine

Background:

  • Distal radius fractures (DRFs) are common upper-extremity injuries, especially in older adults and osteoporotic individuals.
  • Current treatments include volar locking plate (VLP) fixation, percutaneous pinning, splinting, and bracing.
  • Comparative effectiveness data for these DRF treatment modalities are limited.

Purpose of the Study:

  • To compare functional outcomes and complication rates of VLP, percutaneous pinning, bracing, and splinting for DRF treatment.
  • To inform clinical decision-making for distal radius fracture management.

Main Methods:

  • Systematic literature search of PubMed, Google Scholar, and Cochrane Library (2001-2025).
  • Inclusion of randomized controlled trials and cohort studies comparing DRF treatments.
  • Analysis of functional outcomes (DASH, PRWE, grip strength) and complication rates (infection, malunion, nonunion, delayed union).

Main Results:

  • Twenty-seven studies with 3,200 patients were analyzed.
  • No significant differences between VLP and splinting, or bracing and splinting for DASH, PRWE, or grip strength.
  • Percutaneous pinning showed better PRWE scores but higher infection rates than VLP; superior DASH, PRWE, and grip strength than bracing.
  • VLP demonstrated better DASH, PRWE, and grip strength, with lower malunion rates compared to bracing.

Conclusions:

  • All four treatments for distal radius fractures yield acceptable outcomes with distinct trade-offs.
  • Percutaneous pinning offers optimal functional results but carries an increased infection risk.
  • VLP fixation provides superior functional outcomes and lower malunion rates compared to bracing.
  • Individualized treatment selection is crucial, balancing functional benefits against complication risks and patient preferences.