Meta-analysis of the efficacy of plate fixation and external fixator fixation in the treatment of AO-C type distal radius fractures.
10.12200/j.issn.1003-0034.20240557
- Author:
Guang-Yao LI
1
;
Yong-Zhong CHENG
2
;
Huan LIU
3
;
Jun-Jie JIANG
3
;
Yong-Yao LI
4
;
Yang CHEN
4
;
Yu-Xiang YAO
5
Author Information
1. Beijing University of Chinese Medicine, Beijing 100029, China.
2. Department of Traumatology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China; Nanyang Hospital of Traditional Chinese Medicine, Nanyang 473007, Henan, China.
3. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
4. Department of Traumatology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
5. Unit 66322 of the People's Liberation Army, Beijing 100000, China.
- Publication Type:English Abstract
- Keywords:
AO-C type distal radius fracture;
External fixator;
Meta-analysis;
Plate internal fixation
- MeSH:
Humans;
External Fixators;
Bone Plates;
Radius Fractures/surgery*;
Fracture Fixation/methods*;
Fracture Fixation, Internal;
Wrist Fractures
- From:
China Journal of Orthopaedics and Traumatology
2025;38(1):66-80
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:Meta-analysis of the clinical efficacy of plate and external fixator fixation in the treatment of AO-C type distal radius fractures.
METHODS:PubMed, Embase, Cochrane Medical Library, Web of Science, CNKI, Wanfang, VIP and SinoMed databases were searched for all literature on randomized controlled clinical trials of AO-C distal radius fractures. The search time limits were from each database. The database will be established until June 30, 2023. The included studies were extracted according to the Cochrane Handbook (Version 6.3, 2022) for information extraction and literature quality evaluation. RevMan 5.4 was used to evaluate the risk of Publication bias, test heterogeneity and Perform Meta-analysis. The outcome indicators were:imaging anatomy indicators (volar inclination angle, ulnar deviation angle, radial height), wrist joint mobility (flexion, extension, rotation, ulnar deviation), complication rate, and comparison of surgical treatments (operative blood loss, operation time, hospitalization time, fracture healing time) and wrist joint function scores and related scales.
RESULTS:(1) A total of 28 studies were included, with a total of 2 192 patients, including 1 096 cases in the plate internal fixation group and 1 096 cases in the external fixation group.(2) Meta analysis results showed:the surgical treatment situation of the external fixation group:surgical blood loss MD=-37.93, 95%CI(-48.54, -27.31), P<0.000 01;operation time MD=-31.58, 95%CI(-48.96, -14.20), P<0.000 4;hospitalization time MD=-4.58, 95%CI(-5.44, -3.71), P<0.000 01;the fracture healing time MD=-0.88, 95%CI(-1.35, -0.41), P<0.000 2, which were significantly better than that of the plate internal fixation group(P<0.05).(3) The two groups:palmar inclination angle MD=-0.17, 95%CI(-0.95, 0.61), P=0.68;ulnar declination MD=0.22, 95%CI(-0.73, 1.17), P=0.65, radial height MD=-0.24, 95%CI(-1.15, 0.67), P=0.60;flexion and extension MD=-5.63, 95%CI(-11.85, 0.58), P=0.08;rotation MD=-5.80, 95%CI(-12.77, 1.17), P=0.10, radioulnar deviation MD=-2.86, 95%CI(-10.87, 5.15), P=0.48;complication rate RR=0.96, 95%CI(0.63, 1.46), P=0.83;Gartland-Werley clinical wrist score MD=0.13, 95%CI(-0.80, 1.06), P=0.78;excellent and good rate of Gartland-Werley wrist clinical score RR=0.93, 95%CI(0.87, 1.01), P=0.08;excellent and good rate of Cooney wrist score RR=0.99, 95%CI(0.62, 1.59), P=0.98;wrist DASH score MD=-4.67, 95%CI(-14.96, 5.62), P=0.37;the differences were not significant (P>0.05).
CONCLUSION:Compared with internal fixation with plate, external fixation can significantly reduce the amount of surgical bleeding, shorten the operation time, hospitalization time and fracture healing time, and its imaging anatomical indicators, wrist mobility, and complications can be significantly reduced in treating AO-C distal radius fractures. Rates and wrist function scores were equivalent.
