The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters fol...The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius （IFDR） in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after I week and 3, 6 and 12 months. After 3 months, the plating group had better pronation （P = 0.001）, supination, （P = 0.047） and extension （P = 0.043） scores. These differences were somewhat attenuated by 6 months and disappeared at I year. The plating group had a greater occurrence of wound infection （P = 0.043）, tendonitis, （P = 0.024） and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the ＂gross motor＂ category （walking upstairs, bending over, walking 500 yards; P = 0.023）. Internal fixation was more advantageous than external fixation in the early rehabilitation period; after I year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries.展开更多
Purpose： Distal radial fracture is one of the most common fractures. Up to now, locking plates （LP） and external fixation （EF） are two conventional surgical approaches to type C radius fracture. Which method is s...Purpose： Distal radial fracture is one of the most common fractures. Up to now, locking plates （LP） and external fixation （EF） are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two in- terventions by this meta-analysis. Methods： We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow： radial inclination, patmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results： Seven studies included 162 patients （LP group） and 190 patients （EF group）. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI （0.17, 3.50）, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [（WMD = 3.61, 95% CI （0.00, 7.23）, p = 0.05; WMD = 0.05, 95% CI （-0.99,1.09）, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI （-6.88, 26.96）, p = 0.24; WMD = 12.53, 95% CI （-9.99, 35.06）, p = 0.28]. Conclusion： Locking plate and external fixation is feasible to heal radius type C fracture. We found the small difference between the two groups on imaging examination. The locking plate has the advantage on maintaining reduction, however no significant difference regarding outcomes has been found be- tween the two groups.展开更多
基金supported by National Natural Science Foundation of China Grant 81560350
文摘The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius （IFDR） in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after I week and 3, 6 and 12 months. After 3 months, the plating group had better pronation （P = 0.001）, supination, （P = 0.047） and extension （P = 0.043） scores. These differences were somewhat attenuated by 6 months and disappeared at I year. The plating group had a greater occurrence of wound infection （P = 0.043）, tendonitis, （P = 0.024） and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the ＂gross motor＂ category （walking upstairs, bending over, walking 500 yards; P = 0.023）. Internal fixation was more advantageous than external fixation in the early rehabilitation period; after I year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries.
文摘Purpose： Distal radial fracture is one of the most common fractures. Up to now, locking plates （LP） and external fixation （EF） are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two in- terventions by this meta-analysis. Methods： We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow： radial inclination, patmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results： Seven studies included 162 patients （LP group） and 190 patients （EF group）. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI （0.17, 3.50）, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [（WMD = 3.61, 95% CI （0.00, 7.23）, p = 0.05; WMD = 0.05, 95% CI （-0.99,1.09）, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI （-6.88, 26.96）, p = 0.24; WMD = 12.53, 95% CI （-9.99, 35.06）, p = 0.28]. Conclusion： Locking plate and external fixation is feasible to heal radius type C fracture. We found the small difference between the two groups on imaging examination. The locking plate has the advantage on maintaining reduction, however no significant difference regarding outcomes has been found be- tween the two groups.
