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Comparison of immobilization periods following open reduction and internal fixation of distal radius fracture: A systematic review and meta-analysis

  • Abdullah A. Ghaddaf
    Correspondence
    Corresponding author. A.A. Ghaddaf, College of Medicine, King Saud bin Abdulaziz University for health sciences, Jeddah 21589, Saudi Arabia. Tel: +966 12 224 5000Fax: +966 12 224 5000
    Affiliations
    College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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  • Ahmed S. Abdulhamid
    Affiliations
    College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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  • Mohammed S. Alomari
    Affiliations
    College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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  • Mohammed S. Alquhaibi
    Affiliations
    College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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  • Abdulaziz A. Alshehri
    Affiliations
    College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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  • Mohammed S. Alshehri
    Affiliations
    College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    King Abdullah International Medical Research Center, Jeddah, Saudi Arabia

    Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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      Highlights

      • Volar locking plate heralded a shift in the management of distal radius fracture.
      • Early mobilization is beneficial after distal radius fracture repair.
      • Early mobilization improves clinical outcomes after distal radius fracture repair.

      Abstract

      Study Design

      Systematic review and meta-analysis.

      Introduction

      The use of volar locking plate (VLP) in the fixation of fracture fragments promised a new era in the management of distal radius fracture (DRF).

      Purpose of the Study

      To compare the patient-reported outcomes, functional outcomes, pain, and adverse events between the different periods of immobilization following open reduction and internal fixation of DRFs with VLP.

      Methods

      We searched Medline/Pubmed, Web of Science, Ovid, and CINAHL. The inclusion criteria was randomized controlled trials that compared different immobilization periods after open reduction and internal fixation of DRFs with VLP. The last search was performed on 2 June 2020. The different immobilization periods were divided into the following 3 groups: ≤1-week group, 2-3-week group, and 5-6-week group.

      Results

      Seven eligible randomized controlled trials provided data on 509 patients. We found that compared to 5-6-week group, ≤1-week and 2-3-week groups showed a reduction in overall Patient-Reported Wrist Evaluation score (SMD = –0.48, 95% CI –0.73 to –0.22, P < .001; SMD = –0.69, 95% CI –0.97 to –0.41, P < .001, respectively). We also found that there were improvements in the other patient-reported outcomes including overall Disabilities of the Arm, Shoulder, and Hand score and pain; and functional outcomes including overall grip strength and range of motion measures in favor of ≤1-week and 2-3-week groups.

      Conclusion

      This systematic review and meta-analysis showed that compared to immobilization for 5 to 6 weeks after DRF repair, immobilization for ≤1 week or 2-3 weeks showed improvements in the patients-reported outcomes and functional outcomes. The differences between the 3 immobilization groups may not be clinically important considering the small changes as follow up progresses.

      Keywords

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