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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Article info
Publication history
Published online: June 23, 2021
Accepted:
June 17,
2021
Received in revised form:
May 18,
2021
Received:
March 24,
2021
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: The authors have nothing to disclose.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
