Introduction
Materials and methods
Eligibility criteria
Types of outcome measures
Data sources
Medline
((((distal[Title/Abstract]) AND fracture*[Title/Abstract]) AND ((radius[Title/Abstract]) OR radial[Title/Abstract])) OR (((((colles’ fracture*[Title/Abstract]) OR colles fracture*[Title/Abstract]) OR smith fracture*[Title/Abstract]) OR barton fracture*[Title/Abstract]) OR wrist fracture*[Title/Abstract])) AND (((volar[Title/Abstract]) OR palmar[Title/Abstract]) OR palmer[Title/Abstract]) AND ((((external fix*[Title/Abstract]) OR fixation ext*[Title/Abstract]) OR fixateur ext*[Title/Abstract]) OR fixator ext*[Title/Abstract]) |
EMBASE
((((distal.ti,ab) AND fracture*.ti,ab) AND ((radius.ti,ab) OR radial.ti,ab)) OR (((((colles’ fracture*.ti,ab) OR colles fracture*.ti,ab) OR smith fracture*.ti,ab) OR barton fracture*.ti,ab) OR wrist fracture*.ti,ab)) AND (((volar.ti,ab) OR palmar.ti,ab) OR palmer.ti,ab) AND ((((external fix*.ti,ab) OR fixation ext*.ti,ab) OR fixateur ext*.ti,ab) OR fixator ext*.ti,ab) |
Cochrane Central Register of Controlled Trials
(distal:ti,ab,kw and fracture*:ti,ab,kw) AND (radius:ti,ab,kw or radial:ti,ab,kw or “Colles’ fracture*”:ti,ab,kw or “Colles fracture*”:ti,ab,kw or “Barton’s fracture”:ti,ab,kw or smith fracture*:ti,ab,kw or “Smith’s fracture*”:ti,ab,kw or wrist fracture*:ti,ab,kw) AND (“volar”:ti,ab,kw or “palmar”:ti,ab,kw or “Palmer”:ti,ab,kw) AND (extern*:ti,ab,kw or “fixation”:ti,ab,kw or “fixator”:ti,ab,kw or fixat*:ti,ab,kw) |
Study selection
Data extraction
Data synthesis
Sensitivity analysis
Results
Literature search
Description of included studies
Author | Study design | AO classification of included fractures | Sample size | Mean age (years) | Country | Year published | DASH reported at | |
---|---|---|---|---|---|---|---|---|
Fix ex | Vo. Lo. plate | |||||||
Egol et al. | RCTa | A, B, C | 38 | 39 | 51 | USA | 2008 | 3, 6, 12 months |
Wei et al. | RCT | A3, C1, C2, C3 | 22 | 12 | 57 | USA | 2009 | 3, 6, 12 months |
Wilcke et al. | RCT | A, C1 | 30 | 33 | 56 | Sweden | 2011 | 3, 6, 12 months |
Methodological quality
Functional and radiological outcome
Outcome | Number of studies | Mean difference |
---|---|---|
Grip strength as percentage of uninjured side | 3 | −1.73 (−12.27, 15.73) |
Flexion (degrees) | 2 | 0.44 (−4.66, 5.53) |
Extension (degrees) | 2 | 4.46 (−5.21, 14.14) |
Radial inclination (degrees) | 2 | −2.06 (−4.6, 0.49) |
Ulnar variance (mm) | 3 | −0.086 (1.82, 0.10) |
Radial length (mm) | 3 | −0.96 (−1.96, 0.04) |
Sensitivity analysis
Complications
Complication | ORIF with volar locking plate (N) | Bridging external fixator (N) |
---|---|---|
Pin tract infection | 9 | |
Deep infection | 1 | |
Ruptured extensor/flexor pollicis longus tendon | 3 | 1 |
CRPS Ia | 3 | |
Nonunion | 1 | 1 |
Painful retained hardware | 4 | |
CTSb | 2 | |
Tenolysis for postoperative stiffness | 1 | |
Malunion | 4 | |
Tendinitis | 1 | 1 |
Total | 17/84 (20 %) | 23/90 (26 %) |