Wei Jie, Yang Tu-Bao, Luo Wei, Qin Jia-Bi, Kong Fan-Jing
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China.
J Int Med Res. 2013 Apr;41(2):265-75. doi: 10.1177/0300060513476438. Epub 2013 Feb 7.
A meta-analysis to compare complication rates following volar or dorsal surgical fixation of distal radius fracture.
A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized and nonrandomized controlled trials published before 25 August 2012 that compared volar with dorsal fixation, in patients with distal radius fracture.
A quantitative meta-analysis of 12 trials (952 patients) was performed. There was no between-group difference in the overall rate of complications. Volar fixation was associated with significant increases in neuropathy (relative risk [RR] 2.19; 95% confidence intervals [CI] 1.27, 3.76) and carpal tunnel syndrome (RR 4.56; 95% CI 1.02, 20.44), and a reduction in tendon irritation, compared with the dorsal approach (RR 0.38; 95% CI 0.17, 0.86).
Dorsal fixation offers a lower risk of neuropathy and carpal tunnel syndrome than the volar approach, but a higher risk of tendon irritation. Patients with a distal radius fracture can expect similar outcomes after volar or dorsal surgery.
进行一项荟萃分析，比较桡骨远端骨折掌侧或背侧手术固定后的并发症发生率。
对PubMed®/MEDLINE®进行详细检索，以确定2012年8月25日前发表的比较桡骨远端骨折患者掌侧与背侧固定的随机和非随机对照试验。
对12项试验（952例患者）进行了定量荟萃分析。两组间总体并发症发生率无差异。与背侧入路相比，掌侧固定与神经病变显著增加（相对危险度[RR]2.19；95%置信区间[CI]1.27，3.76）和腕管综合征（RR 4.56；95%CI 1.02，20.44）相关，且肌腱激惹减少（RR 0.38；95%CI 0.17，0.86）。
与掌侧入路相比，背侧固定导致神经病变和腕管综合征的风险较低，但肌腱激惹风险较高。桡骨远端骨折患者接受掌侧或背侧手术后的预后相似。
