Department of Orthopaedic Surgery, Armed Forces Daegu Hospital, Gyeongsan, Korea.
Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Clin Orthop Surg. 2019 Jun;11(2):208-219. doi: 10.4055/cios.2019.11.2.208. Epub 2019 May 9.
Open reduction and internal fixation using a volar locking plate has been increasingly performed for distal radius fractures. Both conventional and minimally invasive plate osteosynthesis (MIPO) techniques are widely used to treat distal radius fractures. However, it is unclear which of the techniques yields better outcomes after surgery for distal radius fractures. The purpose of this meta-analysis was to compare the benefits of conventional and MIPO techniques for distal radius fractures in terms of clinical outcomes.
Medline, Embase, and the Cochrane Central Register of Controlled Trials electronic databases were searched for articles comparing the outcomes of the conventional and MIPO techniques and published up until July 2017. Data search, extraction, analysis, and quality assessment were performed based on the Cochrane Collaboration guidelines. Clinical outcomes were evaluated using various outcome measures.
Four clinical studies were included in the analysis. No significant clinical differences were found between the techniques in clinical hand scoring, grip strength, and range of motion. However, patient satisfaction after surgery was significantly higher in the MIPO group than that in the conventional group (standard mean difference, -0.54; 95% confidence interval [CI], -0.79 to -0.29; I = 0%). Furthermore, although there were no significant differences in volar tilt and ulnar variance between the two groups, radial inclination revealed a significant difference between the two groups (radial inclination: weighted mean difference, 1.20; 95% CI, 0.25 to 2.15; I = 19%).
Both conventional and MIPO techniques were effective for patients with distal radius fractures. Despite limited high quality evidence to compare osteosynthesis with a volar locking plate via the conventional and MIPO techniques, the present study showed that the MIPO technique was associated with more favorable patient satisfaction.
掌侧锁定钢板切开复位内固定已广泛应用于桡骨远端骨折。传统的和微创钢板接骨术（MIPO）技术广泛应用于治疗桡骨远端骨折。然而，对于桡骨远端骨折患者，哪种技术在手术后的结果更好尚不清楚。本荟萃分析的目的是比较传统和 MIPO 技术治疗桡骨远端骨折的临床结果。
通过 Medline、Embase 和 Cochrane 对照试验中心注册数据库检索比较传统和 MIPO 技术治疗桡骨远端骨折的结果，并对截至 2017 年 7 月的文章进行筛选。数据检索、提取、分析和质量评估均基于 Cochrane 协作组指南进行。使用各种结果测量指标评估临床结果。
纳入的 4 项临床研究进行了分析。在临床手部评分、握力和活动范围方面，两种技术之间没有显著的临床差异。然而，MIPO 组患者术后满意度显著高于传统组（标准均数差，-0.54；95%置信区间 [CI]，-0.79 至 -0.29；I = 0%）。此外，两组间掌倾角和尺侧偏距无显著差异，但桡骨倾斜度有显著差异（桡骨倾斜度：加权均数差，1.20；95% CI，0.25 至 2.15；I = 19%）。
传统和 MIPO 技术均对桡骨远端骨折患者有效。尽管有比较传统和 MIPO 技术经掌侧锁定钢板接骨术的高质量证据有限，但本研究显示 MIPO 技术与患者满意度更高相关。
