Dorsal Bridge Plating versus External Fixation for Distal Radius Fractures.

External fixation and dorsal bridge plating are wrist spanning fixation options for distal radius fractures; however, their comparative effectiveness is not well understood. A meta-analysis was conducted to compare the clinical outcomes between these two techniques.  A PubMed database query of all distal radius fracture cases managed with spanning external fixation or dorsal bridge plating was performed. A total of 28 articles met inclusion criteria, yielding 895 patients for data extraction and comparative analysis.  Dorsal bridge plating demonstrated lower rates of infection (2 vs. 10%,  = 0.05) and complex regional pain syndrome (1 vs. 4%,  = 0.04) but higher rates of hardware failure (4 vs. 1%,  = 0.026). Bridge plating also demonstrated higher rates of excellent/good ratings under the Gartland and Werley outcome score (91 vs. 83%,  = 0.016). There was no significant difference in DASH (Disability of the Arm, Shoulder, and Wrist) scores, radiographic parameters, or unplanned reoperations between the two spanning fixation options.  Bridge plating and external fixation both appear to be comparable for spanning fixation constructs for distal radius fractures, but with bridge plating having a potentially lower complication profile.