Gou Qi, Xiong Xiong, Cao Dan, He Yuanliang, Li Xu
Department of Orthopedics, The First People's Hospital of Longquanyi District, 610100, Chengdu, China.
Department of Anesthesiology, The First People's Hospital of Longquanyi District, 610100, Chengdu, China.
BMC Musculoskelet Disord. 2021 May 12;22(1):433. doi: 10.1186/s12891-021-04312-7.
The outcomes for volar locking plate (VLP) and external fixation (EF) in distal radius fracture cases remain controversial. The current study of randomized controlled trials (RCTs) aimed to assess VLP and EF, which might benefit distal radius fracture cases.
RCTs comparing VLP and EF in distal radius fracture cases, until 18 March 2020, were systematically reviewed and summarized. The functional and radiographic outcomes, together with complications, for distal radius fracture cases, were evaluated.
In total, 12 studies comprising 1205 distal radius fracture cases were included. The VLP group had observed lower disability in the arm shoulder and hand score (DASH) at 3rd, 6th, and 12th -month post-operation, with the mean differences (MDs) of - 10.43 (95 % CI = - 15.77 to - 5.08, P < 0.01), - 3.48 (95 % CI = - 6.37 to - 0.59, P = 0.02), and - 4.13 (95 % CI = - 6.94 to - 1.33, P < 0.01), respectively. The VLP group also had lower visual analog scale scores (VAS) compared to the EF group, with MDs of - 0.10 (95 % CI = - 0.18 to - 0.03, P < 0.01) for the former at 6th -month post-operation. Also, the EF group exhibited better grip strength than that in the VLP group, with MD of 12.48 (95 % CI = 7.00-17.95, P < 0.01) at the 3rd month and 4.54 (95 % CI = 0.31-8.76, P = 0.04) at 6th month. No significant differences in radiographic outcomes were observed between the VLP and EF groups (P > 0.05). The VLP group had a lower complication rate than that in the EF group.
VLP had a lower DASH score and VAS score but with lower grip strength. No significant differences in radiographic outcomes were observed. VLP had a lower complication rate than that of EF.
在桡骨远端骨折病例中，掌侧锁定钢板（VLP）和外固定（EF）的治疗效果仍存在争议。本随机对照试验（RCT）研究旨在评估VLP和EF对桡骨远端骨折病例可能带来的益处。
系统回顾并总结了截至2020年3月18日比较VLP和EF治疗桡骨远端骨折病例的RCT。评估了桡骨远端骨折病例的功能和影像学结果以及并发症情况。
总共纳入了12项研究，包含了1205例桡骨远端骨折病例。VLP组在术后第3、6和12个月时，上肢肩手功能障碍评分（DASH）较低，平均差值（MDs）分别为-10.43（95%置信区间=-15.77至-5.08，P<0.01）、-3.48（95%置信区间=-6.37至-0.59，P=0.02）和-4.13（95%置信区间=-6.94至-1.33，P<0.01）。VLP组在术后第6个月时的视觉模拟量表评分（VAS）也低于EF组，MD为-0.10（95%置信区间=-0.18至-0.03，P<0.01）。此外，EF组在术后第3个月时握力比VLP组更好，MD为12.48（95%置信区间=7.00-17.95，P<0.01），在第6个月时MD为4.54（95%置信区间=0.31-8.76，P=0.04）。VLP组和EF组在影像学结果上未观察到显著差异（P>0.05）。VLP组的并发症发生率低于EF组。
VLP的DASH评分和VAS评分较低，但握力较弱。在影像学结果上未观察到显著差异。VLP的并发症发生率低于EF。
