College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
J Hand Ther. 2023 Jan-Mar;36(1):23-32. doi: 10.1016/j.jht.2021.06.004. Epub 2021 Jul 23.
Systematic review and meta-analysis.
The use of volar locking plate (VLP) in the fixation of fracture fragments promised a new era in the management of distal radius fracture (DRF).
To compare the patient-reported outcomes, functional outcomes, pain, and adverse events between the different periods of immobilization following open reduction and internal fixation of DRFs with VLP.
We searched Medline/Pubmed, Web of Science, Ovid, and CINAHL. The inclusion criteria was randomized controlled trials that compared different immobilization periods after open reduction and internal fixation of DRFs with VLP. The last search was performed on 2 June 2020. The different immobilization periods were divided into the following 3 groups: ≤1-week group, 2-3-week group, and 5-6-week group.
Seven eligible randomized controlled trials provided data on 509 patients. We found that compared to 5-6-week group, ≤1-week and 2-3-week groups showed a reduction in overall Patient-Reported Wrist Evaluation score (SMD = -0.48, 95% CI -0.73 to -0.22, P < .001; SMD = -0.69, 95% CI -0.97 to -0.41, P < .001, respectively). We also found that there were improvements in the other patient-reported outcomes including overall Disabilities of the Arm, Shoulder, and Hand score and pain; and functional outcomes including overall grip strength and range of motion measures in favor of ≤1-week and 2-3-week groups.
This systematic review and meta-analysis showed that compared to immobilization for 5 to 6 weeks after DRF repair, immobilization for ≤1 week or 2-3 weeks showed improvements in the patients-reported outcomes and functional outcomes. The differences between the 3 immobilization groups may not be clinically important considering the small changes as follow up progresses.
系统评价和荟萃分析。
掌侧锁定板（VLP）在骨折碎片固定中的应用开创了桡骨远端骨折（DRF）治疗的新纪元。
比较不同固定时间段对 VLP 固定 DRF 后患者报告的结果、功能结果、疼痛和不良事件的影响。
我们检索了 Medline/Pubmed、Web of Science、Ovid 和 CINAHL。纳入标准为比较 VLP 固定 DRF 切开复位内固定后不同固定时间段的随机对照试验。最后一次检索时间为 2020 年 6 月 2 日。不同的固定时间段分为以下 3 组：≤1 周组、2-3 周组和 5-6 周组。
7 项符合纳入标准的随机对照试验共纳入 509 例患者的数据。我们发现，与 5-6 周组相比，≤1 周和 2-3 周组的总体患者报告腕关节评估评分（SMD=-0.48，95%CI-0.73 至-0.22，P<0.001；SMD=-0.69，95%CI-0.97 至-0.41，P<0.001）降低。我们还发现，其他患者报告的结果包括总体上肢功能障碍、肩和手评分和疼痛，以及功能结果包括总体握力和运动范围测量，在≤1 周和 2-3 周组中均有改善。
本系统评价和荟萃分析显示，与 DRF 修复后 5-6 周的固定相比，≤1 周或 2-3 周的固定在患者报告的结果和功能结果方面有所改善。考虑到随着随访的进行，差异变化较小，3 个固定组之间的差异可能没有临床意义。
