Pacchiarini Luca, Massimo Oldrini Lorenzo, Feltri Pietro, Lucchina Stefano, Filardo Giuseppe, Candrian Christian
Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.
Surgical Department, Hand Surgery Unit EOC, Locarno's Regional Hospital, Locarno, Switzerland.
EFORT Open Rev. 2024 Jun 3;9(6):567-580. doi: 10.1530/EOR-23-0188.
Distal radius fractures (DRFs) represent up to 18% of all fractures in the elderly population, yet studies on the rate of complications following surgery are lacking in the literature. This systematic review aimed to quantify the rate of complications and reinterventions in patients treated with volar plate for distal radius fractures, and analyze if there was any predisposing factor.
A comprehensive literature search was performed on three databases up to January 2023, following PRISMA guidelines. Studies describing volar plate complications and hardware removal were included. A systematic review was performed on complications and rate of reintervention. Assessment of risk of bias and quality of evidence was performed with the 'Down and Black's Checklist for measuring quality'.
About112 studies including 17 288 patients were included. The number of complications was 2434 in 2335 patients; the most frequent was carpal tunnel syndrome (CTS), representing 14.3% of all complications. About 104 studies reported the number of reinterventions, being 1880 with a reintervention rate of 8.5%. About 84 studies reported the reason of reintervention; the most common were patient's will (3.0%), pain (1.1%), CTS (1.2%), and device failure (1.1%).
The complication rate after DRFs is 13.5%, with the main complication being CTS (14.3%), followed by pain and tendinopathy. The reintervention rate is 8.5%, mainly due to the patient's willingness, and all these patients had plate removal. Correct positioning of the plate and correct information to the patient before surgery can reduce the number of hardware removal, thereby reducing costs and the risk of complications associated with VLP for distal radius fractures.
桡骨远端骨折（DRF）占老年人群所有骨折的18%，但文献中缺乏关于手术并发症发生率的研究。本系统评价旨在量化采用掌侧钢板治疗桡骨远端骨折患者的并发症和再次干预率，并分析是否存在任何易感因素。
按照PRISMA指南，截至2023年1月在三个数据库中进行了全面的文献检索。纳入描述掌侧钢板并发症和内固定取出的研究。对并发症和再次干预率进行了系统评价。使用“Down和Black质量测量清单”对偏倚风险和证据质量进行评估。
纳入了约112项研究，共17288例患者。2335例患者出现2434例并发症；最常见的是腕管综合征（CTS），占所有并发症的14.3%。约104项研究报告了再次干预的次数，为1880次，再次干预率为8.5%。约84项研究报告了再次干预的原因；最常见的是患者意愿（3.0%）、疼痛（1.1%）、CTS（1.2%）和器械故障（1.1%）。
桡骨远端骨折后的并发症发生率为13.5%，主要并发症是CTS（14.3%），其次是疼痛和肌腱病。再次干预率为8.5%，主要原因是患者意愿，且所有这些患者均取出了钢板。钢板的正确定位以及术前向患者提供正确信息可减少内固定取出次数，从而降低成本以及与桡骨远端骨折掌侧锁定钢板相关的并发症风险。
