Xiong Wantao, Cui Xin, Li Junchen, Guo Chenqi, Yan Yizhuo, Li Yongyao
Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
Medicine (Baltimore). 2025 Jul 18;104(29):e43366. doi: 10.1097/MD.0000000000043366.
The optimal treatment of distal radius fractures (DRFs) remains unclear. This study aimed to compare the clinical outcomes of traditional Chinese medicine (TCM) splints and internal fixation in the treatment of DRFs.
A comprehensive search was conducted for randomized controlled trials comparing TCM splints with internal fixation for DRFs using databases such as PubMed, Web of Science, EMBASE, Cochrane Library, SinoMed, the Chinese National Knowledge Infrastructure Database, Wanfang Database, and VIP Database. Following literature screening, data extraction, and evaluation of the risk of bias, data analysis was performed using RevMan 5.3 and Stata 14.2 software. The quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system.
Eighteen studies comprising 1682 patients with DRFs were included in this analysis. No significant differences were observed in clinical effective rate, volar tilt, radial inclination, radial height, visual analog scale score, or complication rate between the treatment of TCM splints and internal fixation for DRFs. In addition, for clinical effective rate, subgroup analysis based on different evaluation criteria showed no significant difference between the groups. TCM splints demonstrated advantages in fracture healing time.
TCM splints and internal fixation methods are similar in most clinical outcomes in the treatment of DRFs. However, TCM splints exhibited superior performance in terms of fracture healing time, making them a preferable option. Nonetheless, TCM splints are not a replacement for internal fixation, and internal fixation should still be performed when there are surgical indications. When considering internal fixation surgery, it is critical to thoroughly evaluate the risks and benefits. The optimal treatment plan should be tailored based on the patient's specific needs, individual circumstances, and available clinical expertise.
桡骨远端骨折（DRF）的最佳治疗方法仍不明确。本研究旨在比较中医夹板和内固定治疗DRF的临床疗效。
使用PubMed、Web of Science、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中国知网数据库、万方数据库和维普数据库等数据库，全面检索比较中医夹板与内固定治疗DRF的随机对照试验。经过文献筛选、数据提取和偏倚风险评估后，使用RevMan 5.3和Stata 14.2软件进行数据分析。使用推荐分级评估、制定和评价系统评估每个结局的证据质量。
本分析纳入了18项研究，共1682例DRF患者。中医夹板和内固定治疗DRF在临床有效率、掌倾角、桡偏角、桡骨高度、视觉模拟评分或并发症发生率方面均未观察到显著差异。此外，对于临床有效率，基于不同评估标准的亚组分析显示组间无显著差异。中医夹板在骨折愈合时间方面表现出优势。
中医夹板和内固定方法在治疗DRF的大多数临床结局方面相似。然而，中医夹板在骨折愈合时间方面表现更优，使其成为更可取的选择。尽管如此，中医夹板不能替代内固定，有手术指征时仍应进行内固定。在考虑内固定手术时，全面评估风险和益处至关重要。最佳治疗方案应根据患者的具体需求、个体情况和可用的临床专业知识量身定制。
