Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan

Tahir, Muhammad; Zimri, Faridullah Khan; Ahmed, Nadeem; Jamali, Allah Rakhio; Mehboob, Ghulam; Watson, Katherine Rose; Faraz, Ahmad

doi:10.1177/1753193420977780

Cited by 16 publications

(46 citation statements)

References 22 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The DASH score was used in eight studies at 3 months and in ten studies at ≥12 months ( 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ). A statistical difference was found between the conservative and surgical groups at 3 months ( P < 0.05), with the mean difference (MD) of 9.9 points in favor of the ORIF group.…”

Section: Resultsmentioning

confidence: 99%

“…ROM was analyzed at 3, 6, and 12 months in extension, flexion, pronation, and supination, by 7, 5, and 8 studies, respectively, and in radial and ulnar deviation by 6, 5, and 7 studies ( Table 2 ) ( 31 , 23 , 24 , 25 , 26 , 27 , 28 ). No statistically significant difference for any of the ROM parameters was found between the two treatments, at all-time points.…”

Section: Resultsmentioning

confidence: 99%

“…), and at ≥3 months, it was reported by six studies: the MD was 1.3° ( P = n.s.) ( 22 , 23 , 24 , 26 , 28 , 30 ). Radial inclination in the post-op period was reported by six studies with 0.8° MD ( P = n.s.)…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of malunion was higher in the CR group (17.5% of all complications) compared with the VLP fixation group (2.2%). The main major complication in the VLP fixation group (15.6% of all complications) was carpal tunnel syndrome, while in the CR group, accounted for 10.1% of all complications ( Table 3 for further details) ( 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 32 , 33 ).…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Volar locking plate vs cast immobilization for distal radius fractures: a systematic review and meta-analysis

Oldrini¹,

Feltri²,

Albanese³

et al. 2022

EFORT Open Reviews

View full text Add to dashboard Cite

Introduction The aim of this systematic review and meta-analysis was to evaluate whether volar locking plate (VLP) fixation leads to better clinical and radiological outcomes than those of closed reduction and cast immobilization for the treatment of distal radius fractures (DRFs). Materials and methods A comprehensive literature search was performed in PubMed, Web of Science, and Cochrane databases up to January 2022. Inclusion criteria included randomized controlled trial (RCT) studies comparing VLP fixation with cast immobilization for DRFs. Investigated parameters were Patient-Rated Wrist Evaluation questionnaire, Disabilities of the Harm, Shoulder, and Hand score (DASH), range of motion (ROM), grip strength, quality of life (QoL), radiological outcome, and complication and reoperation rate, both at short- and mid-/long-term follow-up. Assessment of risk of bias and quality of evidence was performed with Downs and Black’s ‘Checklist for Measuring Quality’. Results A total of 12 RCTs (1368 patients) were included. No difference was found for ROM, grip strength, QoL, and reoperation, while the DASH at 3 months was statistically better in the VLP group (P < 0.05). No clinical differences were confirmed at longer follow-up. From a radiological perspective, only radial inclination (4°) and ulnar variance (mean difference 1.1 mm) at >3 months reached statistical significance in favor of the VLP group (both P < 0.05). Fewer complications were found in the VLP group (P < 0.05), but they did not result in different reintervention rates. Conclusions This meta-analysis showed that the surgical approach leads to a better clinical outcome in the first months, better fracture alignment, and lower complication rate. However, no differences in the clinical outcomes have been confirmed after 3 months. Overall, these findings suggest operative treatment for people with higher functional demand requiring a faster recovery, while they support the benefit of a more conservative approach in less demanding patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Volar locking plate vs cast immobilization for distal radius fractures: a systematic review and meta-analysis

Oldrini¹,

Feltri²,

Albanese³

et al. 2022

EFORT Open Reviews

View full text Add to dashboard Cite

show abstract

“…Patients who underwent testing after a fracture had a longer fracture-free interval (819 days) compared with those who did not have testing (579 days), once again highlighting the importance of early intervention. A study conducted in Pakistan showed further evidence that surgical treatment for a distal radial fracture in the elderly population does not portend better functional outcomes than casting 35 . In a younger population with a distal radial fracture treated with a volar locking plate, Goyal et al reported that 90% of patients returned to weight-bearing yoga activities at a mean of 7 months, which may be valuable in counseling patients on return to activity 36 .…”

Section: Wrist Traumamentioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

Wise

2022

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

The intent is to serve as an update of the hand surgery literature for the practicing general orthopaedic surgeon. Carpal Tunnel SyndromeCarpal tunnel syndrome is one of the most common disorders in hand surgery. Nevertheless, the optimum method for diagnosis remains controversial. A growing body of evidence suggests that electrodiagnostic studies [1][2][3][4] are not more sensitive and specific than diagnosis by ultrasound or clinical history and examination. D'Auria et al. 5 examined the role of electrodiagnostic studies compared with clinical judgment and found that the utility of electrodiagnostic studies may be greatest in patients for whom a diagnosis of carpal tunnel syndrome is questionable. Even so, electrodiagnostic studies are performed in many patients with carpal tunnel syndrome 6 . Less expensive, office-based diagnostic tools such as the Carpal Tunnel Syndrome 6 (CTS-6), a 26-point scale that incorporates aspects of the history and clinical examination to predict the probability of carpal tunnel syndrome, and ultrasound will likely supplant the routine use of electrodiagnostic studies for carpal tunnel syndrome.Strong evidence exists for the use of night splints and corticosteroid injections for early treatment of carpal tunnel syndrome. In a comparison of the 2 treatments, 100 patients with a diagnosis of carpal tunnel syndrome were randomized to a night splint or a corticosteroid injection 7 . In the 95 patients who completed follow-up, corticosteroid injections were superior in terms of nocturnal paresthesias, pain, and Boston Carpal Tunnel Questionnaire (BCTQ) function and symptom domains at 1, 3, and 6 months.A novel study on hand function with decreased sensation showed that a digital nerve block to the thumb had the greatest negative impact on dexterity and a loss of sensation in the index and long fingers caused decreased grip and chuck pinch strength, thus explaining the common symptoms of decreased dexterity and strength in patients with carpal tunnel syndrome 8 .Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G899).

show abstract

Association of Open Reduction and Internal Fixation With Volar Locking Plate for Distal Radius Fractures With Patient-Reported Outcomes in Older Adults

et al. 2023

View full text Add to dashboard Cite

ImportanceRandomized clinical trials (RCTs) and meta-analyses have reported inconsistent conclusions regarding optimal distal radius fracture (DRF) treatment in older adults and are limited due to the inclusion of cohort studies with small sample sizes. A network meta-analysis (NMA) addresses these limitations by only synthesizing direct and indirect evidence from RCTs and may clarify optimal DRF treatment in older adults.ObjectiveTo examine DRF treatment results in optimal short-term and intermediate-term patient-reported outcomes.Data SourcesSearches of MEDLINE, Embase, Scopus, and Cochrane Central Register of Controlled Trials were conducted for RCTs that investigated DRF treatment outcomes in older adults between January 1, 2000, and January 1, 2022.Study SelectionRandomized clinical trials including patients with a mean age of 50 years or older that compared the following DRF treatments were eligible for inclusion: casting, open reduction and internal fixation with volar lock plating (ORIF), external fixation, percutaneous pinning, and nail fixation.Data Extraction and SynthesisTwo reviewers independently completed all data extraction. An NMA aggregated all direct and indirect evidence among DRF treatments. Treatments were ranked by surface under the cumulative ranking curve score. Data are reported as standard mean differences (SMDs) and 95% CIs.Main Outcomes and MeasuresThe primary outcome was short-term (≤3 months) and intermediate-term (&gt;3 months to 1 year) Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores. Secondary outcomes included Patient-Rated Wrist Evaluation (PRWE) scores and 1-year complication rates.ResultsIn this NMA, 23 RCTs consisting of 3054 participants (2495 women [81.7%]) with a mean (SD) age of 66 (7.8) years were included. At 3 months, DASH scores were significantly lower for nail fixation (SMD, −18.28; 95% CI, −29.93 to −6.63) and ORIF (SMD, −9.28; 95% CI, −13.90 to −4.66) compared with casting. The PRWE scores were also significantly lower for ORIF (SMD, −9.55; 95% CI, −15.31 to −3.79) at 3 months. In the intermediate term, ORIF was associated with lowered DASH (SMD, −3.35; 95% CI, −5.90 to −0.80) and PRWE (SMD, −2.90; 95% CI, −4.86 to −0.94) scores. One-year complication rates were comparable among all treatments.Conclusions and RelevanceThe findings of this NMA suggest that ORIF may be associated with clinically significant improvements in short-term recovery compared with casting for multiple patient-reported outcomes measures with no increase in 1-year complication rates. Shared decision-making with patients may be useful to identify patient preferences regarding recovery to determine optimal treatment.

show abstract

Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan

Cited by 16 publications

References 22 publications

Volar locking plate vs cast immobilization for distal radius fractures: a systematic review and meta-analysis

Volar locking plate vs cast immobilization for distal radius fractures: a systematic review and meta-analysis

What’s New in Hand and Wrist Surgery

Association of Open Reduction and Internal Fixation With Volar Locking Plate for Distal Radius Fractures With Patient-Reported Outcomes in Older Adults

Contact Info

Product

Resources

About