The external fixation can be a good alternative to plate-screw treatment in the surgical treatment of bilateral distal radius fractures: A retrospective cohort study

Dağtaş, Mirza Zafer; Ünal, Ömer Kays

doi:10.52312/jdrs.2021.151

Cited by 8 publications

(8 citation statements)

References 27 publications

(38 reference statements)

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“…Therefore, the EF group had significantly lower surgery time and intraoperative blood loss than the VLP group (both p < 0.001), and avoided the trouble of second surgery to remove the implant. Dağtaş et al [ 10 ] compared the efficacy of EF and ORIF in the treatment of bilateral DRF and found that the wrist joint function in the EF group was better than that in the ORIF group during the first 2 months of treatment, making it a good choice for surgical treatment of bilateral DRF. Zhang et al [ 15 ] compared the efficacy of EF and ORIF in the treatment of DRF through a retrospective cohort study, and the results showed that external fixation can provide faster functional recovery and better functional outcomes than ORIF within 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…The main surgical treatment for DRF in adults is open reduction and internal fixation (ORIF) with a volar locking plate (VLP) being the most widely used due to its superior biomechanical properties [ 9 ]. External fixation (EF) is a traditional and commonly used treatment method for DRF due to its mature technique and ease of application, and many surgeons have applied it in the treatment of DRF [ 10 ]. However, there is still no consensus on the optimal surgical treatment for DRF [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is still no consensus on the optimal surgical treatment for DRF [ 11 , 12 ]. Although some related literature has compared the treatment of DRF with EF and VLP in the past, the conclusions drawn are not clear and even contradictory [ 10 , 13 – 15 ]. This study aims to compare two surgical methods in elderly patients aged 65 and above with type C distal radius fractures through retrospective analysis of perioperative data, imaging data, and final wrist joint function, in order to guide clinical decision-making when selecting surgical treatment for this patient population.…”

Section: Introductionmentioning

confidence: 99%

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Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate

Zhang,

Liu,

Duan

et al. 2023

J Orthop Surg Res

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Background ue to the lack of consensus on the optimal surgical treatment for distal radius fractures (DRF) in elderly patients over 65 years old, the purpose of this study was to compare the efficacy of external fixation (EF) with Kirschner wires and volar locking plate (VLP) in the treatment of DRF through a retrospective cohort study. We hypothesized that there would be no significant difference in overall complications and functional recovery between the two methods. Methods We retrospectively analyzed 62 patients over 65 years old who underwent surgical treatment for C-type DRF between 2019 and 2022. Based on the different treatment methods, they were divided into the EF group and the VLP group. General data, inpatient data, and postoperative complications during follow-up were recorded. The X-ray images before surgery, after surgery, and at the last follow-up were analyzed, and the results of wrist motion range, Gartland–Werley wrist joint score, and DASH score were evaluated 6 months after surgery for both groups. Result Thirty patients underwent closed reduction and external fixation combined with Kirschner wire fixation, while 32 underwent open reduction and VLP fixation. The EF group had significantly shorter operation time, intraoperative blood loss, injury-to-surgery time, and hospital stay compared to the VLP group (all p < 0.001). At the last follow-up, the radiographic parameters (ulnar variance and radial inclination) and wrist joint function (wrist dorsiflexion and forearm supination) were better in the VLP group than in the EF group (p = 0.04, p = 0.01, p = 0.001, p = 0.02, respectively). However, there was no significant difference in overall Gartland-Werley wrist joint score, DASH score, and incidence of postoperative complications between the two groups (p = 0.31, p = 0.25, p = 0.47, respectively). Conclusion For patients aged 65 and above with distal radius fractures (DRF) of type C, VLP and external fixation with Kirschner wires yield comparable functional outcome and complications rate at the short term. However, VLP allowed restoration of better radiological parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate

Zhang,

Liu,

Duan

et al. 2023

J Orthop Surg Res

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“…1). Seven articles compared volar plating with dorsal plating [1,8,24,29,30,34,53], eight compared volar plating with casting [2,5,10,18,29,43,44,54], 15 compared volar plating with external fixation [3,7,11,12,15,17,21,23,36,39,40,42,50,52,55], and six compared volar plating with K-wire fixation [9,27,32,35,51,56]. Study characteristics, including the number of patients in each treatment group, the sensitivity analyses implemented (if any), and RRs for total and major complications were recorded (Table 1).…”

Section: Study Retrieval and Characteristicsmentioning

confidence: 99%

Are Observational Studies on Distal Radius Fracture Treatment Robust? An E-value Approach to Analysis

Wang

Chung

Baxter

et al. 2023

Clin Orthop Relat Res

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BackgroundReported complication frequencies after distal radius fracture (DRF) treatment vary widely in the literature and are based mostly on observational evidence. Whether that evidence is sufficiently robust to use in practice is controversial. The E-value is an innovative sensitivity analysis that quantitates the robustness of observational evidence against unmeasured confounders, whereby a greater E-value usually implies more robust evidence and vice versa; with DRF complications, this approach can help guide readers to a more confident interpretation of the available evidence.Questions/purposesIn this study, we sought (1) to compare the complication frequencies among different DRF treatment modalities, and (2) to evaluate the robustness of these observational studies using the E-value as an index for unmeasured confounding.MethodsWe searched PubMed, Embase, and SCOPUS for observational studies on the management of DRFs that were published from January 2001 to July 2021 with the last database search performed on July 31, 2021. All articles that compared different DRF treatment modalities with reported complication frequencies were included to accurately capture the quality of the observational studies in research about DRF. Risk ratios (RRs) of the overall complication and major complication risks were calculated for each subgroup comparison: volar plating versus dorsal plating, casting, external fixation, and percutaneous K-wire fixation. The RRs and their corresponding lower limits of the 95% confidence intervals (CIs) were used to derive the E-values. E-values can have a minimum possible value of 1, which signifies that the treatment-outcome association is not strong and can readily be overturned by unmeasured confounders. By contrast, a large E-value means that the observed treatment-outcome association is robust against unmeasured confounders. We averaged RRs and E-values for the effect estimates and lower limits of CIs across studies in each treatment comparison group. We identified 36 comparative observational studies that met the inclusion criteria. Seven studies compared volar with dorsal plating techniques. Volar plating was also compared with casting (eight studies), external fixation (15 studies), and percutaneous K-wire fixation (six studies).ResultsTotal and major complication risks did not differ among different DRF treatments. The mean RRs for total and major complications were 1.2 (95% CI 0.4 to 3.9; p = 0.74) and 1.8 (95% CI 0.4 to 11.4; p = 0.52) for the volar versus dorsal plating group; 1.2 (95% CI 0.3 to 11.2; p = 0.87) and 1.5 (95% CI 0.3 to 14.9; p = 0.74) for the volar plating versus casting group; 0.6 (95% CI 0.2 to 2.2; p = 0.33) and 0.8 (95% CI 0.2 to 6.7; p = 0.86) for the volar plating versus external fixation group; and 0.6 (95% CI 0.2 to 2.6; p = 0.47) and 0.7 (95% CI 0.2 to 4.0; p = 0.67) for the volar plating versus K-wire fixation group. The mean E-values for total and major complication frequencies for the between-group comparison ranged from 3.1 to 5.8; these were...

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“…The prognosis of patients with good joint function recovery is crucial for improving the quality of life of patients. [ 1 ] Belonging to the transforming growth factor-alpha (TGF-β) family, bone morphogenetic protein-7 (BMP-7) has been verified to promote the rapid recovery of bone injuries in clinic. [ 2 ] Thromboxane A2 (TXA2) is a vasoactive factor.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of bone morphogenetic protein-7, thromboxane A2, and osteoprotegerin for prognosis of patients with distal radius fractures

et al. 2023

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Objectives This study aims to investigate the predictive value of bone morphogenetic protein-7 (BMP-7), thromboxane A2 (TXA2), and osteoprotegerin (OPG) for the prognosis of patients with distal radius fractures. Patients and methods Between January 2021 and January 2022, a total of 124 patients (71 males, 53 females; mean age: 49.8±5.1 years; range, 34 to 68 years) with distal radius fractures were included in the fracture group. Healthy volunteers receiving physical examination in our hospital in the same period were included in the control group (n=50; 29 males, 21 females; mean age: 50.1±5.4 years; range, 35 to 68 years). The expressions of BMP-7, TXA2, and OPG in the peripheral blood were detected. In the fracture group, 124 patients underwent internal fixation after inclusion and followed for six months. The prognosis was evaluated based on the Gartland & Werley scoring system for wrist joint function. The factors influencing prognosis were analyzed, and the predictive values of BMP-7, TXA2, and OPG were calculated. Results Age, fracture classification, early loss of palmar tilt, late loss of palmar tilt, time to return to exercise after surgery, BMP-7, TXA2, and OPG were all factors influencing the prognosis (p<0.05). For predicting the prognosis, the area under the ROC curve of BMP-7 + TXA2 + OPG (0.928) was significantly larger than those of BMP-7 (0.810), TXA2 (0.856) and OPG (0.823) alone, and BMP-7 + TXA2 + OPG had the highest predictive efficiency. The BMP-7 was negatively correlated with TXA2 (r=-0.471), but positively correlated with OPG (r=0.437). Conclusion The combined detection of BMP-7, OPG, and TXA2 is highly valuable for predicting the prognosis of patients with distal radius fractures.

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The external fixation can be a good alternative to plate-screw treatment in the surgical treatment of bilateral distal radius fractures: A retrospective cohort study

Cited by 8 publications

References 27 publications

Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate

Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate

Are Observational Studies on Distal Radius Fracture Treatment Robust? An E-value Approach to Analysis

Predictive value of bone morphogenetic protein-7, thromboxane A2, and osteoprotegerin for prognosis of patients with distal radius fractures

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