Comparison of treatment outcomes between nonsurgical and surgical treatment of distal radius fracture in elderly: a systematic review and meta-analysis

• Published in: Langenbeck's archives of surgery Vol. 400; no. 7; pp. 767 - 779
• Main Authors: Ju, Ji-Hui, Jin, Guang-Zhe, Li, Guan-Xing, Hu, Hai-Yang, Hou, Rui-Xing
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2015
• Subjects: Abdominal Surgery; Age Factors; Aged; Aged, 80 and over; Cardiac Surgery; Casts, Surgical; Female; Fracture Fixation, Internal - methods; Fracture Healing - physiology; General Surgery; Geriatric Assessment; Humans; Injury Severity Score; Male; Medicine; Medicine & Public Health; Pain Measurement; Radiography; Radius Fractures - diagnostic imaging; Radius Fractures - surgery; Radius Fractures - therapy; Randomized Controlled Trials as Topic; Range of Motion, Articular - physiology; Recovery of Function; Risk Assessment; Systematic Review and Meta-analysis; Thoracic Surgery; Traumatic Surgery; Vascular Surgery; Wrist Injuries - diagnostic imaging; Wrist Injuries - therapy; Internal fixation; Open reduction; Nonsurgical; Elderly; Distal radius fracture; Meta-analysis
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-015-1324-9

Purpose The best treatment of distal radius fractures (DRFs) in the elderly is uncertain. The purpose of this meta-analysis was to compare the outcomes of surgical and nonsurgical management of DRFs in persons 65 years of age or older. Methods Medline, Cochrane, EMBASE, and Google Scholar databases were searched until April 27, 2015 using the following search terms: distal radius fracture, conservative treatment, nonoperative treatment, nonsurgical treatment, surgical treatment, operative, elderly, and older. The primary outcome measure was DASH score, and secondary outcomes were functional and radiological assessments. The standard difference in post-treatment means was calculated for the outcomes to compare the two groups. Results Of 59 articles identified, eight studies with a total of 440 patients in the surgical groups and 449 in the control groups were included in the analysis. No significant differences in DASH score, VAS pain score, grip strength, wrist extension, pronation, or supination, and ulnar deviation were noted between the groups. The nonsurgical group had significantly greater wrist flexion, radial deviation, and ulnar variance and less radial inclination than the surgical group. Conclusions Surgical and nonsurgical methods produce similar results in the treatment of DRFS in the elderly, and minor objective functional differences did not result an impact on subjective function outcome and quality of life.