Abstract: OBJECTIVE: In recent years, a large number of articles have reported whether to repair pronator muscle after metacarpal plate fixation of distal radius fracture, but the effectiveness and clinical benefits of repairing pronator muscle are still controversial. Thus, this meta-analysis evaluated the clinical effect of repairing pronator muscle after metacarpal plate fixation of distal radius fracture. 
METHODS: We searched the related randomized controlled trials on the repair of pronator muscle after metacarpal plate fixation of distal radius using the computer in CNKI, Wanfang, VIP, China Biology Medicine disc, PubMed, Embase, and Cochrane Library. The search date was from January 2001 to January 2020. Data extraction and quality evaluation to all the documents that are in accordance with the inclusion were carried out. The methodological quality of 14 randomized controlled trials was evaluated by modified Jadad scale. The DASH score, visual analogue scale score, ulnar deviation angle, dorsal extension angle, pronation angle, supination angle and pronation muscle strength were analyzed by RevMan 5.3 software for meta-analysis.
RESULTS: (1) A total of 11 randomized controlled trials were included. (2) The follow-up time of 3 months is short-term, 3-12 months is medium-term, and longer than 1 year is long-term. (3) Meta-analysis results demonstrated that the DASH score (MD=-0.79, 95%CI:-1.50 to -0.09, P=0.03), short-and medium-term  visual analogue scale score (MD=-3.04, 95%CI:-3.53 to -2.55, P < 0.000 01; MD=-1.69, 95%CI:-1.99 to -1.39, P < 0.000 01), long-term dorsal extension angle (MD=5.15, 95%CI:2.50-7.80, P=0.000 1), medium-and long-term pronation angle (MD=1.83, 95%CI:0.69-2.96, P=0.002; MD=1.81, 95%CI:0.32-3.30, P=0.02), mid-term pronation muscle strength (MD=1.35, 95%CI:0.90-1.80, P < 0.000 01) and ulnar deviation angle (MD=4.28, 95%CI:3.26-5.31, P < 0.000 01) in the group of repairing pronator muscle after metacarpal plate fixation were better than those in the group without repairing pronator muscle. There was no significant difference in long-term DASH score, short-term dorsal extension angle and short- and long-term supination angle between the two groups (P > 0.05). 
CONCLUSION: After metacarpal plate fixation of distal radius fracture, combined repair of pronator muscle on the basis of internal fixation may further enhance the medium-and long-term joint motion angle, reduce the patients’ medium-and short-term pain, and enhance the patients’ medium-and short-term joint function after operation, and enhance the patient’s sense of experience after operation. However, due to the limited number of literature included, more large samples and high-quality randomized controlled trials are needed to provide further effective data.

Key words: bone, radius, fracture, muscle, plate, internal fixation, repair, meta-analysis