BACKGROUND: At present, it remains controversial whether open reduction plate fixation is needed for distal radius fracture in the elderly to restore anatomic reduction of imaging.
OBJECTIVE: To systematically evaluate the curative effects of operative and nonoperative treatments for distal radius fractures in the elderly.
METHODS: We retrieved PubMed, Springer and Wanfang database using computer. Relevant English and Chinese journals of orthopedics were retrieved by hand. All literatures on curative effects of operative and nonoperative treatments for distal radius fractures in the elderly were collected. RevMan 5.0 software provided by Cochrane was used to statistically analyze the data.
RESULTS AND CONCLUSION: Six literatures were included, including two of randomized controlled study and four of retrospective cohort study. Meta-analysis results displayed that there were no significant differences in both groups in range of motion of wrist joint extension [mean difference (MD)=-0.87, 95% confidence interval (CI) (-3.31, 1.58), P=0.49], range of motion of wrist joint flexion [MD=-2.79, 95%CI(-6.47, 0.88), P=0.14], range of motion of wrist pronation [MD=-0.08, 95%CI(-1.49, 1.64), P=0.92], range of motion of supination [MD=-0.7, 95% CI(-3.52, 2.12), P=0.63] and the occurrence of complication [MD=1.35, 95%CI(0.71, 2.56), P=0.36]. The length of radius in the surgery group was similar to that of normal [MD=2.46, 95%CI(1.78, 3.15), P < 0.01]. Ulnar inclination [MD=3.73, 95%CI(2.97, 4.48), P < 0.000 01] and palmar tilt angle [MD=6.81, 95%CI(3.72, 9.90), P < 0. 000 1] in the surgery group were close to that of normal. There are no significant differences in extension, flexion, pronation and supination activities of wrist and posttreatment complication between two groups. Operative treatment result is superior to that of nonoperative treatment in anatomic reduction.