Purpose:The aim of this study was to analyze if any difference exists on the type of immobilisation(above elbow vs.below elbow)in the conservative treatment of distal end radius fractures in adults.Methods:The study w...Purpose:The aim of this study was to analyze if any difference exists on the type of immobilisation(above elbow vs.below elbow)in the conservative treatment of distal end radius fractures in adults.Methods:The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses.An electronic literature search was performed up to 1st October 2021 in Medline,Embase,Ovid and Cochrane database using the search terms,"distal end radius fractures OR fracture of distal radius","conservative treatment OR non-surgical treatment","above elbow immobilisation"and"below elbow immobilisation".Randomized clinical trials written in English,describing outcome of distal end radius fractures in adults by conservative or non-surgical means using above elbow immobilisation or below elbow immobilisation were included and assessed according to the risk of bias assessment(RoB2)tool by Cochrane collaboration.Non-randomized clinical trials,observational studies,retrospec-tive studies,review articles,commentaries,editorials,conference presentations,operative techniques and articles without availability of full text were excluded from this review.The meta-analysis was performed using Review Manager version 5.4.1(The Cochrane Collaboration,Copenhagen,Denmark).Results:Six randomized clinical trials were included for quantitative review.High heterogeneity(I2>75%)was noted among all the studies.The standard mean difference(MD)between the disability of the arm,shoulder and hand scores in both the groups was 0.52(95%CI:-0.28 to 1.32)which was statistically non-significantt.There was no statistical difference in the radial height(MD=0.10,95%CI:-0.91 to 1.12),radial inclination(MD=0.5,95%CI:-1.88 to 2.87,palmar tilt(MD=1.06,95%CI:-0.31 to 2.43)and ulnar variance(MD=0.05,95%CI:-0.74 to 0.64).It was observed that shoulder pain occurred more commonly as a complication in above elbow immobilisation and the values were statistically significant(above elbow:38/92,41.3%;below elbow:19/94,20.2%).Conclusion:This two-armed systematic review on the above elbow or below elbow immobilisation to be used for conservative treatment of the distal end radius fracture in adults resulted in non-significant differences in terms of functional and radiological scores among the 2 groups but significant increase in the complication rates in the above elbow group.展开更多
文摘Purpose:The aim of this study was to analyze if any difference exists on the type of immobilisation(above elbow vs.below elbow)in the conservative treatment of distal end radius fractures in adults.Methods:The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses.An electronic literature search was performed up to 1st October 2021 in Medline,Embase,Ovid and Cochrane database using the search terms,"distal end radius fractures OR fracture of distal radius","conservative treatment OR non-surgical treatment","above elbow immobilisation"and"below elbow immobilisation".Randomized clinical trials written in English,describing outcome of distal end radius fractures in adults by conservative or non-surgical means using above elbow immobilisation or below elbow immobilisation were included and assessed according to the risk of bias assessment(RoB2)tool by Cochrane collaboration.Non-randomized clinical trials,observational studies,retrospec-tive studies,review articles,commentaries,editorials,conference presentations,operative techniques and articles without availability of full text were excluded from this review.The meta-analysis was performed using Review Manager version 5.4.1(The Cochrane Collaboration,Copenhagen,Denmark).Results:Six randomized clinical trials were included for quantitative review.High heterogeneity(I2>75%)was noted among all the studies.The standard mean difference(MD)between the disability of the arm,shoulder and hand scores in both the groups was 0.52(95%CI:-0.28 to 1.32)which was statistically non-significantt.There was no statistical difference in the radial height(MD=0.10,95%CI:-0.91 to 1.12),radial inclination(MD=0.5,95%CI:-1.88 to 2.87,palmar tilt(MD=1.06,95%CI:-0.31 to 2.43)and ulnar variance(MD=0.05,95%CI:-0.74 to 0.64).It was observed that shoulder pain occurred more commonly as a complication in above elbow immobilisation and the values were statistically significant(above elbow:38/92,41.3%;below elbow:19/94,20.2%).Conclusion:This two-armed systematic review on the above elbow or below elbow immobilisation to be used for conservative treatment of the distal end radius fracture in adults resulted in non-significant differences in terms of functional and radiological scores among the 2 groups but significant increase in the complication rates in the above elbow group.
