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

Abstract

Background Distal radius fractures (DRFs) are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Purpose To introduce a systematic review and meta-analysis about the results of DRF treatment in the elderly with nonoperative treatment in comparison with percutaneous pinning. Patients and methods This meta-analysis and systematic review were conducted in accordance with PRISMA guidelines. Medline, Cochrane, EMBASE, and Google Scholar databases were searched until November 2020, using combinations of the following search terms: DRF, wrist fractures, Colles fractures and Smith fractures, conservative treatment, nonoperative treatment, nonsurgical treatment, surgical treatment, operative, pinning, elderly, and older. Reference lists of relevant studies were manually searched. Results In total, five studies were included from 2005 to 2011 with total cases 265. There was statistically significant heterogeneity in the studies (I2=86.21%, P<0.0001). Using the random-effect model, the outcome results revealed that extension was significantly different in percutaneous pinning and casting group versus nonsurgical group (mean, 95% confidence interval: 69.89–93.69) with absence of publication bias. Conclusion The outcome results revealed that there was no significant difference between the nonsurgical and percutaneous pinning treatments of DRF in the elderly regarding grip strength, pronation, supination range of motion, and ulnar variance (pre). We also found that there was no clinically significant difference in the functional (Patient-Rated Wrist Evaluation and Disabilities of Arm, Shoulder and Hand) scores. Thus, the two methods have similar results.