Table 1.
Characteristics of the 10 included studies
| Author (year) | Study Design | Surgical/Conservative (number of patients) | Age (years) Surgical/Conservative | Type of distal radial fracture | Surgical Treatment Details | Conservative Treatment | Outcome Measure | Follow-up Surgical/Conservative |
|---|---|---|---|---|---|---|---|---|
| Gupta 1999 | Single-center, prospective randomized controlled trail | 25/25 | 55.64 (22–80) | Colles' Fracture | Percutaneous Crossed-Pin Fixation | Plaster of Paris Cast Immobilization | Radiographic parameters, average loss of various movements, and complications. | 8 weeks/8 weeks |
| Rodriguez-Merchan 1997 | Single-center, prospective randomized controlled trail | 20/20 | 58(47–65)/ 56(46–63) | Unstable Frykman III–VIII distal radius fracture | Percutaneous transfixion with K-wires | Anatomic reduction and immobilized in a split below-elbow cast | Initial displacement, quality of reduction, carpal malalignment, articular step-off. Range of motion and grip strength. | 1 week, 3 weeks, 7 weeks, 1 year/ 1 week, 3 weeks, 7 weeks, 1 year |
| Wong 2010 | Single-center, prospective randomized controlled trail | 30/30 | 70(66–76)/ 71(65–76) | Unstable, dorsally angulated, extra-articular fracture of the distal radius | Percutaneous K-wires insertion | Plaster cast | The active ranges of motion of the wrist, the pain level, the grading of the activities of daily living, the subjective satisfaction score, the World Health Organization Quality of Life (WHOQoL) questionnaire and radiological assessment. | 1,2,4,6 weeks, 3 months, 6 months, 1 year/ 1,2,4,6 weeks, 3 months, 6 months, 1 year |
| Azzopardi 2005 | Single-center, prospective randomized controlled trail | 27/27 | 72(8)/ 71(9) | Unstable, dorsally angulated, extra-articular fracture of the distal radius(AO–A3 or Frykman I and Frykman II | Supplementary percutaneous pinning | Cast | The range of movement and grip strength, radiological evaluation, and implications. | Clinical and radiological reviews were performed at one, two, and five weeks, after four months and at one year. |
| Howard 1989 | Single-center, prospective randomized controlled trail | 25/25 | 45.3/ 49.2 | Several displaced comminuted Colles’ fractures, severe displacement was defined as either 30° of dorsal angulation or more than 1 cm of radial shortening as compared with the normal side. | External fixation using a Medium-C-Hoffman fixator | Conventional manipulation and plaster | Anatomical results, functional results, complications, and cosmetic result | 2 weeks, 3 months, 6 months |
| Bartl 2014 | Multi-center, prospective randomized controlled trail | 86/88 | 75.3(6.7)/ 74.4(7.1) | Colsed, unstable intra-articular fracture of the distal radius according to the AO criteria (fracture types 23-C1 to C3) | Open reduction with volar locking plate fixation | Closed reduction and cast immobilization | Short Form 36 (SF-36) questionnaire and Arm, Shoulder and Hand (DASH), EuroWol-5 Dimensions (EQ-5D) score, | 3 months, 12 months |
| Arora 2011 | Single-center, prospective randomized controlled trail | 36/37 | 75.9(65–88)/ 77.4(65–89) | Unstable dorsally displaced distal radial fractures | Open reduction and internal fixation with a volar locking plate | Closed reduction and cast immobilization | Patient-Rated Wrist Evaluation (PRWE) score, the Disabilities of the Arm, Shoulder and Hand (DASH) score, the level of pain, the range of wrist motion, and the rate of complications. | Clinical evaluation and radiographs at 1 week, 6 weeks, 12 weeks, 6 months, and 12 months |
| Saving 2019 | Multi-center, prospective randomized controlled trail | 58/64 | 80(70–90)/ 78(70–98) | Dorsally displaced distal radial fractures | Volar locking plate fixation | Plaster | Patient-Rated Wrist Evaluation (PRWE) score, the Disabilities of the Arm, Shoulder and Hand (DASH) score, EuroWol-5 Dimensions (EQ-5D) score, range of motion, grip strength, radiographic outcomes, and complications | 3 months and 12 months |
| Sharma 2014 | Single-center, prospective randomized controlled trail | 32/32 | 52.39(9.05)/ 48.10(10.30) | Fractures of the distal radius (AO type B and C) | Volar locking plate fixation | Closed reduction and plaster cast application | The range of movement, grip strength, functional outcomes scores and radiological parameters. | 6 weeks |
| Martinez-Mendez 2018 | Single-center, prospective randomized controlled trail | 50/47 | 67(8)/70(7) | Displaced complex intra-articular distal radius fracture (AO type C) | Volar locking plate fixation | Closed reduction and plaster cast application | The range of movement, grip strength, functional outcomes scores (PRWE, DASH, VAS-pain), and radiological parameters. | 24 months |
DASH: disability arm shoulder hand score; EQ-5D: EuroWol-5 Dimensions; WHOQoL: Health Organization Quality of Life