Comparison of treatment results between surgical and conservative treatment of distal radius fractures in adults: A meta-analysis of randomized controlled trials

This meta-analysis study aims to determine the efficacy and safety of surgical and conservative treatments for distal radius fractures (DRFs) in adults. Reports of randomized controlled trials were retrieved from the Web of Science, Pubmed, Google Scholar, EMBASE, Cochrane Library, Medline, Ovid, and BIOSIS for studies that met the eligibility criteria. The search was limited to human subjects and had no language limits. The search strategy was check by two independent reviewers. If there was any dispute, a third reviewer was consulted. Primary outcomes were: (1) the active wrist range of motion including flexion, extension, pronation, supination, radial, and ulnar deviation; (2) the Disabilities of the Arm, Shoulder, and Hand (DASH) score; and (3) radiological outcomes including radial inclination and ulnar variance. Secondary outcomes were the number of complications including non-infectious and infectious. Quality assessment was performed using the Cochrane Risk of Bias Tool provided by the Cochrane Review Manager 5.3. A total of 10 randomized controlled trials were included. The meta-analysis detected no statistically significant difference in pooled data for complications not included infection (MD 0.64, CI: 0.33 to 1.23, Z=1.34, p=0.18). Surgical treatment achieved a better range of motion (MD 3.76, CI: 1.58 to 5.95, Z=3.37, p=0.0007), DASH score (MD -6.57, CI: -9.08 to -4.06, Z=5.12, p