Please login to view this media
- Talk
- 22/09/2023
- UK
Operative Versus Non-Operative Management of Distal Radius Fractures in Adults: A Systematic Review and Meta-Analysis of Randomised Controlled Trials With An Elderly Subgroup Analysis
Description
In this presentation, Katrina Bell introduces a systematic review and meta-analysis focusing on the management of distal radius fractures, which are the most prevalent type of fracture treated in orthopedic settings. The study aims to compare the efficacy of operative versus non-operative management in terms of pain, disability, grip strength, and radiographic outcomes, particularly in the elderly population.
Katrina notes the importance of understanding the optimal treatment strategy, especially given the rising incidence of fractures among post-menopausal females, and highlights the variability in defining 'elderly' across existing literature. The systematic review incorporates new randomized controlled trials that delve into this issue, aiming to settle the debate on effective management approaches.
The methodology includes a comprehensive search of multiple databases, ensuring both published and unpublished studies were considered. Rigorous assessment used the Cochrane risk-of-bias tool, narrowing down 2,287 abstracts to 32 for the review and 16 for the meta-analysis, ultimately analyzing data from 1947 patients with a mean age of 66.
Results show a lack of clinically significant differences in pain levels and function at various intervals, including 12 weeks and 12 months post-treatment. Although improvements were noted in some aspects of range of motion and radiographic parameters, overall findings suggest no clear advantage of operative management over non-operative options in treating distal radius fractures among the elderly.
Katrina concludes by emphasizing that while there may be minor improvements in certain ranges and parameters, the overall difference in clinical outcomes between the two management strategies is negligible, thus providing critical insights into treatment frameworks for one of the most common orthopedic injuries.