Surgical vs. Conservative Treatment of Distal Radius Fractures in the Elderly: A Systematic Review and Meta-Analysis
2024

Surgical vs. Conservative Treatment of Distal Radius Fractures in the Elderly

Sample size: 2400 publication Evidence: moderate

Author Information

Author(s): Muacevic Alexander, Adler John R, Alanazi Abdulelah A, Alsharari Abdulkarim M, Alrumaih Nawaf H, Alsudays Aseel I, Alanazi Amer K, Alhilali Mohamed, Bo Shagea Fatemah, Al-Rawaf Mohammed M, Alsiwat Faisal J

Hypothesis

What is the relative effectiveness of surgical versus conservative treatments for distal radius fractures in elderly patients?

Conclusion

Surgical treatment offers slight functional advantages in grip strength and upper limb function but is associated with higher pain levels compared to conservative treatment.

Supporting Evidence

  • Thirteen randomized controlled trials with 2400 participants were included in the analysis.
  • After one year, there was no significant difference in wrist function between surgical and conservative groups.
  • Surgical treatment significantly improved grip strength but resulted in higher pain levels.
  • Upper limb function favored surgery as measured by the DASH score.
  • Results showed substantial heterogeneity and publication bias.

Takeaway

This study looked at how surgery and casting help older people with wrist fractures. Surgery might help them grip better, but it can also hurt more.

Methodology

A systematic review and meta-analysis of randomized controlled trials comparing surgical and conservative treatments for distal radius fractures in patients aged 65 and older.

Potential Biases

Varying levels of risk of bias were noted across studies, particularly in performance and detection bias.

Limitations

The study faced significant heterogeneity and potential publication bias, and the focus on one-year outcomes limits understanding of long-term effects.

Participant Demographics

Participants were elderly patients aged 65 and older, with a mix of genders and health statuses.

Statistical Information

P-Value

p=0.0007

Confidence Interval

95% CI -3.66 to -0.98

Statistical Significance

p=0.0007

Digital Object Identifier (DOI)

10.7759/cureus.75879

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