Volar versus Dorsal Plating for Fracture Distal Radius (A Systematic Review/Meta-Analysis)

• Published in: QJM : An International Journal of Medicine Vol. 117; no. Supplement_1
• Main Authors: Diab, Ramy Ahmed, Mohamed, Amr Moustafa, Razmy Rophael, Mina Mansour
• Format: Journal Article
• Language: English
• Published: 03-07-2024
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcae070.401

Abstract Background Fractures of the distal radius are the most common of all orthopedic injuries accounting for nearly 16–20% of all fractures presenting to the emergency department. Treatment of distal radius fractures historically has been predominantly by inexpensive means as some surgeons advocate treatment by manipulation and plaster immobilization. Aim of the Work This study aims to review systematically and to meta-analyze the currently available literature regarding volar and dorsal plating for distal radial fractures regarding functional outcome and complications. Patients and Methods This study was approved by the Ethical Committee of Ain Shams University Faculty of Medicine. Written informed consent was not needed because of the study design(systematic review). Results The results of our study showed that there were significant difference between volar and dorsal groups regarding ROM (Flexion, Extension, Ulnar deviation and Radial deviation). Also we found significant difference regarding PRWE Score, DASH Score and complication rate. Also the results showed non significant difference between volar and dorsal plating groups regarding VAS Score for Pain, Grip Strength and ROM (Supination and Pronation). We also found the dorsal fixation offers a lower risk of neuropathy and carpal tunnel syndrome than the volar fixation, But a higher risk of tendon irritation and rupture in dorsal group so we recommend removal of dorsal plates after good healing and regain good range of motion. Conclusion In conclusion, Based on our outcomes of current systematic review and meta-analysis, it appears that fractures of distal radius treated previously with dorsal plating showed poor outcomes and unclear results, meanwhile more recent studies favored volar plating for fixation compared to indicated dorsal plating biased by these studies.