Evidence map›Paper›PMID 21527140›Full record

SynthesisThe Journal of hand surgery2011

A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly.

Rafael J Diaz-Garcia, Takashi Oda, Melissa J Shauver, Kevin C Chung

Open access · greenAbstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of hand surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 159 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
159citing papers in PubMed, 12 pooled it
22.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

159 citing papers in PubMed, 12 syntheses or guidelines pooled it, 406 citations in OpenAlex.

  1. Pooled it
  2. Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
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99 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Rafael J Diaz-GarciaSection of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, MI 48109-5340, USA.
Takashi Oda
Melissa J Shauver
Kevin C Chung
Michigan Medicine · US

Funding

Evidence-Based Research in Hand SurgeryK24AR053120 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUNG, KEVIN C · 2008 to 2018
$1.6M
Understanding Treatment Variation of Distal Radius Fracture in the US ElderlyR21AR056988 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUNG, KEVIN C · 2008 to 2009
$368k
A Clinical Trial for the Surgical Treatment of Elderly Distal Radius FractureR34AR055992 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUNG, KEVIN C · 2009 to 2009
$155k
NIAMS NIH HHS K24 AR053120NIAMS NIH HHS R21 AR056988NIAMS NIH HHS R34 AR055992NIAMS NIH HHS R34AR055992-01
6 · The paper itself

Abstract

purposeAs the population in developed countries continues to age, the incidence of osteoporotic distal radius fractures (DRFs) will increase as well. Treatment of DRF in the elderly population is controversial. We systematically reviewed the existing literature for the management of DRFs in patients aged 60 and over with 5 common techniques: the volar locking plate system, nonbridging external fixation, bridging external fixation, percutaneous Kirschner wire fixation, and cast immobilization (CI).

methodsWe reviewed articles retrieved from MEDLINE, Embase, and CINAHL Plus that met predetermined inclusion and exclusion criteria in 2 literature reviews. Outcomes of interest included wrist arc of motion, grip strength, functional outcome measurements, radiographic parameters, and the number and type of complications. We statistically analyzed the data using weighted means and proportions based on the sample size in each study.

resultsWe identified 2,039 papers and selected 21 papers fitting the inclusion criteria in the primary review of articles with a mean patient age of 60 and older. Statistically significant differences were detected for wrist arc of motion, grip strength, and Disabilities of the Arm, Shoulder, and Hand score, although these findings may not be clinically meaningful. Volar tilt and ulnar variance revealed significant differences among groups, with CI resulting in the worst radiographic outcomes. The complications were significantly different, with CI having the lowest rate of complications, whereas the volar locking plate system had significantly more major complications requiring additional surgical intervention.

conclusionsThis systematic review suggests that despite worse radiographic outcomes associated with CI, functional outcomes were no different from those of surgically treated groups for patients age 60 and over. Prospective comparative outcomes studies are necessary to evaluate the rate of functional recovery, cost, and outcomes associated with these 5 treatment methods.

Indexed as

Casts, SurgicalAgedAged, 80 and overBone PlatesBone WiresCase-Control StudiesFemaleFollow-Up StudiesFracture Fixation, InternalFracture HealingGeriatric AssessmentHumansInjury Severity ScoreJoint InstabilityMalePostoperative Complications

Identifiers

PMID21527140
PMCPMC3093102
OpenAlexW2077608225

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.