Evidence map›Paper›PMID 38594456›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Is reduction necessary in overriding metaphyseal distal radius fractures in children under 11 years: a systematic review and meta-analysis of comparative studies.

María Galán-Olleros, Jorge Mayans-Sanesteban, Sergio Martínez-Álvarez, Carlos Miranda-Gorozarri, Ana Ramírez-Barragán, Rosa M Egea-Gámez, Javier Alonso-Hernández, Ignacio Martínez-Caballero

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 17% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
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

8 authors at 2 institutions in 1 country.

María Galán-OllerosOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain. mgalanolleros@gmail.com.ORCID http://orcid.org/0000-0001-9074-9215
Jorge Mayans-SanestebanOrthopaedic Surgery and Traumatology Department, Hospital Universitario de La Ribera, Alzira, Valencia, Spain.
Sergio Martínez-ÁlvarezOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain.
Carlos Miranda-GorozarriOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain.
Ana Ramírez-BarragánOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain.
Rosa M Egea-GámezOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain.
Javier Alonso-HernándezOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain.
Ignacio Martínez-CaballeroOrthopaedic Surgery and Traumatology Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, 28009, Madrid, Spain.
Hospital Infantil Universitario Niño Jesús · ESHospital de La Ribera · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the necessity of reduction in the treatment of overriding metaphyseal distal radius fractures (DRF) in children under 11 years.

methodsIn this systematic review and meta-analysis, PubMed, Embase, and Cochrane databases were searched to retrieve studies published from inception to 2023. Two reviewers independently screened for studies with observational or randomized control design comparing two treatments for overriding metaphyseal DRF in patients under 11 years: simple casting without reduction (SC group) versus closed reduction plus casting or pin fixation (CRC/F group); with varying outcomes reported (CRD471761). The risk of bias was assessed using the ROBINS-I tool.

resultsOut of 3,024 screened studies, three met the inclusion criteria, 180 children (mean age 7.1 ± 0.9 years) with overriding metaphyseal DRF: SC-group (n = 79) versus CRC/F-group (n = 101). Both treatment groups achieved 100% fracture consolidation without requiring further manipulation. The SC-group showed significantly fewer complications (mean difference [MD] 0.08; 95% CI [0.01, 0.53]; I2 = 22%; P < 0.009) and trends towards better sagittal alignment (MD 5.11; 95% CI [11.92, 1.71]; I2 = 94%; P < 0.14), less reinterventions (MD 0.31; 95% CI [0.01, 8.31]; P < 0.48), and fewer patients with motion limitation at the end of follow-up (MD 0.23; 95% CI [0.03,  1.98]; P < 0.18), although these findings were not statistically significant.

conclusionsDespite a limited number of studies comparing SC versus CRC/F in overriding DRF in children under 11 years, this study suggests that anatomical reduction is not necessary. Treating these fractures with SC, even when presenting with an overriding position, leads to reduced complications, shows a trend towards fewer reinterventions, improved sagittal alignment, and less limitation in patient motion. LEVEL OF EVIDENCE: Level III, Systematic review of Level-III studies.

Indexed as

Casts, SurgicalClosed Fracture ReductionRadius FracturesBone NailsChildChild, PreschoolFracture FixationFracture HealingHumansWrist FracturesCasts, surgicalFracture fixation, internalImmobilizationPaediatricPins fixationRadius fractures

Identifiers

PMID38594456
OpenAlexW4394596688

What OpenQuestion holds

Textmetadata
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.