Evidence map›Paper›PMID 39910653›Full record

SynthesisJournal of orthopaedic surgery and research2025

Is surgery superior for distal ulna fractures? a comprehensive systematic review and meta-analysis.

Zakaria Chabihi, Brahim Demnati, Mohamed Moussadiq, Tariq Aalil, Yassine Fath El Khir, El Mehdi Boumediane, Mohamed Amine Benhima, Imad Abkari

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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.

Zakaria ChabihiTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco. z.chabihi@gmail.com.
Brahim DemnatiChemistry-Biochemistry, Environment, Nutrition and Health Laboratory, FMPC, Hassan II University Casablanca, Casablanca, Morocco.
Mohamed MoussadiqTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.
Tariq AalilTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.
Yassine Fath El KhirTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.
El Mehdi BoumedianeTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.
Mohamed Amine BenhimaTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.
Imad AbkariTraumatology and Orthopedics Department B, Mohammed VI University Hospital, Marrakesh, Morocco.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of distal ulna fractures remains a subject of considerable debate within orthopedic practice. This systematic review and meta-analysis aims to evaluate the efficacy of surgical versus non-surgical management strategies for distal ulna fractures and their impact on functional outcomes.

methodsThis study followed PRISMA guidelines and involved a systematic search of databases like PubMed, Scopus, and Web of Science for relevant studies published in English up to December 2023. The search included keywords such as "ulnar styloid fracture", "non-surgical management", "surgical management", and "treatment outcomes". Studies were selected based on predefined inclusion and exclusion criteria, and data were extracted on patient demographics, fracture characteristics, treatment details, functional outcomes, patient-reported outcomes, complications, and follow-up duration. The methodological quality of included studies was assessed using the GRADE system. The meta-analysis used standardized mean differences for continuous outcomes and log odds ratios for dichotomous outcomes.

resultsThe initial search yielded 1253 studies, which were narrowed down to 12 studies suitable for review after removing duplicates and irrelevant articles. These studies included a total of 709 patients, with 422 receiving non-surgical management and 287 undergoing surgical treatment. The results showed no significant differences in grip strength, DASH score, or VAS score between surgical and non-surgical management. However, a higher union rate was observed with surgical management. LIMITATIONS: The moderate quality of the included studies and the moderate to high heterogeneity among them are noted as limitations, indicating a need for more standardized research methodologies in this area.

conclusionsWhile surgical management may offer a higher union rate, the choice of treatment should be individualized, balancing the potential benefits against the risks of surgery, as ORIF implants are typically associated with higher ulnar-sided pain rates and limited ulnar deviation due to implant prominence. Future research should focus on standardizing study designs to improve the quality of evidence in the management of distal ulna fractures. LEVEL OF EVIDENCE I: Evidence from a meta-analysis and systematic review from all relevant studies.

Indexed as

Fracture Fixation, InternalUlna FracturesFemaleHand StrengthHumansMaleTreatment OutcomeWrist FracturesDistal radioulnar joint instabilityDistal radius fractureNon-surgical managementOutcomeSurgical managementUlnar fractures

Identifiers

PMID39910653
PMCPMC11800572

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Registered trials

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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.