$In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis$
Código QR

In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis

Abstract Objectives It remains debatable if early mobilization (EM) yields a better clinical outcome than the late mobilization (LM) in adults with an acute and displaced distal radial fracture (DRF) of open reduction internal fixation (ORIF). Therefore, we aimed to perform a systematic review and m...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	ZhiBo Deng, JiangPing Wu, KaiYing Tang, Han Shu, Ting Wang, FuBing Li, Mao Nie
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Meta-analysis Distal radius fracture Open reduction internal fixation Early mobilization Late mobilization Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/4c610f9660b34791b5c08cf87cac20df
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4c610f9660b34791b5c08cf87cac20df
record_format	dspace
spelling	oai:doaj.org-article:4c610f9660b34791b5c08cf87cac20df2021-11-28T12:27:04ZIn adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis10.1186/s13018-021-02837-01749-799Xhttps://doaj.org/article/4c610f9660b34791b5c08cf87cac20df2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02837-0https://doaj.org/toc/1749-799XAbstract Objectives It remains debatable if early mobilization (EM) yields a better clinical outcome than the late mobilization (LM) in adults with an acute and displaced distal radial fracture (DRF) of open reduction internal fixation (ORIF). Therefore, we aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs), comparing clinical results with the safety of EM with LM following ORIF. Methods Databases such as Medline, Cochrane Central Register, and Embase were searched from Jan 1, 2000, to July 31, 2021, and RCTs comparing EM with LM for DRF with ORIF were included in the analysis. The primary outcome of study included disabilities of the Arm, Shoulder, and Hand (DASH) score at different follow-up times. Wherever the secondary outcomes included patient-rated wrist evaluation (PRWE), grip strength (GS), visual analog scale (VAS), wrist range of motion (WROM), and associated complications, the two independent reviewers did data extraction for the analysis. Effect sizes of outcome for each group were pooled using random-effects models; thereafter, the results were represented in the forest plots. Results Nine RCTs with 293 EM and 303 LM participants were identified and included in the study. Our analysis showed that the DASH score of the EM group was significantly better than LM group at the six weeks postoperatively (− 10.15; 95% CI − 15.74 to − 4.57, P < 0.01). Besides, the EM group also had better outcomes in PRWE, GS and WROM at 6 weeks. However, EM showed potential higher rate for implant loosening and/or fracture re-displacement complication (3.00; 95% CI 1.02–8.83, P = 0.05). Conclusion Functionally, at earlier stages, EM for patients with DRF of ORIF may have a beneficial effect than LM. The mean differences in the DASH score at 6 weeks surpassed the minimal clinically important difference; however, the potentially higher risk of implant loosening and/or fracture re-displacement cannot be ignored. Due to the lack of definitive evidence, multicenter and large sample RCTs are required for determining the optimal rehabilitation protocol for DRF with ORIF. PROSPERO registration number: CRD42021240214 2021/2/28.ZhiBo DengJiangPing WuKaiYing TangHan ShuTing WangFuBing LiMao NieBMCarticleMeta-analysisDistal radius fractureOpen reduction internal fixationEarly mobilizationLate mobilizationOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Meta-analysis Distal radius fracture Open reduction internal fixation Early mobilization Late mobilization Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	Meta-analysis Distal radius fracture Open reduction internal fixation Early mobilization Late mobilization Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 ZhiBo Deng JiangPing Wu KaiYing Tang Han Shu Ting Wang FuBing Li Mao Nie In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
description	Abstract Objectives It remains debatable if early mobilization (EM) yields a better clinical outcome than the late mobilization (LM) in adults with an acute and displaced distal radial fracture (DRF) of open reduction internal fixation (ORIF). Therefore, we aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs), comparing clinical results with the safety of EM with LM following ORIF. Methods Databases such as Medline, Cochrane Central Register, and Embase were searched from Jan 1, 2000, to July 31, 2021, and RCTs comparing EM with LM for DRF with ORIF were included in the analysis. The primary outcome of study included disabilities of the Arm, Shoulder, and Hand (DASH) score at different follow-up times. Wherever the secondary outcomes included patient-rated wrist evaluation (PRWE), grip strength (GS), visual analog scale (VAS), wrist range of motion (WROM), and associated complications, the two independent reviewers did data extraction for the analysis. Effect sizes of outcome for each group were pooled using random-effects models; thereafter, the results were represented in the forest plots. Results Nine RCTs with 293 EM and 303 LM participants were identified and included in the study. Our analysis showed that the DASH score of the EM group was significantly better than LM group at the six weeks postoperatively (− 10.15; 95% CI − 15.74 to − 4.57, P < 0.01). Besides, the EM group also had better outcomes in PRWE, GS and WROM at 6 weeks. However, EM showed potential higher rate for implant loosening and/or fracture re-displacement complication (3.00; 95% CI 1.02–8.83, P = 0.05). Conclusion Functionally, at earlier stages, EM for patients with DRF of ORIF may have a beneficial effect than LM. The mean differences in the DASH score at 6 weeks surpassed the minimal clinically important difference; however, the potentially higher risk of implant loosening and/or fracture re-displacement cannot be ignored. Due to the lack of definitive evidence, multicenter and large sample RCTs are required for determining the optimal rehabilitation protocol for DRF with ORIF. PROSPERO registration number: CRD42021240214 2021/2/28.
format	article
author	ZhiBo Deng JiangPing Wu KaiYing Tang Han Shu Ting Wang FuBing Li Mao Nie
author_facet	ZhiBo Deng JiangPing Wu KaiYing Tang Han Shu Ting Wang FuBing Li Mao Nie
author_sort	ZhiBo Deng
title	In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
title_short	In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
title_full	In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
title_fullStr	In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
title_full_unstemmed	In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
title_sort	in adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/4c610f9660b34791b5c08cf87cac20df
work_keys_str_mv	AT zhibodeng inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis AT jiangpingwu inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis AT kaiyingtang inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis AT hanshu inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis AT tingwang inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis AT fubingli inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis AT maonie inadultsearlymobilizationmaybebeneficialfordistalradiusfracturestreatedwithopenreductionandinternalfixationasystematicreviewandmetaanalysis
_version_	1718407949558218752

In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis

Ejemplares similares