{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:05:29Z","timestamp":1787598329683,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2024YFC3044700"],"award-info":[{"award-number":["2024YFC3044700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Plate fixation is the preferred method for treating forearm shaft fractures. However, it remains controversial regarding the necessity of implant removal after bone union. This review aims to assess refracture risk after plate removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched various data sources, including PubMed, Embase, Web of Science, and Cochrane Library. A total of 6749 papers were identified, of which 23 studies were eligible for final quantitative syntheses. Subgroup analyses and sensitivity analyses were conducted to reduce heterogeneity and make the results more reliable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total risk difference (RD) was 0.06 (0.04\u20130.09), indicating that the difference was significant. In the \u201cReasons for Removal\u201d subgroup analysis, the RD of the \u201cNo Symptom\u201d subgroup was 0.07 (95% CI\u2009=\u20090.04\u20130.11), while the RD of the \u201cSymptoms\u201d subgroup was 0.04 (95% CI = \u22120.02 to 0.10). In the \u201cPlate Type\u201d subgroup analysis, the RD of the \u201cLCP\u201d subgroup was 0.07 (95% CI\u2009=\u20090.02\u20130.13), while the RD of the \u201cDCP\u201d subgroup was 0.07 (95% CI\u2009=\u20090.01\u20130.13). After omitting each study one by one, the RDs were all significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Plate retention is significantly associated with a lower rate of refracture than plate removal. Consequently, it is not recommended to remove implants, especially for patients without implant\u2010related symptoms, but more reliable evidence is still needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>The review was registered on PROSPERO and the registration ID is CRD42023424743, and a protocol was not prepared<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14307","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T18:19:10Z","timestamp":1733941150000},"page":"36-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Removal of Forearm Plate Leads to a Higher Risk of Refracture\u2014A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"17","author":[{"given":"Renwei","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weitong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-1357","authenticated-orcid":false,"given":"Xieyuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehan","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yejun","family":"Zha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoqi","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Beijing Jishuitan Hospital, Capital Medical University  Beijing China"},{"name":"Peking University Fourth School of Clinical Medicine  Beijing China"},{"name":"National Center of Orthopaedics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"StatPearls","author":"Small R. 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