{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:44:02Z","timestamp":1793753042388,"version":"4.6.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The outcomes for volar locking plate (VLP) and external fixation (EF) in distal radius fracture cases remain controversial. The current study of randomized controlled trials (RCTs) aimed to assess VLP and EF, which might benefit distal radius fracture cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>RCTs comparing VLP and EF in distal radius fracture cases, until 18 March 2020, were systematically reviewed and summarized. The functional and radiographic outcomes, together with complications, for distal radius fracture cases, were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 12 studies comprising 1205 distal radius fracture cases were included. The VLP group had observed lower disability in the arm shoulder and hand score (DASH) at 3rd, 6th, and 12th -month post-operation, with the mean differences (MDs) of \u2212\u200910.43 (95\u2009% CI = \u2212\u200915.77 to \u2212\u20095.08,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01), \u2212\u20093.48 (95\u2009% CI = \u2212\u20096.37 to \u2212\u20090.59,\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.02), and \u2212\u20094.13 (95\u2009% CI\u2009=\u2009\u2212\u20096.94 to \u2212\u20091.33,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01), respectively. The VLP group also had lower visual analog scale scores (VAS) compared to the EF group, with MDs of \u2212\u20090.10 (95\u2009% CI = \u2212\u20090.18 to \u2212\u20090.03,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) for the former at 6th -month post-operation. Also, the EF group exhibited better grip strength than that in the VLP group, with MD of 12.48 (95\u2009% CI\u2009=\u20097.00\u201317.95,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) at the 3rd month and 4.54 (95\u2009% CI\u2009=\u20090.31\u20138.76,\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.04) at 6th month. No significant differences in radiographic outcomes were observed between the VLP and EF groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05). The VLP group had a lower complication rate than that in the EF group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VLP had a lower DASH score and VAS score but with lower grip strength. No significant differences in radiographic outcomes were observed. VLP had a lower complication rate than that of EF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12891-021-04312-7","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T10:03:17Z","timestamp":1620813797000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials"],"prefix":"10.1186","volume":"22","author":[{"given":"Qi","family":"Gou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanliang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"issue":"2","key":"4312_CR1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1302\/0301-620X.80B2.0800243","volume":"80","author":"BR Singer","year":"1998","unstructured":"Singer BR, McLauchlan GJ, Robinson CM, Christie J: Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg Br 1998, 80(2):243\u2013248.","journal-title":"J Bone Joint Surg Br"},{"issue":"1\u20132","key":"4312_CR2","first-page":"40","volume":"62","author":"N Paksima","year":"2004","unstructured":"Paksima N, Panchal A, Posner MA, Green SM, Mehiman CT, Hiebert R: A meta-analysis of the literature on distal radius fractures: review of 615 articles. Bull Hosp Jt Dis 2004, 62(1\u20132):40\u201346.","journal-title":"Bull Hosp Jt Dis"},{"issue":"5","key":"4312_CR3","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1016\/S0363-5023(98)80174-3","volume":"23","author":"S Kawaguchi","year":"1998","unstructured":"Kawaguchi S, Sawada K, Nabeta Y, Hayakawa M, Aoki M: Recurrent dorsal angulation of the distal radius fracture during dynamic external fixation. J Hand Surg Am 1998, 23(5):920\u2013925.","journal-title":"J Hand Surg Am"},{"issue":"10","key":"4312_CR4","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1016\/j.jhsa.2006.09.014","volume":"31","author":"JC Wolf","year":"2006","unstructured":"Wolf JC, Weil WM, Hanel DP, Trumble TE: A biomechanic comparison of an internal radiocarpal-spanning 2.4-mm locking plate and external fixation in a model of distal radius fractures. J Hand Surg Am 2006, 31(10):1578\u20131586.","journal-title":"J Hand Surg Am"},{"issue":"2","key":"4312_CR5","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1053\/jhsu.2002.32081","volume":"27","author":"JL Orbay","year":"2002","unstructured":"Orbay JL, Fernandez DL: Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. J Hand Surg Am 2002, 27(2):205\u2013215.","journal-title":"J Hand Surg Am"},{"issue":"10","key":"4312_CR6","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1302\/0301-620X.90B10.21293","volume":"90","author":"ND Downing","year":"2008","unstructured":"Downing ND, Karantana A: A revolution in the management of fractures of the distal radius? J Bone Joint Surg Br 2008, 90(10):1271\u20131275.","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"4312_CR7","doi-asserted-by":"publisher","first-page":"478","DOI":"10.3109\/17453670903171875","volume":"80","author":"A Abramo","year":"2009","unstructured":"Abramo A, Kopylov P, Geijer M, T\u00e4gil M: Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures: a randomized study of 50 patients. Acta Orthop 2009, 80(4):478\u2013485.","journal-title":"Acta Orthop"},{"issue":"9","key":"4312_CR8","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1097\/BOT.0b013e318186006f","volume":"22","author":"U Kandemir","year":"2008","unstructured":"Kandemir U, Matityahu A, Desai R, Puttlitz C: Does a volar locking plate provide equivalent stability as a dorsal nonlocking plate in a dorsally comminuted distal radius fracture?: a biomechanical study. J Orthop Trauma 2008, 22(9):605\u2013610.","journal-title":"J Orthop Trauma"},{"issue":"4","key":"4312_CR9","first-page":"E46","volume":"36","author":"EO Cooper","year":"2007","unstructured":"Cooper EO, Segalman KA, Parks BG, Sharma KM, Nguyen A: Biomechanical stability of a volar locking-screw plate versus fragment-specific fixation in a distal radius fracture model. Am J Orthop (Belle Mead NJ) 2007, 36(4):E46\u201349.","journal-title":"Am J Orthop (Belle Mead NJ)"},{"issue":"1","key":"4312_CR10","doi-asserted-by":"publisher","first-page":"76","DOI":"10.3109\/17453674.2011.552781","volume":"82","author":"MK Wilcke","year":"2011","unstructured":"Wilcke MK, Abbaszadegan H, Adolphson PY: Wrist function recovers more rapidly after volar locked plating than after external fixation but the outcomes are similar after 1 year. Acta Orthop 2011, 82(1):76\u201381.","journal-title":"Acta Orthop"},{"issue":"2","key":"4312_CR11","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.injury.2011.05.021","volume":"43","author":"J Jeudy","year":"2012","unstructured":"Jeudy J, Steiger V, Boyer P, Cronier P, Bizot P, Massin P: Treatment of complex fractures of the distal radius: a prospective randomised comparison of external fixation \u2018versus\u2019 locked volar plating. Injury 2012, 43(2):174\u2013179.","journal-title":"Injury"},{"issue":"2","key":"4312_CR12","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s11751-013-0169-4","volume":"8","author":"MM Walenkamp","year":"2013","unstructured":"Walenkamp MM, Bentohami A, Beerekamp MS, Peters RW, van der Heiden R, Goslings JC, Schep NW: Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis. Strategies in trauma and limb reconstruction 2013, 8(2):67\u201375.","journal-title":"Strategies in trauma and limb reconstruction"},{"issue":"1","key":"4312_CR13","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.jss.2014.06.018","volume":"193","author":"Z Li-hai","year":"2015","unstructured":"Li-hai Z, Ya-nan W, Zhi M, Li-cheng Z, Hong-da L, Huan Y, Xiao-xie L, Pei-fu T: Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: a meta-analysis of randomized controlled trials. J Surg Res 2015, 193(1):324\u2013333.","journal-title":"J Surg Res"},{"issue":"4","key":"4312_CR14","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s10195-014-0317-8","volume":"15","author":"R Shukla","year":"2014","unstructured":"Shukla R, Jain RK, Sharma NK, Kumar R: External fixation versus volar locking plate for displaced intra-articular distal radius fractures: a prospective randomized comparative study of the functional outcomes. J Orthop Traumatol 2014, 15(4):265\u2013270.","journal-title":"J Orthop Traumatol"},{"issue":"1","key":"4312_CR15","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jhsa.2014.09.025","volume":"40","author":"YH Roh","year":"2015","unstructured":"Roh YH, Lee BK, Baek JR, Noh JH, Gong HS, Baek GH: A randomized comparison of volar plate and external fixation for intra-articular distal radius fractures. J Hand Surg Am 2015, 40(1):34\u201341.","journal-title":"J Hand Surg Am"},{"issue":"4","key":"4312_CR16","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1097\/BOT.0000000000000519","volume":"30","author":"C Mellstrand Navarro","year":"2016","unstructured":"Mellstrand Navarro C, Ahrengart L, T\u00f6rnqvist H, Ponzer S: Volar Locking Plate or External Fixation With Optional Addition of K-Wires for Dorsally Displaced Distal Radius Fractures: A Randomized Controlled Study. J Orthop Trauma 2016, 30(4):217\u2013224.","journal-title":"J Orthop Trauma"},{"issue":"4","key":"4312_CR17","doi-asserted-by":"publisher","first-page":"311","DOI":"10.2106\/JBJS.18.00014","volume":"101","author":"OL Hammer","year":"2019","unstructured":"Hammer OL, Clementsen S, Hast J, \u0160altyt\u0117 Benth J, Madsen JE, Randsborg PH: Volar Locking Plates Versus Augmented External Fixation of Intra-Articular Distal Radial Fractures: Functional Results from a Randomized Controlled Trial. J Bone Joint Surg Am 2019, 101(4):311\u2013321.","journal-title":"J Bone Joint Surg Am"},{"key":"4312_CR18","doi-asserted-by":"publisher","first-page":"b2700","DOI":"10.1136\/bmj.b2700","volume":"339","author":"A Liberati","year":"2009","unstructured":"Liberati A, Altman DG, Tetzlaff J, Mulrow C, G\u00f8tzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009, 339:b2700.","journal-title":"BMJ"},{"key":"4312_CR19","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","volume":"343","author":"JP Higgins","year":"2011","unstructured":"Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA et al.: The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials. BMJ 2011, 343:d5928.","journal-title":"BMJ"},{"issue":"1","key":"4312_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","volume":"17","author":"AR Jadad","year":"1996","unstructured":"Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996, 17(1):1\u201312.","journal-title":"Control Clin Trials"},{"key":"4312_CR21","unstructured":"SD S: Statistical Evidence in Medical Trials: What Do the Data Really Tell Us. Oxford University Press 2006."},{"issue":"7414","key":"4312_CR22","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","volume":"327","author":"JP Higgins","year":"2003","unstructured":"Higgins JP, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. BMJ 2003, 327(7414):557\u2013560.","journal-title":"BMJ"},{"issue":"4","key":"4312_CR23","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.2307\/2533446","volume":"50","author":"CB Begg","year":"1994","unstructured":"Begg CB, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics 1994, 50(4):1088\u20131101.","journal-title":"Biometrics"},{"issue":"7129","key":"4312_CR24","first-page":"469","volume":"316","author":"V Seagroatt","year":"1997","unstructured":"Seagroatt V,., Stratton I,. Bias in meta-analysis detected by a simple, graphical test. Test had 10\u2009% false positive rate. Bmj British Medical Journal 1997, 316(7129):469\u2013471.","journal-title":"Bmj British Medical Journal"},{"issue":"9","key":"4312_CR25","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1302\/0301-620X.90B9.20521","volume":"90","author":"K Egol","year":"2008","unstructured":"Egol K, Walsh M, Tejwani N, McLaurin T, Wynn C, Paksima N: Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. J Bone Joint Surg Br 2008, 90(9):1214\u20131221.","journal-title":"J Bone Joint Surg Br"},{"issue":"7","key":"4312_CR26","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.2106\/JBJS.H.00722","volume":"91","author":"DH Wei","year":"2009","unstructured":"Wei DH, Raizman NM, Bottino CJ, Jobin CM, Strauch RJ, Rosenwasser MP: Unstable distal radial fractures treated with external fixation, a radial column plate, or a volar plate. A prospective randomized trial. J Bone Joint Surg Am 2009, 91(7):1568\u20131577.","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"4312_CR27","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1007\/s00402-013-1698-5","volume":"133","author":"G Gradl","year":"2013","unstructured":"Gradl G, Gradl G, Wendt M, Mittlmeier T, Kundt G, Jupiter JB: Non-bridging external fixation employing multiplanar K-wires versus volar locked plating for dorsally displaced fractures of the distal radius. Arch Orthop Trauma Surg 2013, 133(5):595\u2013602.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"8","key":"4312_CR28","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1016\/j.jhsa.2013.04.039","volume":"38","author":"JH Williksen","year":"2013","unstructured":"Williksen JH, Frihagen F, Hellund JC, Kvernmo HD, Husby T: Volar locking plates versus external fixation and adjuvant pin fixation in unstable distal radius fractures: a randomized, controlled study. J Hand Surg Am 2013, 38(8):1469\u20131476.","journal-title":"J Hand Surg Am"},{"issue":"19","key":"4312_CR29","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.2106\/JBJS.L.00232","volume":"95","author":"A Karantana","year":"2013","unstructured":"Karantana A, Downing ND, Forward DP, Hatton M, Taylor AM, Scammell BE, Moran CG, Davis TR: Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods: a randomized controlled trial. J Bone Joint Surg Am 2013, 95(19):1737\u20131744.","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"4312_CR30","doi-asserted-by":"publisher","first-page":"e187053","DOI":"10.1001\/jamanetworkopen.2018.7053","volume":"2","author":"KC Chung","year":"2019","unstructured":"Chung KC, Malay S, Shauver MJ, Kim HM: Assessment of Distal Radius Fracture Complications Among Adults 60 Years or Older: A Secondary Analysis of the WRIST Randomized Clinical Trial. JAMA network open 2019, 2(1):e187053.","journal-title":"JAMA network open"},{"issue":"9","key":"4312_CR31","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1177\/1753193417743936","volume":"43","author":"CJC Gouk","year":"2018","unstructured":"Gouk CJC, Bindra RR, Tarrant DJ, Thomas MJE: Volar locking plate fixation versus external fixation of distal radius fractures: a meta-analysis. J Hand Surg Eur Vol 2018, 43(9):954\u2013960.","journal-title":"J Hand Surg Eur Vol"},{"issue":"6","key":"4312_CR32","doi-asserted-by":"publisher","first-page":"602","DOI":"10.4103\/ortho.IJOrtho_601_16","volume":"52","author":"Q Fu","year":"2018","unstructured":"Fu Q, Zhu L, Yang P, Chen A: Volar Locking Plate versus External Fixation for Distal Radius Fractures: A Meta-analysis of Randomized Controlled Trials. Indian J Orthop 2018, 52(6):602\u2013610.","journal-title":"Indian J Orthop"},{"issue":"5","key":"4312_CR33","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/j.jhsa.2011.02.005","volume":"36","author":"RJ Diaz-Garcia","year":"2011","unstructured":"Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC: A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am 2011, 36(5):824\u2013835 e822.","journal-title":"J Hand Surg Am"},{"issue":"5","key":"4312_CR34","doi-asserted-by":"publisher","first-page":"610","DOI":"10.3109\/17453674.2011.618910","volume":"82","author":"M Landgren","year":"2011","unstructured":"Landgren M, Jerrhag D, Tagil M, Kopylov P, Geijer M, Abramo A: External or internal fixation in the treatment of non-reducible distal radial fractures? Acta Orthop 2011, 82(5):610\u2013613.","journal-title":"Acta Orthop"},{"issue":"7","key":"4312_CR35","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1016\/j.jhsa.2015.03.008","volume":"40","author":"JH Williksen","year":"2015","unstructured":"Williksen JH, Husby T, Hellund JC, Kvernmo HD, Rosales C, Frihagen F: External Fixation and Adjuvant Pins Versus Volar Locking Plate Fixation in Unstable Distal Radius Fractures: A Randomized, Controlled Study With a 5-Year Follow-Up. J Hand Surg Am 2015, 40(7):1333\u20131340.","journal-title":"J Hand Surg Am"},{"issue":"6","key":"4312_CR36","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.aott.2016.04.001","volume":"50","author":"A Kara","year":"2016","unstructured":"Kara A, Celik H, Oc Y, Uzun M, Erdil M, Tetik C: Flexor tendon complications in comminuted distal radius fractures treated with anatomic volar rim locking plates. Acta Orthop Traumatol Turc 2016, 50(6):665\u2013669.","journal-title":"Acta Orthop Traumatol Turc"},{"issue":"9","key":"4312_CR37","doi-asserted-by":"publisher","first-page":"1905","DOI":"10.1016\/j.jhsa.2015.03.014","volume":"40","author":"DM Brogan","year":"2015","unstructured":"Brogan DM, Richard MJ, Ruch D, Kakar S: Management of Severely Comminuted Distal Radius Fractures. J Hand Surg Am 2015, 40(9):1905\u20131914.","journal-title":"J Hand Surg Am"},{"issue":"3","key":"4312_CR38","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1055\/s-0037-1620271","volume":"7","author":"A Duprat","year":"2018","unstructured":"Duprat A, Diaz J, Vernet P, Gouzou S, Facca S, Igeta Y, Liverneaux P: Volar Locking Plate Fixation of Distal Radius Fractures: Splint versus Immediate Mobilization. J Wrist Surg 2018, 7(3):237\u2013242.","journal-title":"J Wrist Surg"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04312-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-021-04312-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04312-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T22:03:18Z","timestamp":1620856998000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-021-04312-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,12]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4312"],"URL":"https:\/\/doi.org\/10.1186\/s12891-021-04312-7","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,12]]},"assertion":[{"value":"5 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"433"}}