{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:40:56Z","timestamp":1788406856560,"version":"build-2803163510"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>It remains unclear whether volar locked plating (VLP) yields a better functional outcome than closed reduction and casting (CRC) for elderly patients with an acute, displaced distal radial fracture. Our purpose was to conduct a systematic review and meta-analysis of randomized controlled trials comparing outcomes of VLP and CRC for elderly patients (age, \u226560 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Multiple databases, including MEDLINE, were searched for randomized controlled trials evaluating outcomes following distal radial fracture treatment. Raw data were obtained for studies that included patients of all ages, and the elderly subgroup was included for analysis. The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) score at \u22651 year of follow-up. Secondary outcomes included the 3-month DASH score, range of motion, final radiographic alignment, and complications. Effect sizes for the comparison of each outcome between groups were pooled across studies using random-effects models with the inverse variance weighting method. Changes in DASH score were compared with a minimal clinically important difference (MCID) estimate of 10 to assess clinical relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 2,152 screened articles, 6 were included. Demographics were similar for the 274 VLP and 287 CRC patients. DASH scores were significantly better following VLP than CRC at the time of final follow-up (12 to 24 months postoperatively; score difference, \u22125.9; 95% confidence interval [CI], \u22128.7 to \u22123.1) and at 3 months (\u22128.9; 95% CI, \u221213.0 to \u22124.8). VLP yielded significantly better palmar tilt, radial inclination, and supination, with no differences in ulnar variance, flexion-extension, pronation, or total complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Functional outcome was significantly better following VLP than CRC 3 months into the treatment of acute, displaced distal radial fractures in an elderly population and up to 2 years after injury. However, the observed differences in the final DASH score did not exceed published estimates of the MCID, suggesting that clinical outcomes are similar for both treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.01442","type":"journal-article","created":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T00:23:06Z","timestamp":1590452586000},"page":"1280-1288","source":"Crossref","is-referenced-by-count":59,"title":["Volar Locked Plating Versus Closed Reduction and Casting for Acute, Displaced Distal Radial Fractures in the Elderly"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3877-7723","authenticated-orcid":false,"given":"Andrew R.","family":"Stephens","sequence":"first","affiliation":[{"name":"Division of Public Health (A.P.P. and C.Z.), Eccles Health Sciences Library (M.M.M.), Department of Orthopaedics (A.R.T. and N.H.K.), and School of Medicine (A.R.S.), University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7400-3923","authenticated-orcid":false,"given":"Angela P.","family":"Presson","sequence":"additional","affiliation":[{"name":"Division of Public Health (A.P.P. and C.Z.), Eccles Health Sciences Library (M.M.M.), Department of Orthopaedics (A.R.T. and N.H.K.), and School of Medicine (A.R.S.), University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-2393","authenticated-orcid":false,"given":"Mary M.","family":"McFarland","sequence":"additional","affiliation":[{"name":"Division of Public Health (A.P.P. and C.Z.), Eccles Health Sciences Library (M.M.M.), Department of Orthopaedics (A.R.T. and N.H.K.), and School of Medicine (A.R.S.), University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-4331","authenticated-orcid":false,"given":"Chong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Public Health (A.P.P. and C.Z.), Eccles Health Sciences Library (M.M.M.), Department of Orthopaedics (A.R.T. and N.H.K.), and School of Medicine (A.R.S.), University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-4022","authenticated-orcid":false,"given":"Kai","family":"Sirni\u00f6","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0575-0447","authenticated-orcid":false,"given":"Marjolein A.M.","family":"Mulders","sequence":"additional","affiliation":[{"name":"Trauma Unit, Department of Surgery, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6475-7286","authenticated-orcid":false,"given":"Niels W.L.","family":"Schep","sequence":"additional","affiliation":[{"name":"Department of Hand and Trauma Surgery, Maasstad Hospital, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1580-1428","authenticated-orcid":false,"given":"Andrew R.","family":"Tyser","sequence":"additional","affiliation":[{"name":"Division of Public Health (A.P.P. and C.Z.), Eccles Health Sciences Library (M.M.M.), Department of Orthopaedics (A.R.T. and N.H.K.), and School of Medicine (A.R.S.), University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3685-1662","authenticated-orcid":false,"given":"Nikolas 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