{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:37:02Z","timestamp":1787755022764,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Distal radial fractures in adults are common, representing a substantial burden to patients and health systems. The 2 main treatments are closed reduction and cast immobilization (CR) and volar locking plate (VLP) fixation. Our primary aim was to determine if VLP fixation leads to better patient-reported pain and function at 12 months compared with CR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We searched systematically for randomized controlled trials (RCTs) comparing outcomes of VLP fixation with CR for the treatment of distal radial fractures in adults. The Cochrane Collaboration risk-of-bias tool was used to assess the methodological quality of each study. Meta-analyses of patient-reported outcomes, clinical outcomes, and complications were performed. Key findings were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 8 RCTs (810 participants) were eligible for inclusion. Based on moderate-certainty evidence, no clinically important differences in patient-reported pain and function were found: although the mean difference (MD) in the Disabilities of the Arm, Shoulder and Hand (DASH) score at 12 months was 4.1 points (95% confidence interval [CI], 1.2 to 7.0 points) in favor of VLP fixation, this was well below the minimum clinically important difference of 10 points. There was low-certainty evidence that VLP fixation led to better Patient-Rated Wrist Evaluation (PRWE) scores at 12 months (MD, 6.9 points; 95% CI, \u22120.6 to 14.3 points) and better DASH scores at 24 months (MD, 8.9 points; 95% CI, 5.8 to 12.1 points) but again, these differences were not clinically important. There was very low or low-certainty evidence that VLP fixation provided better long-term radiographic outcomes, including palmar tilt (MD, 6.5\u00b0; 95% CI, 2.8\u00b0 to 10.1\u00b0), radial inclination (MD, 3.4\u00b0; 95% CI, 2.5\u00b0 to 4.3\u00b0), and ulnar variance (MD, 0.7 mm; 95% CI, \u22120.8 to 2.1 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There were no clinically important differences between treatments with respect to patient-reported pain and function at 12 months post-treatment, even though VLP fixation resulted in better fracture alignment than CR.<\/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 II<\/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.rvw.20.00022","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T14:52:15Z","timestamp":1611154335000},"page":"e20.00022","source":"Crossref","is-referenced-by-count":23,"title":["Volar Locking Plate Fixation Versus Closed Reduction for Distal Radial Fractures in Adults"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1367-6443","authenticated-orcid":false,"given":"Andrew","family":"Lawson","sequence":"first","affiliation":[{"name":"Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3241-4382","authenticated-orcid":false,"given":"Michael","family":"Na","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9147-1312","authenticated-orcid":false,"given":"Justine M.","family":"Naylor","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6258-3692","authenticated-orcid":false,"given":"Adriane M.","family":"Lewin","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0887-7627","authenticated-orcid":false,"given":"Ian A.","family":"Harris","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1]]},"reference":[{"issue":"2","key":"r1-20230807","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.hcl.2012.02.001","article-title":"The epidemiology of distal radius fractures","volume":"28","author":"Nellans","year":"2012","journal-title":"Hand Clin"},{"issue":"2","key":"r2-20230807","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3109\/17453678508994345","article-title":"Increasing incidence of forearm fractures. 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