This systematic review and meta-analysis assessed the role of nonoperative treatment and volar locking plate (VLP) fixation in elderly patients with distal radial fracture. The systematic literature review identified randomized controlled trials (RCTs) and observational studies using VLP and nonoperative treatment for distal radial fractures in the elderly. Two investigators independently extracted data and evaluated the quality of the studies. A meta-analysis was performed using RevMan version 5.3. The five RCTs and six observational studies included 585 and 604 patients in the VLP and nonoperation groups, respectively. The quality of these 11 studies was moderate. Compared to nonoperation treatment, VLP did not improve the disabilities of the arm, shoulder and hand (DASH) score (weighted mean difference [WMD] = −1.67; 95% confidence interval [CI], −3.58–−0.24; P = 0.09), decrease complications (odds ratio = 1.05; 95% CI, 0.51–2.19; P = 0.89), or improve range of motion in flexion, extension, pronation, supination, and radial deviation. The VLP group had better grip strength (WMD = 10.52; 95% CI, 6.19–14.86; P < 0.0001) and radiographic assessment than the nonoperation group. Although insufficient, the study evidence shows that VLP does not improve DASH scores, complications, or range of motion, but it might provide better grip strength and radiographic assessment than nonoperation treatment.

中文翻译：

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老年radial骨远端骨折的非手术治疗与手掌锁定钢板固定：系统评价和荟萃分析。

这项系统的回顾和荟萃分析评估了非手术治疗和手掌锁定板（VLP）固定在老年radial骨远端骨折患者中的作用。该系统文献综述确定了使用VLP和非手术治疗老年人distal骨远端骨折的随机对照试验（RCT）和观察性研究。两名调查员独立提取数据并评估研究质量。使用RevMan版本5.3进行荟萃分析。五项随机对照试验和六项观察性研究分别包括了VLP组和非手术组的585例和604例患者。这11项研究的质量中等。与非手术治疗相比，VLP并没有改善手臂，肩部和手部（DASH）的评分（加权平均差异[WMD] = -1.67；95％置信区间[CI]，-3.58--0.24；P = 0.09），减少并发症（优势比= 1.05； 95％CI，0.51-2.19； P = 0.89），或改善屈曲，伸展，内旋，旋后和径向偏移的运动范围。VLP组比非手术组具有更好的握力（WMD = 10.52； 95％CI，6.19–14.86； P <0.0001）和影像学评估。尽管不足，但研究证据表明，VLP不能改善DASH评分，并发症或运动范围，但与非手术治疗相比，它可以提供更好的握力和影像学评估。P <0.0001），且放射照相评估高于非手术组。尽管不足，但研究证据表明，VLP不能改善DASH评分，并发症或运动范围，但与非手术治疗相比，它可以提供更好的握力和影像学评估。P <0.0001），且放射照相评估高于非手术组。尽管不足，但研究证据表明，VLP不能改善DASH评分，并发症或运动范围，但与非手术治疗相比，它可以提供更好的握力和影像学评估。