Arthroscopy assistance in the surgical management of distal radius fractures does not result in superior radiological and functional outcomes: A systematic review and meta-analysis of randomized controlled trials.
{"title":"Arthroscopy assistance in the surgical management of distal radius fractures does not result in superior radiological and functional outcomes: A systematic review and meta-analysis of randomized controlled trials.","authors":"Hyun-Gyu Seok, Jeong-Jin Park, Sam-Guk Park","doi":"10.1016/j.arthro.2025.01.026","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of assistant arthroscopy in the surgical treatment of distal radius fractures (DRFs) by the functional and radiological outcomes between the arthroscopic and control groups.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, Web of Science, and Cochrane Library databases for studies that compared the clinical outcomes of patients who underwent surgery with or without adjuvant arthroscopy. After screening the studies, we identified six randomized controlled trials. We analyzed radiological outcomes, range of motion, functional scores, grip strength, operative time, and complication rates. The standardized mean difference (SMD) was used to analyze differences in outcomes between the two groups. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Six studies involving 455 patients were included. The findings of this analysis indicate that the utilization of arthroscopic assistance did not yield superior radiological outcomes and functional outcomes, except in radial deviation (SMD = 0.96; 95% CI = 0.36, 1.55; I<sup>2</sup> = 69%) and ulnar deviation (SMD = 0.69; 95% CI = 0.38, 1.00; I<sup>2</sup> = 16%). In addition, the arthroscopic group exhibited longer operation time (SMD = 0.65; 95% CI = 0.1, 1.2; I<sup>2</sup> = 81%) compared to the control group. There were no significant differences in the grip strength or complication rates between the two groups.</p><p><strong>Conclusion: </strong>The findings of this analysis indicate that arthroscopy-assisted surgery for DRF does not yield significantly enhanced outcomes in terms of radiological outcomes, functional scores, grip strength, and complications, even though range of motion (radial deviation and ulnar deviation) were superior in the arthroscopically assisted cases. Given the extended operational time associated with adjuvant arthroscopy, the efficacy of assistant arthroscopy in the surgical management of distal radius fractures with joint involvement is not justified.</p><p><strong>Level of evidence: </strong>Level II, meta-analysis of Level I and Level II studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.01.026","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the efficacy of assistant arthroscopy in the surgical treatment of distal radius fractures (DRFs) by the functional and radiological outcomes between the arthroscopic and control groups.
Methods: We searched the PubMed, Embase, Web of Science, and Cochrane Library databases for studies that compared the clinical outcomes of patients who underwent surgery with or without adjuvant arthroscopy. After screening the studies, we identified six randomized controlled trials. We analyzed radiological outcomes, range of motion, functional scores, grip strength, operative time, and complication rates. The standardized mean difference (SMD) was used to analyze differences in outcomes between the two groups. Statistical significance was set at p < 0.05.
Results: Six studies involving 455 patients were included. The findings of this analysis indicate that the utilization of arthroscopic assistance did not yield superior radiological outcomes and functional outcomes, except in radial deviation (SMD = 0.96; 95% CI = 0.36, 1.55; I2 = 69%) and ulnar deviation (SMD = 0.69; 95% CI = 0.38, 1.00; I2 = 16%). In addition, the arthroscopic group exhibited longer operation time (SMD = 0.65; 95% CI = 0.1, 1.2; I2 = 81%) compared to the control group. There were no significant differences in the grip strength or complication rates between the two groups.
Conclusion: The findings of this analysis indicate that arthroscopy-assisted surgery for DRF does not yield significantly enhanced outcomes in terms of radiological outcomes, functional scores, grip strength, and complications, even though range of motion (radial deviation and ulnar deviation) were superior in the arthroscopically assisted cases. Given the extended operational time associated with adjuvant arthroscopy, the efficacy of assistant arthroscopy in the surgical management of distal radius fractures with joint involvement is not justified.
Level of evidence: Level II, meta-analysis of Level I and Level II studies.
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
