Is Immobilization Necessary After Open Reduction and Internal Fixation of Distal Radius Fractures? A Meta-Analysis of Randomized Controlled Trials.

Abstract

Distal radius fractures (DRFs) are the most common fractures in adults. With the increased trend in open reduction and internal fixation (ORIF) using a volar locking plate, the postoperative rehabilitation course remains debated and whether or not a postoperative immobilization is necessary is unknown. PubMed, Cochrane, and Google Scholar (pages 1-20) were queried through August 2024. Inclusion criteria consisted of studies that compared patients undergoing immediate mobilization after ORIF for DRF with patients undergoing postoperative immobilization. Adverse events, patient-reported outcomes measures, and range of motion (ROM) were all compared between the 2 groups at various postoperative time points. Four randomized controlled trials were included in this study. No difference was seen in the risk of complications (odds ratio = 1.17, <i>P</i> = .70) and reoperations (odds ratio = 1.35, <i>P</i> = .53) between the 2 groups. The immediate mobilization group had lower pain scores at 6 months (mean difference = -0.46, <i>P</i> = .005) and lower Disabilities of the Arm, Shoulder, and Hand at 3 months (mean difference = -0.45, <i>P</i> = .002), and 6 months (mean difference = -0.46, <i>P</i> = .005). As for ROM, better forearm rotation was seen in the immediate mobilization group at 6 months (mean difference = 3.43, <i>P</i> = .004).