A Cochrane review [Abstract] 1 included 13 studies with a total of 940 subjects, generally older adults with dorsally displaced and potentially or evidently unstable distal radial fractures. Across-fracture percutaneous pinning (5 trials) was associated with improved anatomical outcome and generally minor complications as compared with plaster cast immobilisation. There was some indication of similar or improved function in the pinning group. Biodegradable pins were associated with a significant excess of complications as compared with metal pins (2 trials). Kapandji fixation was associated with a higher incidence of complications as compared with other pinning methods or plaster cast immobilisation.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by inconsistency (heterogeneity in interventions and outcomes).
Primary/Secondary Keywords