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Association between distal radius fracture malunion and patient-reported disability : a systematic review and meta-analysis

Ali, Muhanned LU orcid ; Rosales, Roberto S. ; Brogren, Elisabeth LU ; Waldén, Markus ; Nordenskjöld, Jesper LU and Atroshi, Isam LU (2024) In EFORT Open Reviews 9(11). p.1097-1105
Abstract

• Purpose: To assess whether distal radius fracture (DRF) malunion is associated with greater patient-reported disability. • Methods: We searched PubMed, EMBASE, and Cochrane databases up to 21 May 2023. Two reviewers independently screened retrieved titles/abstracts and assessed the full text of potentially eligible articles to identify cohort studies and randomized controlled trials reporting outcomes of DRF in adults at least 12 months after fracture, confirmed radiologically 3 months or longer after fracture. We excluded studies not reporting patient-reported outcomes according to malunion and studies judged to have a high risk of bias, as assessed independently by two reviewers using the Quality In Prognosis Studies tool. To... (More)

• Purpose: To assess whether distal radius fracture (DRF) malunion is associated with greater patient-reported disability. • Methods: We searched PubMed, EMBASE, and Cochrane databases up to 21 May 2023. Two reviewers independently screened retrieved titles/abstracts and assessed the full text of potentially eligible articles to identify cohort studies and randomized controlled trials reporting outcomes of DRF in adults at least 12 months after fracture, confirmed radiologically 3 months or longer after fracture. We excluded studies not reporting patient-reported outcomes according to malunion and studies judged to have a high risk of bias, as assessed independently by two reviewers using the Quality In Prognosis Studies tool. To express the overall effect of malunion on patient-reported disability, we calculated the standardized mean difference (SMD) with a 95% CI. • Results: Six studies with 898 patients (77% women) were included; five involved adults of all ages, and one restricted to patients aged 65 years and older. In the meta-analysis including the five studies with adults of all ages (1047 observations), the SMD was 0.58 (95% CI: 0.42–0.74; P < 0.001), favoring no malunion, with no statistically significant heterogeneity or publication bias. In the meta-analysis including all six studies (1193 observations), the SMD was 0.51 (95% CI: 0.35–0.67; P < 0.001), favoring no malunion, with moderate but significant heterogeneity. • Conclusion: Malunion of distal radius fracture is associated with significantly greater patient-reported disability with a moderate magnitude in terms of clinical importance. The study does not address the possible influence of age or treatment methods.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
distal radius fracture, malunion, patient-reported outcomes, systematic review
in
EFORT Open Reviews
volume
9
issue
11
pages
9 pages
publisher
British Editorial Society of Bone & Joint Surgery
external identifiers
  • pmid:39513719
  • scopus:85208741223
ISSN
2396-7544
DOI
10.1530/EOR-23-0212
language
English
LU publication?
yes
id
499975f2-72e3-4ac1-a525-9acbab71411b
date added to LUP
2025-02-17 16:18:35
date last changed
2025-07-08 03:59:52
@article{499975f2-72e3-4ac1-a525-9acbab71411b,
  abstract     = {{<p>• Purpose: To assess whether distal radius fracture (DRF) malunion is associated with greater patient-reported disability. • Methods: We searched PubMed, EMBASE, and Cochrane databases up to 21 May 2023. Two reviewers independently screened retrieved titles/abstracts and assessed the full text of potentially eligible articles to identify cohort studies and randomized controlled trials reporting outcomes of DRF in adults at least 12 months after fracture, confirmed radiologically 3 months or longer after fracture. We excluded studies not reporting patient-reported outcomes according to malunion and studies judged to have a high risk of bias, as assessed independently by two reviewers using the Quality In Prognosis Studies tool. To express the overall effect of malunion on patient-reported disability, we calculated the standardized mean difference (SMD) with a 95% CI. • Results: Six studies with 898 patients (77% women) were included; five involved adults of all ages, and one restricted to patients aged 65 years and older. In the meta-analysis including the five studies with adults of all ages (1047 observations), the SMD was 0.58 (95% CI: 0.42–0.74; P &lt; 0.001), favoring no malunion, with no statistically significant heterogeneity or publication bias. In the meta-analysis including all six studies (1193 observations), the SMD was 0.51 (95% CI: 0.35–0.67; P &lt; 0.001), favoring no malunion, with moderate but significant heterogeneity. • Conclusion: Malunion of distal radius fracture is associated with significantly greater patient-reported disability with a moderate magnitude in terms of clinical importance. The study does not address the possible influence of age or treatment methods.</p>}},
  author       = {{Ali, Muhanned and Rosales, Roberto S. and Brogren, Elisabeth and Waldén, Markus and Nordenskjöld, Jesper and Atroshi, Isam}},
  issn         = {{2396-7544}},
  keywords     = {{distal radius fracture; malunion; patient-reported outcomes; systematic review}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1097--1105}},
  publisher    = {{British Editorial Society of Bone & Joint Surgery}},
  series       = {{EFORT Open Reviews}},
  title        = {{Association between distal radius fracture malunion and patient-reported disability : a systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1530/EOR-23-0212}},
  doi          = {{10.1530/EOR-23-0212}},
  volume       = {{9}},
  year         = {{2024}},
}