• Bo He, Xue Tian, Gang Ji, and Achao Han.
• The Central Hospital of Wuhan, Achao Han, 26 Shengli Road, Wuhan, 430014, Hubei, China.
• Arch Orthop Trauma Surg. 2020 Aug 1; 140 (8): 1143-1153.

IntroductionThis study was a systematic review comparing the clinical outcomes of nonsurgical and surgical management for distal radius fractures.Materials And MethodsA comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane. All databases were searched from the earliest records through June 2019 using the following Boolean operators: distal radius fracture, conservative treatment, nonoperative treatment, nonsurgical treatment, surgical treatment, and operative. All prospective and retrospective controlled trials were retrieved that directly compared the functional outcomes between the nonsurgical and surgical groups.ResultsFive prospective studies and six retrospective comparative studies were retrieved. A total of 1049 patients were included: 529 in the nonsurgical group and 520 in the surgical group. Both types of treatment led to similar results with respect to DASH and grip strength, as well as and most other functional assessments. However, there was significant difference in radial inclination, radial length, ulnar variance and range of wrist flexion.ConclusionsNo significant differences in most functional assessments were found when comparing surgical and nonsurgical management of distal radius fractures. Although there were significant differences in radial inclination, radial deviation, ulnar variance, and wrist flexion, they did not seem to have impacts on the quality of wrist. Nonsurgical treatment for the distal radius fractures should be considered firstly. Indications for operative fixation should be considered carefully in the treatment of DRFs.Level Of EvidenceTherapeutic study (systematic review), Level III.

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