Tendon Rupture and Tendonitis in Low-Profile Dorsal versus Volar Plating for Distal Radius Fractures: A Systematic Review and Meta-Analysis
Background: Dorsal plating of distal radius fractures has historically been associated with high rates of hardware removal, tendonitis, and tendon rupture. Newer generation low-profile dorsal plates are thinner (\u3c1.6mm thick) with improved characteristics. We examine whether low-profile dorsal plates still have higher rates of tendon complications than volar locking plates.
Methods: We searched Ovid MEDLINE, Web of Science, and EMBASE for published literature describing tendon complications in association with plating of distal radius fractures. Inclusion criteria encompasses any primary study of low-profile dorsal plates that included data on tendon complications. Studies that included both low-profile dorsal and volar plating arms were included in the meta-analysis.
Results: Nine studies were selected for inclusion. All studies were retrospective cohorts or case series with a total of 446 low-profile dorsal plates. Five studies were included in the meta-analysis with a total of 806 subjects; 584 received volar plates and 222 received low-profile dorsal plates. Meta-analysis showed no significant difference in rates of tendonitis or tendon rupture.
Discussion: The included studies were all of level III or IV evidence. To our knowledge, this review provides the largest comparison of low-profile dorsal and volar locked distal radius plates to date. Pooled analysis results provide further comparison of low-profile dorsal versus volar plating
