Ultrasound-guided manipulation of Colle's fracture in adults is not beneficial over landmark based fracture reduction. The outcome of a systematic review and meta-analysis.

Abstract

Abstract Background This review aims to determine the relative Risk of distal Radius (Colle's) fracture (DRF) malalignment between ultrasound-guided and conventional/landmark guided/blind manipulation. Methods Major electronic bibliographic databases on ultrasound-guided manipulation of DRF were searched. Studies with randomized, quasi-randomized, and cross-sectional study designs meeting the inclusion criteria were included for this review. Ultrasound and landmark guided DRF manipulations were named cases and controls respectively. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. Results Thirteen and nine studies were analysed in the qualitative and quantitative analysis. 951 DRF patients (475 cases and 476 controls) from 9 studies with mean ages of 51.52 ± 11.86 (22-92) and 55.82 ± 11.28 (18-98) years for cases and controls respectively were pooled for this review. The pooled estimate of Relative Risk from the studies included in MA was 0.90 (0.74-1.09). There was a 10% reduction in risk of malreduction of DRF M&R with USG-guided manipulation than the blind manipulation however, sensitivity analysis revealed a relative risk of 1.00 (0.96-1.05). Discussion The ultrasound guided manipulation does not offers benefits in preventing malreduction over the landmark based manipulation of DRF. Unbiased high quality studies can further verify the findings of this review.