Meta-Analysis of Fracture Healing Time between Closed Reduction and Open Reduction for Distal Radius Fractures

Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia

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Abstract

Distal radius fracture, a common upper limb injury with rising elderly incidence, has two mainstream treatments: Open Reduction and Internal Fixation (ORIF) and Closed Reduction with External Fixation (CREF), whose effects on healing time remain controversial. A 2010–2024 meta-analysis included 20 studies (2,864 patients), using MINORS and modified Jadad scales for quality assessment. The primary outcome was fracture healing time, defined as the time from operation/reduction to radiological and clinical evidence of healing (blurred fracture line, continuous callus growth, no tenderness, and absent longitudinal percussion pain).With low heterogeneity (I²=23.7%, P=0.20), fixed-effects model results showed ORIF significantly shortened healing time vs. CREF (MD=-1.52 weeks, P<0.001), consistent in both elderly (≥60) and young/middle-aged subgroups (<60). No publication bias was found (P=0.36). Clinicians should tailor plans to patient conditions; future research needs multi-center large-sample RCTs.