Surgeon. 2026 Aug 13:S1479-666X(26)00049-1. doi: 10.1016/j.surge.2026.08.002. Online ahead of print.
ABSTRACT
AIMS: Distal radius fractures (DRFs) are prevalent injuries, particularly among the elderly and young active individuals. Recent studies have emphasized the timing of surgical intervention, which may influence complication rates and functional outcomes. While some reviews have found no significant differences in outcomes between early and late surgery, others have suggested benefits from early intervention. Current guidelines from the British Orthopaedic Association Audit Standards for Trauma (BOAST) recommend surgical fixation within specific timeframes, yet optimal timing remains a topic of ongoing debate. This systematic review and meta-analysis aimed to assess the impact of surgical timing on complication rates and functional outcomes in closed DRFs.
METHODS: A comprehensive search was conducted across multiple electronic databases, including PubMed, EMBASE, and the Cochrane Library, to identify relevant studies. Eligible studies included randomized control trials and observational studies which compared early versus late surgical treatment. Meta-analyses were conducted on pooled data from compatible studies.
RESULTS: Fourteen studies involving 2104 patients were included in this analysis. Meta-analysis revealed late surgical intervention was associated with an 8% increase in complication rates (95% CI 4% to 13%). Functional outcomes demonstrated that early surgery led to improved range of motion in flexion, pronation, and supination; however, no statistically significant differences were observed in extension. Further, Patient-Reported Outcome Measures did not exhibit significant differences between early and late surgical interventions.
CONCLUSION: Early surgical intervention for DRFs is associated with lower complication rates and improved range of motion, however it does not improve patient reported outcomes.
PMID:42595586 | DOI:10.1016/j.surge.2026.08.002
