Staples, tension-band plates, and percutaneous epiphysiodesis screws used for leg-length discrepancy treatment: a systematic review and proportional meta-analysis.

IF 2.5 2区医学 Q1 ORTHOPEDICS

Acta Orthopaedica Pub Date : 2024-07-18 DOI:10.2340/17453674.2024.41104

Maria Tirta, Mette Holm Hjorth, Jette Frost Jepsen, Søren Kold, Ole Rahbek

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引用次数: 0

Abstract

Background and purpose: The primary aim of this systematic review and meta-analysis was to evaluate the success rate of 3 different epiphysiodesis techniques with implant usage for the treatment of leg-length discrepancy (LLD) in the pediatric population. The secondary aim was to address effectiveness (final LLD) and the reported complications of staples, tension-band plates (TBP), and percutaneous epiphysiodesis screws (PETS).

Methods: In this systematic review we searched MEDLINE (PubMed), Embase, Cochrane Library, Web of Science and Scopus for studies on skeletally immature patients with LLD treated with epiphysiodesis with an implant. The extracted outcome categories were effectiveness of epiphysiodesis (LLD measurements pre-/postoperatively, successful/unsuccessful) and complications that were graded on severity.

Results: 44 studies (2,184 patients) were included. 455 underwent epiphysiodesis with PETS, 578 patients with TBP, and 1,048 with staples. Successful epiphysiodesis was reported in 76% (95% confidence interval [CI] 61-89) with PETS (9 studies), 67% (CI 54-79) with TBP (10 studies), and 51% (CI 28-65) with Blount staples (8 studies). From pooled analysis, the severe complications rate was 7% for PETS, 17% for TBP, and 16% for Blount staples. Angular deformity was reported in 4% after PETS, 10% after TBP, and 17% after Blount staples.

Conclusion: Our results showed that epiphysiodesis with PETS implants was the most successful technique. PETS had a higher success rate, fewer severe complications, and a lower proportion with angular deformity.

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用于治疗腿长不一致的订书钉、张力带钢板和经皮骺端螺钉：系统综述和比例荟萃分析。

背景和目的：这篇系统综述和荟萃分析的主要目的是评估3种不同的骺板固定技术和植入物用于治疗儿童腿长不一致（LLD）的成功率。次要目的是探讨钉书针、张力带钢板（TBP）和经皮外展螺钉（PETS）的有效性（最终 LLD）和报告的并发症：在这篇系统性综述中，我们检索了 MEDLINE (PubMed)、Embase、Cochrane Library、Web of Science 和 Scopus，以了解关于骨骼尚未发育成熟的 LLD 患者接受带植入物的骨外固定治疗的研究。提取的结果类别为骺板切除术的有效性（术前/术后LLD测量值、成功/不成功）以及根据严重程度分级的并发症：结果：共纳入 44 项研究（2 184 名患者）。结果：共纳入 44 项研究（2,184 名患者），其中 455 名患者接受了 PETS 骨外固定术，578 名患者接受了 TBP 骨外固定术，1,048 名患者接受了缝合术。据报道，76%（95% 置信区间 [CI] 61-89）的患者使用 PETS（9 项研究）、67%（CI 54-79）的患者使用 TBP（10 项研究）和 51%（CI 28-65）的患者使用 Blount 缝合线（8 项研究）进行了骨骺分离术。汇总分析显示，PETS 的严重并发症发生率为 7%，TBP 为 17%，Blount 缝合钉为 16%。PETS术后出现角度畸形的比例为4%，TBP术后为10%，Blount钉术后为17%：我们的研究结果表明，使用 PETS 植入物进行骨外固定是最成功的技术。PETS的成功率更高，严重并发症更少，出现成角畸形的比例也更低。

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来源期刊

Acta Orthopaedica 医学-整形外科

CiteScore

6.40

自引率

8.10%

发文量

105

审稿时长

4-8 weeks

期刊介绍： Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.