A Meta-analysis Comparing External Fixation against Open Reduction and Internal Fixation for the Management of Tibial Plateau Fractures.

IF 1 Q3 ORTHOPEDICS

Strategies in Trauma and Limb Reconstruction Pub Date : 2022-05-01 DOI:10.5005/jp-journals-10080-1557

Ahmad S Naja, Nour Bouji, Mohamad Nasser Eddine, Humaid Alfarii, Rudolf Reindl, Yehia Tfayli, Mohamad Issa, Said Saghieh

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引用次数: 1

Abstract

Aim: This article aims to compare the outcomes between open reduction and internal fixation (ORIF) and external fixation (ExFix) in tibial plateau fractures.

Background: Open reduction and internal fixation and external fixation are common methods for managing tibial plateau fractures without a consensus of choice.

Materials and methods: PubMed, Cochrane Library, Ovid, CINAHL®, Scopus, and Embase were searched. Clinical studies in humans comparing ExFix and ORIF for tibial plateau fractures were included. Case reports, pathological, and biomechanical studies were excluded. Two investigators reviewed the studies independently, and any discrepancies were resolved. The quality and heterogeneity of each study were assessed in addition to calculating the odds ratio (OR) of the surgical outcomes and complications at a 95% confidence interval, with p <0.05 as statistical significance.

Results: Of the 14 included studies, one was a randomised trial, one was a prospective study, and 12 were retrospective studies. The 865 fractures identified across the studies constituted 458 (52.9%) in the ExFix group and 407 (47.1%) in the ORIF group. Most studies indicated a better outcome for ORIF as compared to ExFix. Open reduction and internal fixation had a lower incidence of superficial infection and postoperative osteoarthritis, while ExFix revealed a lower proportion with heterotopic ossification (HTO).

Conclusion: ExFix has a higher rate of superficial infections and osteoarthritis, whereas ORIF has a higher incidence of HTO. Larger studies are needed to compare outcomes and investigate the findings of this study further.

Clinical significance: This up-to-date meta-analysis on tibial plateau management will help surgeons make evidence-based decisions regarding the use of ORIF versus ExFix.

How to cite this article: Naja AS, Bouji N, Eddine MN, et al. A Meta-analysis Comparing External Fixation against Open Reduction and Internal Fixation for the Management of Tibial Plateau Fractures. Strategies Trauma Limb Reconstr 2022;17(2):105-116.

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胫骨平台骨折外固定、切开复位和内固定治疗的meta分析。

目的:比较切开复位内固定(ORIF)和外固定(ExFix)治疗胫骨平台骨折的疗效。背景:切开复位、内固定和外固定是治疗胫骨平台骨折的常用方法，目前尚无一致的选择。资料和方法:检索PubMed、Cochrane Library、Ovid、CINAHL®、Scopus、Embase。比较ExFix和ORIF治疗胫骨平台骨折的临床研究包括在内。排除病例报告、病理和生物力学研究。两名研究人员独立审查了这些研究，任何差异都得到了解决。在95%置信区间内计算手术结果和并发症的比值比(OR)，并对每项研究的质量和异质性进行评估，p值为p。结果:纳入的14项研究中，1项为随机试验，1项为前瞻性研究，12项为回顾性研究。在研究中发现的865例骨折中，ExFix组有458例(52.9%)，ORIF组有407例(47.1%)。大多数研究表明，与ExFix相比，ORIF的结果更好。切开复位内固定的浅表感染和术后骨关节炎发生率较低，而ExFix的异位骨化(HTO)发生率较低。结论:ExFix有较高的浅表感染和骨关节炎发生率，而ORIF有较高的HTO发生率。需要更大规模的研究来比较结果并进一步调查本研究的结果。临床意义:这项关于胫骨平台管理的最新荟萃分析将帮助外科医生在使用ORIF和ExFix时做出基于证据的决定。文章引用方式:Naja AS, Bouji N, Eddine MN等。胫骨平台骨折外固定、切开复位和内固定治疗的meta分析。创伤肢体重建2022;17(2):105-116。

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.