ABSTRACT
BACKGROUND:The hol ow compression screws and absorbable screws can be applied for the treatment of the fifth metatarsal fracture. However, little evidence is obtained in China. OBJECTIVE:To compare ankle function and fracture displacement in patients with the fifth metatarsal fracture after interventions of hol ow compression screws and absorbable screws. METHODS:32 patients with the fifth metatarsal fracture were recruited from Zhongnan Hospital of Wuhan University between June 2012 and June 2014. According to the internal fixation method, the involved patients were divided into hol ow compression screws group (n=18) and absorbable screws group (n=14). Clinical outcomes of patients in the two groups were evaluated through observations of the mean healing time, postoperative infection, ankle activity and fracture displacement. RESULTS AND CONCLUSION:Al the 32 patients were fol owed up for 6-18 months and were al healed. Compared with the absorbable screws group, the healing time was shorter (P<0.05), incidence of postoperative screw rupture and fracture displacement was lower (P<0.05), and ankle activity was better in the hol ow compression screws group (P<0.05). It is necessary to enhance the strength, improve screw thread, increase anti-pul ing property, and al ow early ankle activity, thus reducing the risk of clinical application of the absorbable screws.
ABSTRACT
BACKGROUND:Percutaneous kyphoplasty and percutaneous vertebroplasty are effective safe minimaly invasive treatment methods for osteoporotic vertebral compression fracture. Percutaneous kyphoplasty has a certain advantage on long-period pain release, incidence rate of bone cement leakage, vertebral height recovery, and long-term kyphotic angle reduction compared with percutaneous vertebroplasty. However, we cannot deny the effects of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture. OBJECTIVE:A meta-analysis was performed to assess the safety and efficacy of percutaneous kyphoplasty and percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures. METHODS:A systematic computer-based search of al studies published til May 2013 was conducted in PubMed, Web of science, Ovid medline, Embase, Cochrane central database and CNKI for controled studies concerning percutaneous kyphoplasty and percutaneous vertebroplasty in treatment of osteoporotic vertebral compression fracture. Study selection was done by two reviewers independently according to inclusion and exclusion criteria. Meta analysis was performed using Revman5.2 (5.2.5 edition) software provided by Cochrane Colaboration. RESULTS AND CONCLUSION: A total of 12 studies containing 1 081 patients were included. The results of meta-analysis indicated that there were no significant differences between the two groups in the short-term pain relief, short-term and long-term Oswestry Dability Index scores, incidence of adjacent-level fracture, short-term restoration of kyphosis angle and operation time (P > 0.05). However, there were significant differences in the long-term pain relief, the incidence of cement leakage, postoperative anterior vertebral heights and long-term restoration of kyphosis angle (P < 0.05). Results suggested that percutaneous kyphoplasty was superior to percutaneous vertebroplasty in the long-term pain relief, the incidence of cement leakage, restoration of postoperative anterior vertebral body and long-term restoration of kyphosis angle. Percutaneous kyphoplasty and percutaneous vertebroplasty both are safe and effective surgical procedures. Due to lack of high-quality randomized controled trails in the original studies, more randomized controled trails are required and a prudent choice is suggested.