External fixation versus open reduction and internal fixation for tibial pilon fractures: A meta-analysis based on observational studies / 中华创伤杂志(英文版)
Chinese Journal of Traumatology
;
(6): 278-282, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-235728
ABSTRACT
<p><b>PURPOSE</b>Tibial pilon fractures remain challenging for an orthopaedic surgeon to repair. External fixation (ExFix) and open reduction and internal fixation (ORIF) are two widely used methods for repairing tibial pilon fractures. However, conclusions of comparative studies regarding which method is superior are controversial. Our aim is to compare ORIF and ExFix and clarify which method is better in terms of reduction and union results and major complications.</p><p><b>METHODS</b>A computerized research of MEDLINE, EMBASE, Springer, and Cochrane Library (before December 2014) for studies of any design comparing ORIF and ExFix was conducted. Weighted mean difference (WMD), risk ratio (RR) and corresponding 95% confidence intervals (CI) were used for esti- mating the effects of the two methods. Statistical analyses were done using Review Manager Version 5.2.</p><p><b>RESULTS</b>Ten cohort studies and one randomized clinical trial were included in our ultimate analysis. And the analysis found no significant difference between the two methods in deep infection (p = 0.13), reduction (p = 0.11), clinical evaluation (p = 0.82), post-traumatic arthrosis (p = 0.87), and union time (p = 0.35). Besides, ExFix group was found to have a higher rate of superficial infection (p =0.001), malunion (p = 0.01) and nonunion (p = 0.02), but have a lower risk of unplanned hardware removal (p = 0.0002).</p><p><b>CONCLUSIONS</b>We suggest that ORIF has a relatively lower incidence rate of superficial infection, malunion and nonunion, but a higher rate of unplanned hardware removal. No difference was found in deep infection, reduction, clinical evaluation, post-traumatic arthrosis and union time.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Cirurgia Geral
/
Fraturas da Tíbia
/
Fixadores Externos
/
Fixação Interna de Fraturas
/
Métodos
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo observacional
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
Idioma:
Inglês
Revista:
Chinese Journal of Traumatology
Ano de publicação:
2016
Tipo de documento:
Artigo
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