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Long term outcomes of open reduction internal fixation versus external fixation of distal radius fractures: A meta-analysis

机译:切开复位内固定与versus骨远端骨折外固定的远期疗效:荟萃分析

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摘要

Distal radius fractures are among the most common fractures encountered in the clinical setting. Of these common fractures, it has been said that up to 60% are intraarticular in nature. Intra-articular or unstable and comminuted fractures represent severe and high energy injuries. Despite a large amount of literature, it is surgeon preference which determines the fixation method employed. There are only a few randomised control trials that report 2-year outcomes. There has yet to be a meta-analysis comparing the long-term outcomes of open reduction internal fixation (ORIF) and external fixation (EF). The aim of this metaanalysis is to identify any difference in the outcomes of either fixation method in the long term. We pooled the data of all the available randomised control trials that followed the patients for a minimum of 2 years and compared outcomes of ORIF against EF of distal radius fractures as per PRISMA guidelines from inception of the databases to December 2016. We then performed our meta-analysis using RevMan 5.3 software. Flexion/extension arcs were significantly improved in ORIF, and 7 of the 10 analysed outcomes supported ORIF, although most not to a significant degree. The meta-analysis indicated that there is no difference in outcomes with either form of treatment. Even though the flexion extension arc was statistically better in the ORIF group, the difference is not clinically meaningful.
机译:radius骨远端骨折是临床上最常见的骨折之一。在这些常见的骨折中,据说多达60%是关节内的。关节内或不稳定和粉碎性骨折代表严重和高能量损伤。尽管有大量文献报道,但外科医生的喜好决定了所采用的固定方法。只有少数随机对照试验报告了2年的结果。还没有一项荟萃分析比较开放复位内固定术(ORIF)和外固定术(EF)的长期疗效。这项荟萃分析的目的是从长期角度确定两种固定方法的结局是否存在差异。我们汇总了患者随访至少2年的所有可用随机对照试验的数据,并根据数据库建立之初至2016年12月的PRISMA指南,比较了ORIF与distal骨远端骨折EF的结局。 -使用RevMan 5.3软件进行分析。屈曲/伸展弧在ORIF中得到了显着改善,分析的10项结果中有7项支持ORIF,尽管大多数并未达到显着水平。荟萃分析表明,两种治疗方式的结局均无差异。即使ORIF组的屈伸弧度在统计学上较好,但这种差异在临床上没有意义。

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