Yanbin Zhu1, Ye Tian, Tianhua Dong, Wei Chen, Fei Zhang, Yingze Zhang. 1. Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, People's Republic of China, zhuyanbin111@126.com.
Abstract
PURPOSE: This meta-analysis of randomised controlled trials (RCTs) aimed to investigate the comparative outcomes between plate fixation and intramedullary fixation for management of mid-shaft clavicle fractures. METHODS: Relevant original studies were searched in electronic databases of PubMed, Medline, Embase and CNKI (all through October 2014). RCTs that investigated the effectiveness or complications between both groups and provided sufficient data of interest were included in this meta-analysis. RESULTS: Five RCTs fulfilled inclusion and exclusion criteria and were included in this meta-analysis, with 128 participants in a plate fixation (PF) group and 157 in an intramedullary fixation (IF) group. Patients were followed up for at least one year in all the studies. Compared to PFs, IF is a better alternative for treatment of MSCFs than PF, with a reduced surgery time, a shorter incision, rapid union time, better shoulder function at one year and fewer complications such as infection, symptomatic hardware and hypertrophic scar. In other aspects such as complications of implant failure, refracture and nonunion, both techniques were comparable. CONCLUSIONS: If the surgery is indicated, intramedullary fixation has more advantages than plate fixation for treatment of mid-shaft clavicular fracture. This definitive conclusion could aid surgeons in making evidence-based decisions when selecting an optimal fixation pattern.
PURPOSE: This meta-analysis of randomised controlled trials (RCTs) aimed to investigate the comparative outcomes between plate fixation and intramedullary fixation for management of mid-shaft clavicle fractures. METHODS: Relevant original studies were searched in electronic databases of PubMed, Medline, Embase and CNKI (all through October 2014). RCTs that investigated the effectiveness or complications between both groups and provided sufficient data of interest were included in this meta-analysis. RESULTS: Five RCTs fulfilled inclusion and exclusion criteria and were included in this meta-analysis, with 128 participants in a plate fixation (PF) group and 157 in an intramedullary fixation (IF) group. Patients were followed up for at least one year in all the studies. Compared to PFs, IF is a better alternative for treatment of MSCFs than PF, with a reduced surgery time, a shorter incision, rapid union time, better shoulder function at one year and fewer complications such as infection, symptomatic hardware and hypertrophic scar. In other aspects such as complications of implant failure, refracture and nonunion, both techniques were comparable. CONCLUSIONS: If the surgery is indicated, intramedullary fixation has more advantages than plate fixation for treatment of mid-shaft clavicular fracture. This definitive conclusion could aid surgeons in making evidence-based decisions when selecting an optimal fixation pattern.
Authors: Nicholas A Ferran; Paul Hodgson; Nicola Vannet; Rhys Williams; Richard O Evans Journal: J Shoulder Elbow Surg Date: 2010-09 Impact factor: 3.019
Authors: Vinzenz Smekal; Alexander Irenberger; Peter Struve; Markus Wambacher; Dietmar Krappinger; Franz Sebastian Kralinger Journal: J Orthop Trauma Date: 2009-02 Impact factor: 2.512
Authors: Martijn H J Hulsmans; Mark van Heijl; R Marijn Houwert; Eric R Hammacher; Sven A G Meylaerts; Michiel H J Verhofstad; Marcel G W Dijkgraaf; Egbert J M M Verleisdonk Journal: Clin Orthop Relat Res Date: 2016-11-09 Impact factor: 4.176