Brahman S Sivakumar1, Vincent Vg An2, Kevin Phan3, David J Graham4, James Ledgard1, Richard Lawson1, Dominic Furniss5. 1. Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia. 2. Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. 3. Liverpool Hospital, Liverpool, NSW, Australia. 4. Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, QLD, Australia. 5. Botnar research centre, Nuffield Department of Orthopaedics, Rhuematology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Abstract
Background: Several approaches to plate fixation of the proximal phalanx have been proposed, such as the dorsal extensor splitting approach and the lateral or dorso-lateral extensor sparing approach, which aims to minimise invasiveness to promote native extensor tendon glide. This study aimed to meta-analyse the outcomes of these two approaches. Methods: A systematic review of electronic databases was undertaken, and the outcomes of comparative studies meta-analysed. Results: Three studies were included for meta-analysis. Total active motion (TAM) was significantly greater in the extensor sparing group compared to the extensor splitting (Mean difference 8.52 degrees, 95%CI 0.8-16.36, p = 0.03). Conclusions: This study demonstrates that there is preliminary evidence favouring the use of extensor sparing approaches when fixing proximal phalanxes - however, this result requires validation with randomised controlled trials.
Background: Several approaches to plate fixation of the proximal phalanx have been proposed, such as the dorsal extensor splitting approach and the lateral or dorso-lateral extensor sparing approach, which aims to minimise invasiveness to promote native extensor tendon glide. This study aimed to meta-analyse the outcomes of these two approaches. Methods: A systematic review of electronic databases was undertaken, and the outcomes of comparative studies meta-analysed. Results: Three studies were included for meta-analysis. Total active motion (TAM) was significantly greater in the extensor sparing group compared to the extensor splitting (Mean difference 8.52 degrees, 95%CI 0.8-16.36, p = 0.03). Conclusions: This study demonstrates that there is preliminary evidence favouring the use of extensor sparing approaches when fixing proximal phalanxes - however, this result requires validation with randomised controlled trials.
Entities:
Keywords:
Extensor tendon; Phalanx fractures; Systematic review; Total active motion