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External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis
BACKGROUND: It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. MATERIALS AND METHODS: A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633424/ https://www.ncbi.nlm.nih.gov/pubmed/26307153 http://dx.doi.org/10.1007/s10195-015-0372-9 |
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author | Metcalfe, David Hickson, Craig J. McKee, Lesley Griffin, Xavier L. |
author_facet | Metcalfe, David Hickson, Craig J. McKee, Lesley Griffin, Xavier L. |
author_sort | Metcalfe, David |
collection | PubMed |
description | BACKGROUND: It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. MATERIALS AND METHODS: A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. RESULTS: Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25–5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. CONCLUSION: Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures. LEVEL OF EVIDENCE: II. |
format | Online Article Text |
id | pubmed-4633424 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-46334242015-11-10 External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis Metcalfe, David Hickson, Craig J. McKee, Lesley Griffin, Xavier L. J Orthop Traumatol Review Article BACKGROUND: It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. MATERIALS AND METHODS: A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. RESULTS: Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25–5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. CONCLUSION: Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures. LEVEL OF EVIDENCE: II. Springer International Publishing 2015-08-26 2015-12 /pmc/articles/PMC4633424/ /pubmed/26307153 http://dx.doi.org/10.1007/s10195-015-0372-9 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Review Article Metcalfe, David Hickson, Craig J. McKee, Lesley Griffin, Xavier L. External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
title | External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
title_full | External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
title_fullStr | External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
title_full_unstemmed | External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
title_short | External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
title_sort | external versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633424/ https://www.ncbi.nlm.nih.gov/pubmed/26307153 http://dx.doi.org/10.1007/s10195-015-0372-9 |
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