The fibular intramedullary nail versus plate fixation for ankle fractures in adults: a systematic review and meta-analysis of randomized controlled trials.

Autor: Zhang J; General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, 37# Guoxue Alley, Chengdu, 610041, Sichuan Province, People's Republic of China.; West China School of Nursing, Sichuan University, 37# Guoxue Alley, Chengdu, 610041, Sichuan Province, People's Republic of China., Luo R; Department of Orthopedics Surgery, Trauma Medical Center, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Alley, Chengdu, 610041, Sichuan Province, People's Republic of China., Chen J; Department of Orthopedics Surgery, Trauma Medical Center, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Alley, Chengdu, 610041, Sichuan Province, People's Republic of China. chenjialei2016@wchscu.cn.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2024 Sep 05; Vol. 19 (1), pp. 542. Date of Electronic Publication: 2024 Sep 05.
DOI: 10.1186/s13018-024-05032-z
Abstrakt: Objective: The effectiveness and safety of fibular intramedullary nail fixation (FINF) compared to plate fixation (PF) in treating ankle fractures among adults remains unclear. Therefore, we conducted a meta-analysis to assess the efficacy and safety of FINF versus PF, aiming to provide orthopedic surgeons with valuable insights when choosing between the two internal fixation methods for patient treatment.
Methods: PubMed, EMBASE, and SCOPUS were systematically searched for articles comparing FINF and PF in ankle fractures among adults. Functional outcomes, complications, and bony union were compared between the implants.
Results: A total of seven studies were included in the study, involving 586 patients. The results revealed no statistically significant differences in functional outcomes between two groups at 3, 6, and 12 months postoperatively. The outcomes favoring FINF comprised a lower infection rate (RR = 0.23, 95%CI, 0.11 to 0.47, P < 0.0001). Conversely, the PF group exhibited a superior performance in terms of hardware failure rate (RR = 2.05, 95%CI, 1.16 to 3.60, P = 0.01). A statistically significant difference was observed in the results of hardware failure rate in the subgroup of studies conducted in Europe (RR = 2.74, 95%CI, 1.45 to 5.18, P = 0.002). Comparable findings were also noted in a subgroup of older adults (RR = 4.25, 95%CI, 1.57 to 11.50, P = 0.004).
Conclusion: This systematic review suggests that FINF exhibits comparable effectiveness in the management of ankle fractures among adults, as compared to PF. Consequently, it is imperative to further delineate the surgical indications for both FINF and PF with precision to mitigate the risk of complications. Nevertheless, larger sample sizes and multi-center RCTs are imperative to corroborate this conclusion in the future.
(© 2024. The Author(s).)
Databáze: MEDLINE
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