International journal of surgery (London, England) · 2025
Postoperative functions and complications in minimally invasive percutaneous plate osteosynthesis compared with intramedullary nail for distal tibial fractures: a meta-analysis and systematic review.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zhou Hecheng, Zhang Yanci, Wei Liting, Ge Xiangliang, Liu Dehang, Dong Yue, Chen Yang, Liu Zongshuan, Sun Zhenhui
Аннотация
OBJECTIVE: This meta-analysis aims to compare the minimally invasive percutaneous plate osteosynthesis (MIPPO) versus intramedullary nail (IMN) for distal tibial fractures. The comparison focuses on postoperative functional outcomes, complication rates, time to fracture union, and other relevant clinical indicators.
METHODS: A comprehensive computerized search was conducted across PubMed, Web of Science, Cochrane Library, and Embase, covering all available publications up to 4 August 2024. Two independent researchers assessed the quality of the selected studies using predefined inclusion and exclusion criteria. Key demographic and clinical data, such as patient gender, age, surgery duration, postoperative functional outcomes, and complication rates, were collected from the included studies. Statistical analysis was performed using Review Manager 5.3.
RESULTS: A total of 23 studies, involving 1742 patients, were included in the meta-analysis, with 858 patients treated using MIPPO and 884 patients treated with IMN. The pooled data revealed that patients who underwent IMN experienced a shorter time to bone union, along with a lower incidence of infection, ankle stiffness, and soft tissue complications. Conversely, MIPPO demonstrated advantages in reducing the rates of malalignment and anterior knee pain. No significant differences were observed between the two methods in terms of functional scores, delayed or non-union rates, and overall complication rates.
CONCLUSIONS: IMN was found to promote faster bone union compared to MIPPO with high heterogeneity but no difference was found in function score between the two groups. Although both techniques exhibited similar overall complication rates, the specific types of complications varied between the two. The MIPPO group showed lower rate of malalignment rate and knee pain, whereas the IMN group had fewer infections, ankle stiffness, and soft tissue issues. No significant difference was noted in the rates of delayed or non-union. The choice of surgical method may depend on individual patient conditions, with different techniques potentially better suited for reducing the risk of certain complications. Further clinical studies are needed to better understand patient preferences and optimize treatment strategies for distal tibial fractures.
METHODS: A comprehensive computerized search was conducted across PubMed, Web of Science, Cochrane Library, and Embase, covering all available publications up to 4 August 2024. Two independent researchers assessed the quality of the selected studies using predefined inclusion and exclusion criteria. Key demographic and clinical data, such as patient gender, age, surgery duration, postoperative functional outcomes, and complication rates, were collected from the included studies. Statistical analysis was performed using Review Manager 5.3.
RESULTS: A total of 23 studies, involving 1742 patients, were included in the meta-analysis, with 858 patients treated using MIPPO and 884 patients treated with IMN. The pooled data revealed that patients who underwent IMN experienced a shorter time to bone union, along with a lower incidence of infection, ankle stiffness, and soft tissue complications. Conversely, MIPPO demonstrated advantages in reducing the rates of malalignment and anterior knee pain. No significant differences were observed between the two methods in terms of functional scores, delayed or non-union rates, and overall complication rates.
CONCLUSIONS: IMN was found to promote faster bone union compared to MIPPO with high heterogeneity but no difference was found in function score between the two groups. Although both techniques exhibited similar overall complication rates, the specific types of complications varied between the two. The MIPPO group showed lower rate of malalignment rate and knee pain, whereas the IMN group had fewer infections, ankle stiffness, and soft tissue issues. No significant difference was noted in the rates of delayed or non-union. The choice of surgical method may depend on individual patient conditions, with different techniques potentially better suited for reducing the risk of certain complications. Further clinical studies are needed to better understand patient preferences and optimize treatment strategies for distal tibial fractures.