Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Meta-analysis of adverse outcomes following soft tissue reconstruction of complex open lower limb fractures.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Koubeh W, Tatiqaj L, Kilbey T, Chesters J, Al-Obaidi I, Atkins S, Costa M, Lamyman M, Masters J, Ramsden A, Tucker S, Wormald J C R
Аннотация
AIMS: Complex open lower limb fractures are associated with considerable morbidity. Soft tissue reconstruction is fundamental in the management of severe injuries. This systematic review and meta-analysis was conducted to pool data on key adverse outcomes following treatment of these injuries including total flap failure, infection and amputation.
METHODS: A PRISMA-compliant systematic review and meta-analysis was conducted (PROSPERO CRD420251130703) by searching the MEDLINE, Embase and Cochrane CENTRAL databases from inception to August 2025. Data were extracted in duplicate by 5 reviewers. Risk of bias was assessed using NHLBI Quality Assessment Tools. Meta-analysis of proportions evaluated primary outcomes of total flap failure, amputation, deep infection or osteomyelitis.
RESULTS: The search retrieved 1163 records after deduplication, yielding 188 included studies with 15,551 patients and 10,856 flap reconstructions. Road traffic accidents accounted for 55.6% of the injuries. Most (69.9%) soft tissue reconstructions were free flaps and 30.1% were local flap reconstructions. The pooled total flap failure rate was 8.0% (95% CI 6.9-9.2) across 6071 flaps. Deep infection or osteomyelitis was observed in 12.9% of reconstructed limbs (95% CI 10.6-15.6). Amputation was required in 6.3% (95% CI 5.2-7.6) of 5276 limbs. Risk of bias was low in 21.0% of the studies, moderate in 64.5% and high in 14.5%.
CONCLUSION: This meta-analysis provides summary statistics for key adverse outcomes following complex open lower limb fracture and soft tissue reconstruction. These data may inform future research in this population.
METHODS: A PRISMA-compliant systematic review and meta-analysis was conducted (PROSPERO CRD420251130703) by searching the MEDLINE, Embase and Cochrane CENTRAL databases from inception to August 2025. Data were extracted in duplicate by 5 reviewers. Risk of bias was assessed using NHLBI Quality Assessment Tools. Meta-analysis of proportions evaluated primary outcomes of total flap failure, amputation, deep infection or osteomyelitis.
RESULTS: The search retrieved 1163 records after deduplication, yielding 188 included studies with 15,551 patients and 10,856 flap reconstructions. Road traffic accidents accounted for 55.6% of the injuries. Most (69.9%) soft tissue reconstructions were free flaps and 30.1% were local flap reconstructions. The pooled total flap failure rate was 8.0% (95% CI 6.9-9.2) across 6071 flaps. Deep infection or osteomyelitis was observed in 12.9% of reconstructed limbs (95% CI 10.6-15.6). Amputation was required in 6.3% (95% CI 5.2-7.6) of 5276 limbs. Risk of bias was low in 21.0% of the studies, moderate in 64.5% and high in 14.5%.
CONCLUSION: This meta-analysis provides summary statistics for key adverse outcomes following complex open lower limb fracture and soft tissue reconstruction. These data may inform future research in this population.