Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (48): 9095-9099.doi: 10.3969/j.issn.1673-8225.2010.48.039

Previous Articles     Next Articles

Meta analysis of types B and C Pilon fracture treatment by staged open reduction and internal fixation versus external fixation combined with limited internal fixation

Wang Cheng 1,2, Li Ying2, Wang Man-yi   

  1. 1 Peking University Fourth Clinical Medical College, Beijing   100035, China; 2 Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing  100035, China
  • Online:2010-11-26 Published:2010-11-26
  • Contact: Wang Man-yi, Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China wangmanyi2009@hotmail.com
  • About author:Wang Cheng☆, Studying for doctorate, Attending physician, Peking University Fourth Clinical Medical College, Beijing 100035, China; Department of Traumatic Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China wch4201@126.com

Abstract:

BACKGROUND: Treatment of Pilon fracture has always been a controversial topic, but there is no authoritative clinical instruction at present. Currently, more attention has been paid to the soft tissue and its protection. The main treatment strategy has been focused on staged open reduction and internal fixation or external fixation combined with limited internal fixation. There is no favorable evidence to prove the effectiveness of these two strategies, though a large amount of retrospective studies have been reported. It is still unknown which strategy is better.  
OBJECTIVE: To find out the differences in advantages and disadvantages of different operation methods by Meta analysis, followed by collection of the literatures addressing the effectiveness of different treatments for Pilon fracture of types B and C.
METHODS: The relevant literatures about the effectiveness analysis of staged open reduction plus internal fixation and external fixation combined with limited internal fixation were collected through database retrieval and manual search, with tibia fractures, surgery, therapy and pilon as index words and 1977-2008 as publishing date limit. Soft tissue infection rate, myelitis incidence rate, bone nonunion and malunion incidence rate, joint fusion incidence rate were taken as evaluation indicators, analyzed with RevMan4.2 software, and followed by observation of the analyzing features and results indicated by forest plots.
RESULTS AND CONCLUSION: The risk of soft tissue infection following staged open reduction and internal fixation was lower than external fixation combined with limited internal fixation, and staged open reduction and internal fixation provided a more reliable, accurate and stable reduction to Pilon fracture. Theoretically, it owns obvious advantage in fracture healing at the right anatomy site. The result of Meta analysis is in accord with the hypothesis, but there is no statistic evidence. No difference is found in the risk of deep infection, nonunion, and joint fusion between the two methods.

CLC Number: