Pronation versus supination maneuvers for the reduction of radial head subluxation: A Meta-analysis

doi:10.3969/j.issn.2095-4344.2015.33.028

Abstract

Abstract:

BACKGROUND: Supination maneuver is mainly used for reduction of radial head subluxation in children, but recently, pronation maneuver has also achieved good results in the treatment of radial head subluxation.

OBJECTIVE: To objectively evaluate the efficacy of pronation versus supination maneuvers for the reduction of radial head subluxation by using Meta-analysis.

METHODS: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMbase, the ISI Web of Knowledge databases, VIP, CNKI, CBM and Wanfang were searched from database establishment to December 2014 for collecting the randomized controlled trials (RCTs) about pronation versus supination maneuvers for the reduction of radial head subluxation, and the references of those RCTs were also searched by hand. After study selection, assessment and data extraction were conducted by two reviewers independently. Meta-analyses were performed by using the RevMan 5.2 software.

RESULTS AND CONCLUSION: Five studies involving 436 patients were included. The results of Meta-analyses showed that: compared with the supination maneuvers group the pronation maneuvers group had a higher rate of successful reduction at the first attempt [RR=1.17, 95%CI (1.08, 1.28), P=0.000 3] and lower rate of failed reduction [RR=0.25, 95%CI (0.09, 0.65), P=0.005]. There was no significant difference in the rate of successful reduction at the second attempt [RR=1.39, 95%CI (0.75, 2.58), P=0.30]. Based on the results of systemic assessment, the level of evidence assessed by the GRADE system showed that the outcome indicators of the rate of successful reduction at the first attempt and rate of failed reduction were graded as intermediate level; the outcome indicator of the rate of successful reduction at the second attempt was graded as low level. For the poor quality of the original studies, a prudent choice is suggested; and more highly-quality, large-sample studies are needed.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Dislocations, Pronation, Supination

CLC Number:

R318

Feng Fan, Deng Zhou-ming, Ran Bing, Xie Yuan-long, Ruan Wen-feng, Cai Lin. Pronation versus supination maneuvers for the reduction of radial head subluxation: A Meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(33): 5402-5407.

Figures/Tables 3

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