Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (44): 7209-7216.doi: 10.3969/j.issn.2095-4344.2015.44.028

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Meta analysis of reconstruction plate and Kirschner wire fixation for the treatment of clavicle fractures   

Zhang Xie-zhuo, Liu Li-guo, Ha Si-lu, Xu Chao, Yilihamu•Tuoheti   

  1. Department of Orthopedics, Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China
  • Received:2015-08-30 Online:2015-10-22 Published:2015-10-22
  • Contact: Yilihamu?Tuoheti, M.D., Chief physician, Department of Orthopedics, Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China
  • About author:Zhang Xie-zhuo, Studying for master’s degree, Department of Orthopedics, Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China

Abstract:

BACKGROUND: At present, a large number of studies have confirmed that reconstruction plate compared to Kirschner wire in the treatment of clavicular fracture showed good effects, but there is no precise report on the specific advantages at present. Clinical randomized controlled study is less, and lacks of systematic evaluation.

OBJECTIVE: To systematically evaluate the efficacy and safety of the treatment of the clavicle fractures with the reconstruction plate and the Kirschner wire by using a meta-analysis.
METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database and VIP database from 2008 to 2015 by computer to collect all controlled study relevant to reconstruction plate and Kirschner wire in the treatment of clavicle fracture, and screened the literatures that met the inclusion criteria. All literatures were analyzed in strict quality evaluation. Excellent rate, delayed healing of incision, malunion, postoperative infection, loosening of internal fixation, postoperative fracture displacement, operation time, intraoperative bleeding volume and fracture healing time were selected as the evaluation indexes of a meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Collaboration.
RESULTS AND CONCLUSION: Finally 12 Chinese articles published from 2008 to 2014 were included, with 911 patients. Meta-analysis results showed that compared with Kirschner wire, the reconstruction plate has a certain advantage in improving the excellent and good rate, shortening the delayed wound healing and reducing deformity healing, reducing postoperative infection, preventing the loosening of internal fixation and avoiding postoperative fracture displacement. However, the two surgical methods in the treatment of clavicular fracture were not significant in operation time, intraoperative blood loss and fracture healing time. These results suggest that compared with the Kirschner wire, reconstruction plate fixation for treatment of clavicular fracture had better curative effect. The reconstruction plate can be firstly selected in the permit of patient economic conditions and hospital conditions. Due to the limited sample size in this study, the multicenter, large-sample and long-term clinical randomized controlled studies with more strict design are needed to increase the reliability of the evidence. 
中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Clavicle, Internal Fixators, Randomized Controlled Trial, Evidence-Based Medicine, Meta-Analysis, Tissue Engineering