Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (9): 1465-1470.doi: 10.3969/j.issn.2095-4344.3766

Previous Articles     Next Articles

Treatment of displaced intra-articular calcaneal fractures with cannulated screws and plates: a meta-analysis of 15 randomized controlled trials

Hu Kai1, Qiao Xiaohong2, Zhang Yonghong3, Wang Dong3, Qin Sihe4   

  1. 1Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; 2Lüliang People’s Hospital Affiliated to Shanxi Medical University, Lüliang 033000, Shanxi Province, China; 3Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; 4Rehabilitation Hospital Affiliated to National Rehabilitation Auxiliary Research Center, Beijing 100176, China
  • Received:2020-04-03 Revised:2020-04-11 Accepted:2020-05-27 Online:2021-03-28 Published:2020-12-16
  • Contact: Qiao Xiaohong, MD, Chief physician, Lüliang People’s Hospital Affiliated to Shanxi Medical University, Lüliang 033000, Shanxi Province, China
  • About author:Hu Kai, Master candidate, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

Abstract: OBJECTIVE: Displaced intra-articular calcaneal fractures are the most common type of calcaneal fracture. Cannulated screw fixation and plate fixation are commonly used methods. However, the differences in therapeutic effectiveness between cannulated screw fixation and plate fixation are still unclear. Thus, this study compared the effect of percutaneous cannulated screw fixation and plate fixation in the treatment of intra-articular calcaneal fractures. 
METHODS: The authors searched for randomized controlled trials on displaced intra-articular calcaneal fractures fixated with cannulated screws or plates in the following electronic databases: PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The retrieval time limit was from the establishment of the database to December 2019. The retrieved literatures were screened according to inclusion and exclusion criteria. Quality evaluation was performed to extract effective data. Meta-analysis was conducted using RevMan 5.3 software.
RESULTS: Fifteen randomized controlled studies were included with 1 438 patients with calcaneal fractures. The risk bias evaluation of the included literature showed that the overall quality of literature was above average. Meta-analysis results show that (1) plate fixation group was better than cannulated screw fixation group in terms of Bohler’s angle (MD=0.69, 95%CI:0.27-1.10, P=0.001) and Gissane’s angle (MD=0.95, 95%CI:0.16-1.74, P=0.02) (P < 0.05). (2) Compared with plate fixation, cannulated screw fixation showed a significant reduction in the operation time (MD=-23.92, 95%CI: -25.40 to -22.44, P <         0.000 01) and postoperative complications (OR=0.28, 95%CI:0.19-0.41, P < 0.000 01) (P < 0.05). (3) There was no statistically significant difference between the cannulated screw fixation group and the plate fixation group in terms of calcaneal height (MD=0.43, 95%CI:-0.17-1.03, P=0.16) and AOFAS score (MD=0.61, 95%CI:-0.35-1.58, P=0.21). 
CONCLUSION: Above data concluded that Bohler’s and Gissane’s angles in the plate fixation group are better than those in the cannulated screw fixation group, while the cannulated screw fixation technology has the advantages of short operation time and low complication rate.

Key words: bone, fracture, calcaneus, intra-articular fracture, screw, internal fixation, plate, meta-analysis

CLC Number: