A systematic review and meta-analysis comparing suprapatellar versus infrapatellar approach intramedullary nailing for tibal shaft fractures.

Approach Infrapatellar Intramedullary nailing Suprapatellar Tibal shaft fractures

Journal

European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350

Informations de publication

Date de publication:
21 Nov 2023
Historique:
received: 09 07 2023
accepted: 17 10 2023
medline: 22 11 2023
pubmed: 22 11 2023
entrez: 22 11 2023
Statut: aheadofprint

Résumé

The application of the suprapatellar (SP) approach has challenged the traditional infrapatellar (IP) approach in the surgery treatment of tibial shaft fractures, yet the advantages and disadvantages still remain controversial. We included more high-quality studies for this meta-analysis and systematic review to evaluate the clinical outcomes and prognosis of both approaches and thus to provide new ideas for surgeons. We searched literatures from PubMed, Cochrane Library, Web of Science, and EMBASE databases from January 2000 to December 2022. We extracted general information including sample size, gender, proportion of open fracture, follow-up time, and outcome indicators including entrance accuracy, fluoroscopy time, operation time, intraoperative blood loss, Lysholm score, VAS pain score, range of motion (ROM) function score, reposition accuracy, and revision cases. Cochrane Collaboration's tool and the Newcastle-Ottawa Scale were used to evaluate literature qualities. Meta-analysis was performed using RevMan 5.4 software. A total of 23 studies were generated that qualified for inclusion, 17 of which were used for meta-analysis. This study found statistically significant differences in coronal plane entrance accuracy, fluoroscopy time, Lysholm score, and VAS pain score. The results of our meta-analysis showed that the SP approach was significantly better than the IP approach in angle and distance entrance accuracy of coronal plane, angle entrance accuracy of sagittal plane, fluoroscopy time, Lysholm score, and VAS pain score. There were no significant differences in sagittal angle accuracy, operative time, intraoperative blood loss, and ROM score.

Sections du résumé

BACKGROUND BACKGROUND
The application of the suprapatellar (SP) approach has challenged the traditional infrapatellar (IP) approach in the surgery treatment of tibial shaft fractures, yet the advantages and disadvantages still remain controversial. We included more high-quality studies for this meta-analysis and systematic review to evaluate the clinical outcomes and prognosis of both approaches and thus to provide new ideas for surgeons.
METHOD METHODS
We searched literatures from PubMed, Cochrane Library, Web of Science, and EMBASE databases from January 2000 to December 2022. We extracted general information including sample size, gender, proportion of open fracture, follow-up time, and outcome indicators including entrance accuracy, fluoroscopy time, operation time, intraoperative blood loss, Lysholm score, VAS pain score, range of motion (ROM) function score, reposition accuracy, and revision cases. Cochrane Collaboration's tool and the Newcastle-Ottawa Scale were used to evaluate literature qualities. Meta-analysis was performed using RevMan 5.4 software.
RESULTS RESULTS
A total of 23 studies were generated that qualified for inclusion, 17 of which were used for meta-analysis. This study found statistically significant differences in coronal plane entrance accuracy, fluoroscopy time, Lysholm score, and VAS pain score.
CONCLUSION CONCLUSIONS
The results of our meta-analysis showed that the SP approach was significantly better than the IP approach in angle and distance entrance accuracy of coronal plane, angle entrance accuracy of sagittal plane, fluoroscopy time, Lysholm score, and VAS pain score. There were no significant differences in sagittal angle accuracy, operative time, intraoperative blood loss, and ROM score.

Identifiants

DOI: 10.1007/s00068-023-02384-9 PMID: 37989960
pubmed: 37989960
doi: 10.1007/s00068-023-02384-9
pii: 10.1007/s00068-023-02384-9
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Natural Science Foundation of Guangdong Province
ID : 2018A030313369
Organisme : Innovative Research Group Project of the National Natural Science Foundation of China
ID : 81974575

Informations de copyright

© 2023. The Author(s).

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Auteurs

Zhongqing Wang (Z)

The First Clinical School of Guangzhou, University of Chinese Medicine, Guangzhou, China.

Xianmei Xiong (X)

The First Clinical School of Guangzhou, University of Chinese Medicine, Guangzhou, China.

Zesheng Lu (Z)

The First Clinical School of Guangzhou, University of Chinese Medicine, Guangzhou, China.

Yijia Gao (Y)

The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China. gaoyijia1666@163.com.

Classifications MeSH