Shao-Bo Zhang,Yi-Bao Zhang,Sheng-Hong Wang,Hua Zhang,Peng Liu,Wei Zhang,Jing-Lin Ma,Jing Wang.[J].Chin J Traumatol,2017,20(2):94-98. [doi]
Clinical efficacy and safety of limited internal fixation combined with externalfixation for Pilon fracture: A systematic review and meta-analysis
  
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KeyWord: External fixatorsFracture fixation, internalMeta-analysisPilon fractures
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Author NameAffiliation
Shao-Bo Zhang Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Yi-Bao Zhang Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Sheng-Hong Wang Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Hua Zhang Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Peng Liu Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Wei Zhang Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Jing-Lin Ma Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
Jing Wang Department of Orthopedics, Key Laboratory of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China 
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Abstract:
      Purpose: To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture. Methods: We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the rate of nonunion, malunion/delayed union and the excellent/good rate assessed by Mazur ankle score. The complications including infections and arthritis symptoms after surgery were also investigated. Results: Nine trials including 498 pilon fractures of 494 patients were identified. The meta-analysis found no significant differences in nonunion rate (RR=1.60, 95% CI: 0.66 to 3.86, p=0.30), and the excellent/good rate (RR ¼ 0.95, 95% CI: 0.86 to 1.04, p ¼ 0.28) between LIFEF group and ORIF group. For assessment of infections, there were significant differences in the rate of deep infection (RR=2.18, 95% CI: 1.34 to 3.55, p=0.002), and the rate of arthritis (RR=1.26, 95% CI: 1.03 to 1.53, p=0.02) between LIFEF group and ORIF group. Conclusion: LIFEF has similar effect as ORIF in the treatment of pilon fractures, however, LIFEF group has significantly higher risk of complications than ORIF group does. So LIFEF is not recommended in the treatment of pilon fracture.
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