Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis
Abstract Background There is still a lack of remarkable consensus regarding the clinical efficacy of the application of fibular strut augmentation (FSA) combined with a locking plate for proximal humeral fractures. A systematic review and meta-analysis to assess the effect of the use of FSAs in open...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03211-4 |
| _version_ | 1798037643534008320 |
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| author | Wei Nie Zhaojun Wang Fei Gu Shizhuang Xu Yang Yue Anze Shao Kefu Sun |
| author_facet | Wei Nie Zhaojun Wang Fei Gu Shizhuang Xu Yang Yue Anze Shao Kefu Sun |
| author_sort | Wei Nie |
| collection | DOAJ |
| description | Abstract Background There is still a lack of remarkable consensus regarding the clinical efficacy of the application of fibular strut augmentation (FSA) combined with a locking plate for proximal humeral fractures. A systematic review and meta-analysis to assess the effect of the use of FSAs in open reduction and internal fixation of proximal humeral fractures was conducted. Methods A literature search was conducted in PubMed, Embase, Cochrane, Web of Science Core Collection, and ClinicalTrials.gov to identify trials that compared the clinical outcomes of proximal humeral fractures treated using a locking plate with or without FSA. The primary outcome measures were postoperative complications, radiographical findings, functional recovery scores, and postoperative range of motion (ROM). Data were pooled and analysed using a random-effects model based on the Der Simonian and Laird method. Results Eight studies involving 596 participants were included for further analysis. Compared with using a locking plate independently, the additional application of FSA was associated with the likelihood of lower risk of overall complications (OR 0.37; 95% CI 0.22–0.65; I 2 = 12.22%; 95% PI 0.14–0.98) and the rate of patients with orthopaedic complications (OR 0.48; 95% CI 0.25–0.92; I 2 = 7.52%; 95% PI 0.16–1.45), less changes in postoperative humeral head height (MD − 2.40; 95% CI − 2.49 to − 2.31; I 2 = 0.00%; 95% PI − 2.61 to − 2.20) and the neck–shaft angle (MD − 6.30; 95% CI − 7.23 to − 5.36; I 2 = 79.32%; 95% PI − 10.06 to − 2.53), superior functional outcomes (Constant–Murley score: MD 5.07; 95% CI 3.40 to 6.74; I 2 = 0.00%; 95% PI 2.361–7.78; American Shoulder and Elbow Surgeons Score: MD 5.08; 95% CI 3.67 to 6.49; I 2 = 0.00%; 95% PI 1.98–8.18), and better postoperative ROM in terms of forward elevation and external rotation. However, the evidence regarding postoperative abduction was insufficient. Conclusion Meta-analytic pooling of current evidence showed a significant association between the application of FSAs and favourable clinical outcomes in terms of postoperative complications, radiographical findings, functional recovery, and postoperative elevation and external rotation. |
| first_indexed | 2024-04-11T21:29:20Z |
| format | Article |
| id | doaj.art-48365f36e29c416cb6b08cec70571b5e |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T21:29:20Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-48365f36e29c416cb6b08cec70571b5e2022-12-22T04:02:06ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-06-0117111310.1186/s13018-022-03211-4Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysisWei Nie0Zhaojun Wang1Fei Gu2Shizhuang Xu3Yang Yue4Anze Shao5Kefu Sun6Department of Orthopedic Surgery, Lianyungang 2nd People’s HospitalDepartment of Orthopedic Surgery, Lianyungang 2nd People’s HospitalDepartment of Orthopedic Surgery, Lianyungang 2nd People’s HospitalDepartment of Orthopedic Surgery, Lianyungang 2nd People’s HospitalDepartment of Orthopedic Surgery, Lianyungang 2nd People’s HospitalDepartment of Orthopedic Surgery, Lianyungang 2nd People’s HospitalDepartment of Orthopedic Surgery, Lianyungang 2nd People’s HospitalAbstract Background There is still a lack of remarkable consensus regarding the clinical efficacy of the application of fibular strut augmentation (FSA) combined with a locking plate for proximal humeral fractures. A systematic review and meta-analysis to assess the effect of the use of FSAs in open reduction and internal fixation of proximal humeral fractures was conducted. Methods A literature search was conducted in PubMed, Embase, Cochrane, Web of Science Core Collection, and ClinicalTrials.gov to identify trials that compared the clinical outcomes of proximal humeral fractures treated using a locking plate with or without FSA. The primary outcome measures were postoperative complications, radiographical findings, functional recovery scores, and postoperative range of motion (ROM). Data were pooled and analysed using a random-effects model based on the Der Simonian and Laird method. Results Eight studies involving 596 participants were included for further analysis. Compared with using a locking plate independently, the additional application of FSA was associated with the likelihood of lower risk of overall complications (OR 0.37; 95% CI 0.22–0.65; I 2 = 12.22%; 95% PI 0.14–0.98) and the rate of patients with orthopaedic complications (OR 0.48; 95% CI 0.25–0.92; I 2 = 7.52%; 95% PI 0.16–1.45), less changes in postoperative humeral head height (MD − 2.40; 95% CI − 2.49 to − 2.31; I 2 = 0.00%; 95% PI − 2.61 to − 2.20) and the neck–shaft angle (MD − 6.30; 95% CI − 7.23 to − 5.36; I 2 = 79.32%; 95% PI − 10.06 to − 2.53), superior functional outcomes (Constant–Murley score: MD 5.07; 95% CI 3.40 to 6.74; I 2 = 0.00%; 95% PI 2.361–7.78; American Shoulder and Elbow Surgeons Score: MD 5.08; 95% CI 3.67 to 6.49; I 2 = 0.00%; 95% PI 1.98–8.18), and better postoperative ROM in terms of forward elevation and external rotation. However, the evidence regarding postoperative abduction was insufficient. Conclusion Meta-analytic pooling of current evidence showed a significant association between the application of FSAs and favourable clinical outcomes in terms of postoperative complications, radiographical findings, functional recovery, and postoperative elevation and external rotation.https://doi.org/10.1186/s13018-022-03211-4Fibular strut augmentationProximal humeral fractureOpen reduction and internal fixationLocking plateReviewMeta-analysis |
| spellingShingle | Wei Nie Zhaojun Wang Fei Gu Shizhuang Xu Yang Yue Anze Shao Kefu Sun Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Fibular strut augmentation Proximal humeral fracture Open reduction and internal fixation Locking plate Review Meta-analysis |
| title | Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis |
| title_full | Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis |
| title_fullStr | Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis |
| title_full_unstemmed | Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis |
| title_short | Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis |
| title_sort | effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures a systematic review and meta analysis |
| topic | Fibular strut augmentation Proximal humeral fracture Open reduction and internal fixation Locking plate Review Meta-analysis |
| url | https://doi.org/10.1186/s13018-022-03211-4 |
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