Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis
Background. Plate fixation and intramedullary fixation are the most commonly used surgical treatment options for mid-shaft clavicle fractures; the latter method has demonstrated better performance in some studies. Objectives. Our aim was to critically review and summarize the literature comparing th...
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PeerJ Inc.
2016-02-01
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| Online Access: | https://peerj.com/articles/1540.pdf |
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| author | Yan Gao Wei Chen Yue-Jv Liu Xu Li Hai-Li Wang Zhao-yu Chen |
| author_facet | Yan Gao Wei Chen Yue-Jv Liu Xu Li Hai-Li Wang Zhao-yu Chen |
| author_sort | Yan Gao |
| collection | DOAJ |
| description | Background. Plate fixation and intramedullary fixation are the most commonly used surgical treatment options for mid-shaft clavicle fractures; the latter method has demonstrated better performance in some studies. Objectives. Our aim was to critically review and summarize the literature comparing the outcomes of mid-shaft clavicle fracture treatment with plate fixation or intramedullary fixation to identify the better approach. Search Methods. Potential academic articles were identified from the Cochrane Library, MEDLINE (1966-2015.5), PubMed (1966-2015.5), EMBASE (1980-2015.5) and ScienceDirect (1966-2015.5). Gray studies were identified from the references of the included literature. Selection Criteria. Randomized controlled trials (RCTs) and non-RCTs comparing plate fixation and intramedullary fixation for mid-shaft clavicle fracture were included. Data Collection and Analysis. Two reviewers performed independent data abstraction. The I2 statistic was used to assess heterogeneity. A fixed- or random-effects model was used for the meta-analysis. Results. Six RCTs and nine non-RCTs were retrieved, including 513 patients in the intramedullary fixation group and 521 patients in the plating group. No significant differences in terms of the union rate and shoulder function were found between the groups. Patients in the intramedullary fixation group had a shorter operative time, less blood loss, smaller wound size, and shorter union time than those in the plating group. With respect to complications, significant differences were identified for all complications and major complications (wound infection, nonunion, implant failures, transient brachial plexopathy, and pain after 6 months). Similar secondary complications (symptomatic hardware, hardware irritation, prominence, numbness, hypertrophic callus) were observed in both groups. Conclusions. Intramedullary fixation may be superior to plate fixation in the treatment of mid-shaft clavicle fractures, with similar performance in terms of the union rate and shoulder function, better operative parameters and fewer complications. |
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| spelling | doaj.art-9668fc8958e348a28d521f39ae4678bd2023-12-03T11:35:05ZengPeerJ Inc.PeerJ2167-83592016-02-014e154010.7717/peerj.1540Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysisYan Gao0Wei Chen1Yue-Jv Liu2Xu Li3Hai-Li Wang4Zhao-yu Chen5Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, ChinaDepartment of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, ChinaDepartment of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, ChinaDepartment of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, ChinaDepartment of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, ChinaDepartment of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, ChinaBackground. Plate fixation and intramedullary fixation are the most commonly used surgical treatment options for mid-shaft clavicle fractures; the latter method has demonstrated better performance in some studies. Objectives. Our aim was to critically review and summarize the literature comparing the outcomes of mid-shaft clavicle fracture treatment with plate fixation or intramedullary fixation to identify the better approach. Search Methods. Potential academic articles were identified from the Cochrane Library, MEDLINE (1966-2015.5), PubMed (1966-2015.5), EMBASE (1980-2015.5) and ScienceDirect (1966-2015.5). Gray studies were identified from the references of the included literature. Selection Criteria. Randomized controlled trials (RCTs) and non-RCTs comparing plate fixation and intramedullary fixation for mid-shaft clavicle fracture were included. Data Collection and Analysis. Two reviewers performed independent data abstraction. The I2 statistic was used to assess heterogeneity. A fixed- or random-effects model was used for the meta-analysis. Results. Six RCTs and nine non-RCTs were retrieved, including 513 patients in the intramedullary fixation group and 521 patients in the plating group. No significant differences in terms of the union rate and shoulder function were found between the groups. Patients in the intramedullary fixation group had a shorter operative time, less blood loss, smaller wound size, and shorter union time than those in the plating group. With respect to complications, significant differences were identified for all complications and major complications (wound infection, nonunion, implant failures, transient brachial plexopathy, and pain after 6 months). Similar secondary complications (symptomatic hardware, hardware irritation, prominence, numbness, hypertrophic callus) were observed in both groups. Conclusions. Intramedullary fixation may be superior to plate fixation in the treatment of mid-shaft clavicle fractures, with similar performance in terms of the union rate and shoulder function, better operative parameters and fewer complications.https://peerj.com/articles/1540.pdfMid-shaft clavicle fracturesMeta-analysisPlating fixationIntramedullary fixation |
| spellingShingle | Yan Gao Wei Chen Yue-Jv Liu Xu Li Hai-Li Wang Zhao-yu Chen Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis PeerJ Mid-shaft clavicle fractures Meta-analysis Plating fixation Intramedullary fixation |
| title | Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis |
| title_full | Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis |
| title_fullStr | Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis |
| title_full_unstemmed | Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis |
| title_short | Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis |
| title_sort | plating versus intramedullary fixation for mid shaft clavicle fractures a systemic review and meta analysis |
| topic | Mid-shaft clavicle fractures Meta-analysis Plating fixation Intramedullary fixation |
| url | https://peerj.com/articles/1540.pdf |
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