Anchor repair versus screw fixation in the treatment of posterior malleolar fracture with distal tibiofibular syndesmosis injury: a meta-analysis
10.3760/cma.j.cn121113-20230423-00256
- VernacularTitle:锚钉修复与螺钉固定治疗后踝骨折伴下胫腓联合损伤的meta分析
- Author:
Yong FANG
1
;
Qiuyuan XU
;
Yusheng YANG
;
Haitao MA
;
Jiakuan YE
Author Information
1. 温州医科大学附属萧山医院（杭州市萧山区第一人民医院）骨科，杭州 310000
- Keywords:
Ankle Injuries;
Ligaments, articular;
Fracture fixation, internal;
Meta-analysis
- From:
Chinese Journal of Orthopaedics
2023;43(20):1387-1394
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of anchor repair versus screw fixation in the treatment of posterior malleolar fracture with distal tibiofibular syndesmosis injury.Methods:PubMed, Medline, Web of Science, ScienceDirect, CNKI, Wanfang, and Chinese Medical Journal Full-text Database were searched for articles on anchor repair versus screw fixation in the treatment of posterior malleolar fracture with distal tibiofibular syndesmosis injury. The search time was from the establishment of each database to April 2023. Literature screening, data extraction and literature quality assessment were performed independently by two researchers according to the inclusion and exclusion criteria, and meta-analysis of the included literature was performed.Results:A total of 7 articles were included in the meta-analysis, including 3 randomized controlled trials and 4 case-control studies. There were 280 cases treated with anchor repair and 312 cases treated with screw fixation. The results of meta-analysis showed that the number of fluoroscopy [ MD=-5.08, 95% CI (-9.20, -0.96), P=0.020], postoperative anterior inferior tibiofibular space [ MD=-0.93, 95% CI (-1.06, -0.81), P<0.001] and incidence of malposition [ OR=0.21, 95% CI (0.10, 0.46), P<0.001] in the anchor repair group were smaller than that in the screw fixation group, while postoperative recovery time were earlier than that in the screw fixation group [ MD=-2.22, 95% CI (-2.68, -1.75), P<0.001], postoperative ankle plantarflexion angle [ MD=2.77, 95% CI (0.28, 5.25), P=0.030], and postoperative 6 months of American Orthopedic Foot and Ankle Society score [ MD=5.85, 95% CI (2.05, 9.64), P=0.003] were greater than those of the screw fixation group. The operation time [ MD=-10.45, 95% CI (-24.25, 3.35), P=0.140], the American Orthopaedic Foot and Ankle Society score at 6 months after operation [ MD=0.09, 95% CI (-0.94, 1.11), P=0.860] and the postoperative ankle dorsiflexion angle [ MD=0.66, 95% CI (-0.75, 2.88), P=0.360] were not statistically different. Conclusion:Compared with screw fixation, fixation of anterior inferior tibiofibular ligament with anchor fixation has the advantages of less fluoroscopy, faster recovery time, better reduction quality, and higher ankle function score.
