Screw versus Kirschner wire fixation for lateral humeral condyle fractures in children:a meta analysis
10.12200/j.issn.1003-0034.20221030
- VernacularTitle:螺钉及克氏针内固定治疗儿童肱骨外髁骨折疗效的Meta分析
- Author:
Xiang-Yang YU
1
,
2
;
Gai-Ge WU
;
Hang WANG
;
Ling-An HUANG
;
Peng-Cui LI
;
Xiao-Chun WEI
Author Information
1. 山西医科大学基础医学院,山西 太原 030001
2. 山西医科大学骨与软组织损伤修复山西省重点实验室,山西太原 030001
- Keywords:
Lateral humeral condyle fractures;
Screw;
Kirschner wire;
Fixation;
Children;
Meta-analysis
- From:
China Journal of Orthopaedics and Traumatology
2024;37(4):399-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare screw versus Kirschner wire fixation in the treatment of lateral humeral condyle frac-tures in children.Methods A systematic search was conducted in PubMed,Embase,the Cochrane library,Web of Science,China National Knowledge Internet(CNKI),Wanfang Datebase from in ception to February 2022.Studies comparing screws and Kirschner wire fixation in the treatment of lateral humeral condyle fractures in children were included.Outcome measures included and excluded by a set of inclusion and exclusion criteria and evaluated for their quality,their excellent and good rate of fracture healing,malunion,delayed union or nonunion,infection,limitation of elbow flexion or extension(＞10°)were ex-tracted and analyzed using software Rev Man 5.3.Results A total of 9 retrospective studies involving 647 patients were includ-ed,with 255 patients in the screw fixation group(including screw combined with Kirschner wire)and 392 patients in the Kirschner wire fixation group.Meta analysis showed the following:infection rate in the screw group was significantly lower than that in the Kirschner wire group[OR=0.22,95％CI(0.09,0.56),P=0.001].There were no significant differences between the 2 groups in excellent and good rate of fracture healing,malunion rate(P＞0.05).Subgroup analysis showed that infection rate in the screw-only group was significantly lower than that in the Kirschner wire group[OR=0.18,95％CI(0.05,0.65),P=0.009].Conclusion For lateral humeral condyle fractures,Screw fixation alone had a lower infection rate than kirschner wire fixation and screw combined with Kirschner wire fixation.There were no significant differences in the excellent and good rate of fracture healing,malunion.In terms of postoperative efficacy and safety of internal fixation,orthopaedic surgeons are more like-ly to recommend screws for fixation of lateral humeral condyle fractures in children.
