Comparison of medial-lateral pinning and lateral pinning for pediatric supracondylar humeral fractures: a Meta-analysis
10.3760/cma.j.cn115455-20200219-00159
- VernacularTitle:内外侧交叉进针与单纯外侧进针治疗儿童肱骨髁上骨折的Meta分析
- Author:
Feng YAO
1
;
Quanwen YUAN
;
Gao YU
;
Yao LIU
;
Lin LU
;
Yunfang ZHEN
;
Xiaodong WANG
Author Information
1. 苏州大学附属儿童医院骨科 215000
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(9):817-824
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the safety and efficacy of medial-lateral pinning (MLP) and lateral pinning (LP) in pediatric supracondylar humeral fractures.Methods:According to PRISMA procedure, the randomized controlled trial (RCT) of pediatric supracondylar humeral fractures in PubMed (Medline), EMBASE, the Cochrane Library databases (Cochrane Controlled Trials Register for RCTs) and Wanfang Data from 1 January, 1990 to 1 January, 2020 were retrieved. Two researchers independently extracted the data and evaluated the quality of the original studies; the random-effects model was used for analysis.Results:A total of 4 679 original literatures were retrieved and 11 literatures were finally included, involving 920 children. Meta analysis results showed that there were no statistical differences in excellent ratio of elbow joint function (Flynn criteria), incidence of iatrogenic nerve injury and incidence of pin tract/ superficial infection between MLP group and LP group: 74.3% (255/343) vs. 72.9% (250/343), 6.1% (16/262) vs. 1.6% (4/246) and 5.3% (14/264) vs. 7.6% (20/262); RR = 0.98, 0.43 and 1.31; 95% CI 0.90 to 1.07, 0.18 to 1.03 and 0.64 to 2.67, P>0.05; the incidence of reduction loss in MLP group was significantly lower than that in LP group: 16.6% (51/307) vs. 23.9% (72/301), and there was statistical difference ( RR = 1.39, 95% CI 1.02 to 1.89, P = 0.04). Conclusions:MLP fixation and LP fixation are equally efficacious for supracondylar humeral fractures in children. MLP fixation may reduce the risk of reduction loss without increasing the risk of iatrogenic nerve injury. Manual reduction and MLP percutaneous Kirschner wire fixation for the treatment of displaced supracondylar humeral fractures in children is recommended.
