The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis
Objectives. The necessity of fibular fixation in distal tibia-fibula fractures remains controversial. This study aimed to assess its impact on radiographic outcomes as well as rates of nonunion and infection. Methods. A systematic search of the electronic databases of PubMed, Embase, and Cochrane li...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2021/6668467 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849414998729687040 |
|---|---|
| author | Chengxin Li Zhizhuo Li Qiwei Wang Lijun Shi Fuqiang Gao Wei Sun |
| author_facet | Chengxin Li Zhizhuo Li Qiwei Wang Lijun Shi Fuqiang Gao Wei Sun |
| author_sort | Chengxin Li |
| collection | DOAJ |
| description | Objectives. The necessity of fibular fixation in distal tibia-fibula fractures remains controversial. This study aimed to assess its impact on radiographic outcomes as well as rates of nonunion and infection. Methods. A systematic search of the electronic databases of PubMed, Embase, and Cochrane library was performed to identify studies comparing the outcomes of reduction and internal fixation of the tibia with or without fibular fixation. Radiographic outcomes included malalignment and malrotation of the tibial shaft. Data regarding varus/valgus angulation, anterior/posterior angulation, internal/external rotation deformity, and the rates of nonunion and infection were extracted and then polled. A meta-analysis was performed using the random-effects model for heterogeneity. Results. Additional fibular fixation was statistically associated with a decreased rate of rotation deformity (OR = 0.13; 95% CI 0.02–0.82, p=0.03). However, there was no difference in the rate of malreduction between the trial group and the control group (OR = 0.86; 95% CI 0.27–2.74, p=0.80). There was also no difference in radiographic outcomes of varus-valgus deformity rate (OR = 0.17; 95% CI 0.03–1.00, p=0.05) or anterior-posterior deformity rate (OR = 0.76; 95% CI 0.02–36.91, p=0.89) between the two groups. Meanwhile, statistical analysis showed no significant difference in the nonunion rate (OR = 0.62; 95% CI 0.37–1.02, p=0.06) or the infection rate (OR = 0.81; 95% CI 0.18–3.67, p=0.78) between the two groups. Conclusions. Additional fibular fixation does not appear to reduce the rate of varus-valgus deformity, anterior-posterior deformity, or malreduction. Meanwhile, it does not appear to impair the union process or increase the odds of infection. However, additional fibular fixation was associated with decreased odds of rotation deformity compared to controls. |
| format | Article |
| id | doaj-art-6ab1a8e79856491eb1028f339ee2b949 |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-6ab1a8e79856491eb1028f339ee2b9492025-08-20T03:33:39ZengWileyAdvances in Orthopedics2090-34642090-34722021-01-01202110.1155/2021/66684676668467The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-AnalysisChengxin Li0Zhizhuo Li1Qiwei Wang2Lijun Shi3Fuqiang Gao4Wei Sun5Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, ChinaDepartment of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, ChinaDepartment of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, ChinaDepartment of Orthopedics, Graduate School of Peking Union Medical College, China-Japan Friendship Institute of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, ChinaBeijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, ChinaBeijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, ChinaObjectives. The necessity of fibular fixation in distal tibia-fibula fractures remains controversial. This study aimed to assess its impact on radiographic outcomes as well as rates of nonunion and infection. Methods. A systematic search of the electronic databases of PubMed, Embase, and Cochrane library was performed to identify studies comparing the outcomes of reduction and internal fixation of the tibia with or without fibular fixation. Radiographic outcomes included malalignment and malrotation of the tibial shaft. Data regarding varus/valgus angulation, anterior/posterior angulation, internal/external rotation deformity, and the rates of nonunion and infection were extracted and then polled. A meta-analysis was performed using the random-effects model for heterogeneity. Results. Additional fibular fixation was statistically associated with a decreased rate of rotation deformity (OR = 0.13; 95% CI 0.02–0.82, p=0.03). However, there was no difference in the rate of malreduction between the trial group and the control group (OR = 0.86; 95% CI 0.27–2.74, p=0.80). There was also no difference in radiographic outcomes of varus-valgus deformity rate (OR = 0.17; 95% CI 0.03–1.00, p=0.05) or anterior-posterior deformity rate (OR = 0.76; 95% CI 0.02–36.91, p=0.89) between the two groups. Meanwhile, statistical analysis showed no significant difference in the nonunion rate (OR = 0.62; 95% CI 0.37–1.02, p=0.06) or the infection rate (OR = 0.81; 95% CI 0.18–3.67, p=0.78) between the two groups. Conclusions. Additional fibular fixation does not appear to reduce the rate of varus-valgus deformity, anterior-posterior deformity, or malreduction. Meanwhile, it does not appear to impair the union process or increase the odds of infection. However, additional fibular fixation was associated with decreased odds of rotation deformity compared to controls.http://dx.doi.org/10.1155/2021/6668467 |
| spellingShingle | Chengxin Li Zhizhuo Li Qiwei Wang Lijun Shi Fuqiang Gao Wei Sun The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis Advances in Orthopedics |
| title | The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis |
| title_full | The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis |
| title_fullStr | The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis |
| title_full_unstemmed | The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis |
| title_short | The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis |
| title_sort | role of fibular fixation in distal tibia fibula fractures a meta analysis |
| url | http://dx.doi.org/10.1155/2021/6668467 |
| work_keys_str_mv | AT chengxinli theroleoffibularfixationindistaltibiafibulafracturesametaanalysis AT zhizhuoli theroleoffibularfixationindistaltibiafibulafracturesametaanalysis AT qiweiwang theroleoffibularfixationindistaltibiafibulafracturesametaanalysis AT lijunshi theroleoffibularfixationindistaltibiafibulafracturesametaanalysis AT fuqianggao theroleoffibularfixationindistaltibiafibulafracturesametaanalysis AT weisun theroleoffibularfixationindistaltibiafibulafracturesametaanalysis AT chengxinli roleoffibularfixationindistaltibiafibulafracturesametaanalysis AT zhizhuoli roleoffibularfixationindistaltibiafibulafracturesametaanalysis AT qiweiwang roleoffibularfixationindistaltibiafibulafracturesametaanalysis AT lijunshi roleoffibularfixationindistaltibiafibulafracturesametaanalysis AT fuqianggao roleoffibularfixationindistaltibiafibulafracturesametaanalysis AT weisun roleoffibularfixationindistaltibiafibulafracturesametaanalysis |