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Management of the mid-shaft clavicle fractures using plate fixation versus intramedullary fixation: an updated meta-analysis

Byline: Yanbin Zhu (1,2), Ye Tian (1,2), Tianhua Dong (1,2), Wei Chen (1,2), Fei Zhang (1,2), Yingze Zhang (1,2) Keywords: Mid-shaft clavicle fractures; Intramedullary fixation; Plate fixation; RCTs; Meta-analysis Abstract: Purpose This meta-analysis of randomised controlled trials (RCTs) aimed to i... Full description

Journal Title: International Orthopaedics 2015, Vol.39(2), pp.319-328
Main Author: Zhu, Yanbin
Other Authors: Tian, Ye , Dong, Tianhua , Chen, Wei , Zhang, Fei , Zhang, Yingze
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0341-2695 ; E-ISSN: 1432-5195 ; DOI: 10.1007/s00264-014-2655-9
Link: http://dx.doi.org/10.1007/s00264-014-2655-9
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recordid: springer_jour10.1007/s00264-014-2655-9
title: Management of the mid-shaft clavicle fractures using plate fixation versus intramedullary fixation: an updated meta-analysis
format: Article
creator:
  • Zhu, Yanbin
  • Tian, Ye
  • Dong, Tianhua
  • Chen, Wei
  • Zhang, Fei
  • Zhang, Yingze
subjects:
  • Mid-shaft clavicle fractures
  • Intramedullary fixation
  • Plate fixation
  • RCTs
  • Meta-analysis
ispartof: International Orthopaedics, 2015, Vol.39(2), pp.319-328
description: Byline: Yanbin Zhu (1,2), Ye Tian (1,2), Tianhua Dong (1,2), Wei Chen (1,2), Fei Zhang (1,2), Yingze Zhang (1,2) Keywords: Mid-shaft clavicle fractures; Intramedullary fixation; Plate fixation; RCTs; Meta-analysis Abstract: Purpose This meta-analysis of randomised controlled trials (RCTs) aimed to investigate the comparative outcomes between plate fixation and intramedullary fixation for management of mid-shaft clavicle fractures. Methods Relevant original studies were searched in electronic databases of PubMed, Medline, Embase and CNKI (all through October 2014). RCTs that investigated the effectiveness or complications between both groups and provided sufficient data of interest were included in this meta-analysis. Results Five RCTs fulfilled inclusion and exclusion criteria and were included in this meta-analysis, with 128 participants in a plate fixation (PF) group and 157 in an intramedullary fixation (IF) group. Patients were followed up for at least one year in all the studies. Compared to PFs, IF is a better alternative for treatment of MSCFs than PF, with a reduced surgery time, a shorter incision, rapid union time, better shoulder function at one year and fewer complications such as infection, symptomatic hardware and hypertrophic scar. In other aspects such as complications of implant failure, refracture and nonunion, both techniques were comparable. Conclusions If the surgery is indicated, intramedullary fixation has more advantages than plate fixation for treatment of mid-shaft clavicular fracture. This definitive conclusion could aid surgeons in making evidence-based decisions when selecting an optimal fixation pattern. Author Affiliation: (1) Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, People's Republic of China (2) Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China Article History: Registration Date: 18/12/2014 Received Date: 18/11/2014 Accepted Date: 17/12/2014 Online Date: 22/01/2015 Article note: Yanbin Zhu and Ye Tian contributed equally to this manuscript.
language: eng
source:
identifier: ISSN: 0341-2695 ; E-ISSN: 1432-5195 ; DOI: 10.1007/s00264-014-2655-9
fulltext: fulltext
issn:
  • 1432-5195
  • 14325195
  • 0341-2695
  • 03412695
url: Link


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titleManagement of the mid-shaft clavicle fractures using plate fixation versus intramedullary fixation: an updated meta-analysis
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descriptionByline: Yanbin Zhu (1,2), Ye Tian (1,2), Tianhua Dong (1,2), Wei Chen (1,2), Fei Zhang (1,2), Yingze Zhang (1,2) Keywords: Mid-shaft clavicle fractures; Intramedullary fixation; Plate fixation; RCTs; Meta-analysis Abstract: Purpose This meta-analysis of randomised controlled trials (RCTs) aimed to investigate the comparative outcomes between plate fixation and intramedullary fixation for management of mid-shaft clavicle fractures. Methods Relevant original studies were searched in electronic databases of PubMed, Medline, Embase and CNKI (all through October 2014). RCTs that investigated the effectiveness or complications between both groups and provided sufficient data of interest were included in this meta-analysis. Results Five RCTs fulfilled inclusion and exclusion criteria and were included in this meta-analysis, with 128 participants in a plate fixation (PF) group and 157 in an intramedullary fixation (IF) group. Patients were followed up for at least one year in all the studies. Compared to PFs, IF is a better alternative for treatment of MSCFs than PF, with a reduced surgery time, a shorter incision, rapid union time, better shoulder function at one year and fewer complications such as infection, symptomatic hardware and hypertrophic scar. In other aspects such as complications of implant failure, refracture and nonunion, both techniques were comparable. Conclusions If the surgery is indicated, intramedullary fixation has more advantages than plate fixation for treatment of mid-shaft clavicular fracture. This definitive conclusion could aid surgeons in making evidence-based decisions when selecting an optimal fixation pattern. Author Affiliation: (1) Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, People's Republic of China (2) Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China Article History: Registration Date: 18/12/2014 Received Date: 18/11/2014 Accepted Date: 17/12/2014 Online Date: 22/01/2015 Article note: Yanbin Zhu and Ye Tian contributed equally to this manuscript.
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