A meta-analysis of postoperative complications in tibial Pilon fracture: open reduction and internal fixation versus limited internal fixation combined with external fixator

Abstract

Objective To perform a meta-analysis to analyze the advantages and disadvantages of open reduction and internal fixation (ORIF) versus limited internal fixation combined with external fixator (LIFEF), to provide rational clinical diagnosis and treatment methods for orthopedic surgeons and provide a theoretical basis for the development of guidelines. Methods Controlled clinical trials on ORIF and LIFEF for the treatment of tibial Pilon fracture were searched in PubMed, Science Direct, Wiley Online Library, Cochrane Library, CNKI, VIP, and Wanfang databases. Data were screened, extracted, and evaluated by two independent researchers. A meta-analysis was performed using STATA12.0. Results Thirty-six studies with 2054 fractures in 2054 patients were included in the present study. We found that there were significant differences in Ankle score of Mazuretal (RR=1.10, 95% CI: 1.02-1.19, P=0.021), osteomyelitis (RR=0.47, 95% CI: 0.23-0.96, P=0.015), and traumatic arthritis (RR=1.55, 95% CI: 1.22-1.96, P=0.00), but no significant difference in soft tissue infection (RR=1.13, 95% CI: 0.78-1.64, P=0.511). Conclusion LIFEF is associated with a lower rate of overall incidence complications than ORIF and may have better effect. Key words: Open reduction and internal fixation; External fixation; Limited internal fixation; Tibial Pilon fracture; Meta-analysis