دورية أكاديمية
Dynamic Stabilization of Syndesmosis Injuries Reduces Complications and Reoperations as Compared With Screw Fixation: A Meta-analysis of Randomized Controlled Trials
| العنوان: | Dynamic Stabilization of Syndesmosis Injuries Reduces Complications and Reoperations as Compared With Screw Fixation: A Meta-analysis of Randomized Controlled Trials |
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| المؤلفون: | Grassi A., Samuelsson K., D'Hooghe P., Romagnoli M., Mosca M., Zaffagnini S., Amendola A. |
| المساهمون: | Grassi A., Samuelsson K., D'Hooghe P., Romagnoli M., Mosca M., Zaffagnini S., Amendola A. |
| سنة النشر: | 2020 |
| المجموعة: | IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| مصطلحات موضوعية: | ankle fracture, complication, dynamic fixation, meta-analysi, screw, static fixation, suture button, syndesmosis |
| الوصف: | Background: Several devices for obtaining dynamic fixation of the syndesmosis have been introduced in recent years, but their efficacy has been tested in only a few randomized controlled trials (RCTs), without demonstrating any clear benefit over the traditional static fixation with screws. Purpose: To perform a level 1 meta-analysis of RCTs to investigate the complications, subjective outcomes, and functional results after dynamic or static fixation of acute syndesmotic injuries. Study Design: Meta-analysis of RCTs. Methods: A systematic literature search was performed of the Medline/PubMed, Cochrane Central Register of Controlled Trials, and Embase electronic databases, as well as ClinicalTrials.gov for unpublished studies. Eligible studies were RCTs comparing dynamic fixation and static fixation of acute syndesmosis injuries. A meta-analysis was performed, while bias and quality of evidence were rated according to the Cochrane Database questionnaire and the Grading of Recommendations Assessment, Development and Evaluation guidelines. Results: Dynamic fixation had a significantly reduced relative risk (RR = 0.55, P =.003) of complications—in particular, the presence of inadequate reduction at the final follow-up (RR = 0.36, P =.0008) and the clinical diagnosis of recurrent diastasis or instability (RR = 0.10, P =.03). The effect was more evident when compared with permanent screws (RR = 0.10, P =.0001). The reoperation rate was similar between the groups (RR = 0.64, P =.07); however, the overall risk was reduced after dynamic fixation as compared with static fixation with permanent screws (RR = 0.24, P =.007). The American Orthopaedic Foot & Ankle Society score was significantly higher among patients treated with dynamic fixation—6.06 points higher (P =.005) at 3 months, 5.21 points (P =.03) at 12 months, and 8.60 points (P <.00001) at 24 months—while the Olerud-Molander score was similar. The visual analog scale for pain score was reduced at 6 months (–0.73 points, P =.003) and 12 months (–0.52 points, ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/31188642; info:eu-repo/semantics/altIdentifier/wos/WOS:000523849900025; volume:48; issue:4; firstpage:1000; lastpage:1013; numberofpages:14; journal:THE AMERICAN JOURNAL OF SPORTS MEDICINE; https://hdl.handle.net/11585/717888Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85067858015; http://ajs.sagepub.com/archive/2008.dtlTest |
| DOI: | 10.1177/0363546519849909 |
| الإتاحة: | https://doi.org/10.1177/0363546519849909Test https://hdl.handle.net/11585/717888Test http://ajs.sagepub.com/archive/2008.dtlTest |
| رقم الانضمام: | edsbas.C8A4DE9F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/0363546519849909 |
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