Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury
Purpose To analyze the current randomized controlled trials (RCTs) of dynamic fixations (DFs) and static fixations (SFs) in treating distal tibiofibular syndesmosis injuries (DTSIs). Methods The Cochrane Central Register of Controlled Trials, PubMed, and EMBASE were systematically searched according...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020, Vol.28 (1), p.270-280 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Gan, Kaifeng Xu, Dingli Hu, Keqi Wu, Wei Shen, Yandong |
| description | Purpose
To analyze the current randomized controlled trials (RCTs) of dynamic fixations (DFs) and static fixations (SFs) in treating distal tibiofibular syndesmosis injuries (DTSIs).
Methods
The Cochrane Central Register of Controlled Trials, PubMed, and EMBASE were systematically searched according to the PRISMA guidelines to identify RCTs comparing the DFs and SFs for DTSIs. Included studies were assessed using the Cochrane Risk of Bias Tool. Postoperative functional scores, range of motion (ROM), complication rate, and incidence of reoperation were statistically analyzed using review manager software, and a
p
value of |
| doi_str_mv | 10.1007/s00167-019-05659-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2274559570</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2275949592</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-2bd54b22521ccd11c179f700c06a23aa345e2bfa97e350b16205e5d59d8ff4133</originalsourceid><addsrcrecordid>eNp9kUtLJDEUhYMo2jrzB2YxBNy4qTHPjlmKrxkQ3Og6pFJJk6YqaXOrwN7NTzdt-8KFmyRwvnPuDQehX5T8oYSoUyCEzlVDqG6InMt67qAZFZw3igu1i2ZEC9awqh2gQ4AlIfUp9D464FQwJpiYof-X62SH6HCIT3aMOeEIGKaVLzEXHBMefRkA54BdH1N0tsd5Gl0ePOAxYxir6bM54cEmu4hpgbtY1R6PsY05xHbqbcGwTp2HIUOdEtNyKusfaC_YHvzP1_sIPVxf3V_8bW7vbv5dnN82jis5NqztpGgZk4w611HqqNJBEeLI3DJuLRfSszZYrTyXpKXz-m0vO6m7sxAE5fwInWxzVyU_Th5GM0Rwvu9t8nkCw5iSWmipWUWPv6DLPJVUt9tQQkotFakU21KuZIDig1mVONiyNpSYTT9m24-p_ZiXfszG9Ps1emoH371b3gqpAN8CUKW08OVj9jexzxVJnPs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2274559570</pqid></control><display><type>article</type><title>Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>Springer Journals</source><creator>Gan, Kaifeng ; Xu, Dingli ; Hu, Keqi ; Wu, Wei ; Shen, Yandong</creator><creatorcontrib>Gan, Kaifeng ; Xu, Dingli ; Hu, Keqi ; Wu, Wei ; Shen, Yandong</creatorcontrib><description>Purpose
To analyze the current randomized controlled trials (RCTs) of dynamic fixations (DFs) and static fixations (SFs) in treating distal tibiofibular syndesmosis injuries (DTSIs).
Methods
The Cochrane Central Register of Controlled Trials, PubMed, and EMBASE were systematically searched according to the PRISMA guidelines to identify RCTs comparing the DFs and SFs for DTSIs. Included studies were assessed using the Cochrane Risk of Bias Tool. Postoperative functional scores, range of motion (ROM), complication rate, and incidence of reoperation were statistically analyzed using review manager software, and a
p
value of < 0.05 was considered statistically significant.
Results
Five RCTs with a total of 282 patients were included. Analysis revealed statistically significant differences in favor of DFs with regard to American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot score at a follow-up less than 6 months (MD 5.29; 95% CI 0.99–9.59;
p
= 0.02;
I
2
= 0%) and at a follow-up more than 2 years (MD 7.53; 95% CI 3.30–11.76;
p
= 0.0005;
I
2
= 0%), Olerud–Molander ankle (OMA) score at 1 year follow-up (MD 4.62; 95% CI 0.91–8.32;
p
= 0.01;
I
2
= 14%), and overall postoperative complication rate (RR 0.22; 95% CI 0.07–0.77;
p
= 0.02;
I
2
= 73%). There was no significant difference between the DFs and SFs regarding ROM and incidence of reoperation.
Conclusions
The DF procedure leads to significantly improved functional scores as well as lower rate of overall postoperative complications when compared with SF procedure. On the basis of results of this meta-analysis, the DF should be recommended for managing the DTSI.
Level of evidence
I.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-019-05659-0</identifier><identifier>PMID: 31422424</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Ankle ; Ankle Injuries - surgery ; Ankle Joint - surgery ; Bone Screws ; Clinical outcomes ; Clinical trials ; Complications ; Fixation ; Humans ; Incidence ; Injury analysis ; Lateral Ligament, Ankle - surgery ; Medicine ; Medicine & Public Health ; Meta-analysis ; Orthopedic Procedures - adverse effects ; Orthopedic Procedures - methods ; Orthopedics ; Postoperative Complications - etiology ; Postoperative Period ; Randomized Controlled Trials as Topic ; Range of Motion, Articular ; Recovery of Function ; Reoperation ; Statistical analysis ; Statistical significance ; Suture Techniques ; Treatment Outcome</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020, Vol.28 (1), p.270-280</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019</rights><rights>Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-2bd54b22521ccd11c179f700c06a23aa345e2bfa97e350b16205e5d59d8ff4133</citedby><cites>FETCH-LOGICAL-c375t-2bd54b22521ccd11c179f700c06a23aa345e2bfa97e350b16205e5d59d8ff4133</cites><orcidid>0000-0002-5166-6377</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-019-05659-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-019-05659-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27926,27927,41490,42559,51321</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31422424$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gan, Kaifeng</creatorcontrib><creatorcontrib>Xu, Dingli</creatorcontrib><creatorcontrib>Hu, Keqi</creatorcontrib><creatorcontrib>Wu, Wei</creatorcontrib><creatorcontrib>Shen, Yandong</creatorcontrib><title>Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
To analyze the current randomized controlled trials (RCTs) of dynamic fixations (DFs) and static fixations (SFs) in treating distal tibiofibular syndesmosis injuries (DTSIs).
Methods
The Cochrane Central Register of Controlled Trials, PubMed, and EMBASE were systematically searched according to the PRISMA guidelines to identify RCTs comparing the DFs and SFs for DTSIs. Included studies were assessed using the Cochrane Risk of Bias Tool. Postoperative functional scores, range of motion (ROM), complication rate, and incidence of reoperation were statistically analyzed using review manager software, and a
p
value of < 0.05 was considered statistically significant.
Results
Five RCTs with a total of 282 patients were included. Analysis revealed statistically significant differences in favor of DFs with regard to American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot score at a follow-up less than 6 months (MD 5.29; 95% CI 0.99–9.59;
p
= 0.02;
I
2
= 0%) and at a follow-up more than 2 years (MD 7.53; 95% CI 3.30–11.76;
p
= 0.0005;
I
2
= 0%), Olerud–Molander ankle (OMA) score at 1 year follow-up (MD 4.62; 95% CI 0.91–8.32;
p
= 0.01;
I
2
= 14%), and overall postoperative complication rate (RR 0.22; 95% CI 0.07–0.77;
p
= 0.02;
I
2
= 73%). There was no significant difference between the DFs and SFs regarding ROM and incidence of reoperation.
Conclusions
The DF procedure leads to significantly improved functional scores as well as lower rate of overall postoperative complications when compared with SF procedure. On the basis of results of this meta-analysis, the DF should be recommended for managing the DTSI.
Level of evidence
I.</description><subject>Ankle</subject><subject>Ankle Injuries - surgery</subject><subject>Ankle Joint - surgery</subject><subject>Bone Screws</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Fixation</subject><subject>Humans</subject><subject>Incidence</subject><subject>Injury analysis</subject><subject>Lateral Ligament, Ankle - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Orthopedic Procedures - methods</subject><subject>Orthopedics</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Period</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Range of Motion, Articular</subject><subject>Recovery of Function</subject><subject>Reoperation</subject><subject>Statistical analysis</subject><subject>Statistical significance</subject><subject>Suture Techniques</subject><subject>Treatment Outcome</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtLJDEUhYMo2jrzB2YxBNy4qTHPjlmKrxkQ3Og6pFJJk6YqaXOrwN7NTzdt-8KFmyRwvnPuDQehX5T8oYSoUyCEzlVDqG6InMt67qAZFZw3igu1i2ZEC9awqh2gQ4AlIfUp9D464FQwJpiYof-X62SH6HCIT3aMOeEIGKaVLzEXHBMefRkA54BdH1N0tsd5Gl0ePOAxYxir6bM54cEmu4hpgbtY1R6PsY05xHbqbcGwTp2HIUOdEtNyKusfaC_YHvzP1_sIPVxf3V_8bW7vbv5dnN82jis5NqztpGgZk4w611HqqNJBEeLI3DJuLRfSszZYrTyXpKXz-m0vO6m7sxAE5fwInWxzVyU_Th5GM0Rwvu9t8nkCw5iSWmipWUWPv6DLPJVUt9tQQkotFakU21KuZIDig1mVONiyNpSYTT9m24-p_ZiXfszG9Ps1emoH371b3gqpAN8CUKW08OVj9jexzxVJnPs</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Gan, Kaifeng</creator><creator>Xu, Dingli</creator><creator>Hu, Keqi</creator><creator>Wu, Wei</creator><creator>Shen, Yandong</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5166-6377</orcidid></search><sort><creationdate>2020</creationdate><title>Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury</title><author>Gan, Kaifeng ; Xu, Dingli ; Hu, Keqi ; Wu, Wei ; Shen, Yandong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-2bd54b22521ccd11c179f700c06a23aa345e2bfa97e350b16205e5d59d8ff4133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ankle</topic><topic>Ankle Injuries - surgery</topic><topic>Ankle Joint - surgery</topic><topic>Bone Screws</topic><topic>Clinical outcomes</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Fixation</topic><topic>Humans</topic><topic>Incidence</topic><topic>Injury analysis</topic><topic>Lateral Ligament, Ankle - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Orthopedic Procedures - adverse effects</topic><topic>Orthopedic Procedures - methods</topic><topic>Orthopedics</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Period</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Range of Motion, Articular</topic><topic>Recovery of Function</topic><topic>Reoperation</topic><topic>Statistical analysis</topic><topic>Statistical significance</topic><topic>Suture Techniques</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gan, Kaifeng</creatorcontrib><creatorcontrib>Xu, Dingli</creatorcontrib><creatorcontrib>Hu, Keqi</creatorcontrib><creatorcontrib>Wu, Wei</creatorcontrib><creatorcontrib>Shen, Yandong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gan, Kaifeng</au><au>Xu, Dingli</au><au>Hu, Keqi</au><au>Wu, Wei</au><au>Shen, Yandong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2020</date><risdate>2020</risdate><volume>28</volume><issue>1</issue><spage>270</spage><epage>280</epage><pages>270-280</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
To analyze the current randomized controlled trials (RCTs) of dynamic fixations (DFs) and static fixations (SFs) in treating distal tibiofibular syndesmosis injuries (DTSIs).
Methods
The Cochrane Central Register of Controlled Trials, PubMed, and EMBASE were systematically searched according to the PRISMA guidelines to identify RCTs comparing the DFs and SFs for DTSIs. Included studies were assessed using the Cochrane Risk of Bias Tool. Postoperative functional scores, range of motion (ROM), complication rate, and incidence of reoperation were statistically analyzed using review manager software, and a
p
value of < 0.05 was considered statistically significant.
Results
Five RCTs with a total of 282 patients were included. Analysis revealed statistically significant differences in favor of DFs with regard to American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot score at a follow-up less than 6 months (MD 5.29; 95% CI 0.99–9.59;
p
= 0.02;
I
2
= 0%) and at a follow-up more than 2 years (MD 7.53; 95% CI 3.30–11.76;
p
= 0.0005;
I
2
= 0%), Olerud–Molander ankle (OMA) score at 1 year follow-up (MD 4.62; 95% CI 0.91–8.32;
p
= 0.01;
I
2
= 14%), and overall postoperative complication rate (RR 0.22; 95% CI 0.07–0.77;
p
= 0.02;
I
2
= 73%). There was no significant difference between the DFs and SFs regarding ROM and incidence of reoperation.
Conclusions
The DF procedure leads to significantly improved functional scores as well as lower rate of overall postoperative complications when compared with SF procedure. On the basis of results of this meta-analysis, the DF should be recommended for managing the DTSI.
Level of evidence
I.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31422424</pmid><doi>10.1007/s00167-019-05659-0</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-5166-6377</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020, Vol.28 (1), p.270-280 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_journals_2274559570 |
| source | Wiley-Blackwell Journals; MEDLINE; Springer Journals |
| subjects | Ankle Ankle Injuries - surgery Ankle Joint - surgery Bone Screws Clinical outcomes Clinical trials Complications Fixation Humans Incidence Injury analysis Lateral Ligament, Ankle - surgery Medicine Medicine & Public Health Meta-analysis Orthopedic Procedures - adverse effects Orthopedic Procedures - methods Orthopedics Postoperative Complications - etiology Postoperative Period Randomized Controlled Trials as Topic Range of Motion, Articular Recovery of Function Reoperation Statistical analysis Statistical significance Suture Techniques Treatment Outcome |
| title | Dynamic fixation is superior in terms of clinical outcomes to static fixation in managing distal tibiofibular syndesmosis injury |
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