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European Journal of Orthopaedic Surgery & Traumatology

Open Access 20-04-2024 | Forearm Fracture | General Review

Intramedullary versus plate fixation of both bone forearm fractures in skeletally immature patients: a systematic review and meta-analysis

Authors: Ahmed Mohamed Ahmed, Elsayed Said, Ahmad Addosooki, Hossam Ahmed Attya, Ahmad Khairy Awad, Emad Hamdy Ahmed, Hamdy Tammam

Published in: European Journal of Orthopaedic Surgery & Traumatology

Abstract

Background

Both bone forearm fractures (BBFFs) are a common injury amongst the pediatric population. The main indications of surgical fixation are open, irreducible, or unstable fractures. The two most commonly used surgical techniques are closed or open reduction with intramedullary fixation (IMF) and open reduction with plate fixation (PF). The aim of this systematic review and meta-analysis was to determine which fixation method is superior for BBFFs.

Methods

PubMed, Scopus, Web of Science, and CENTRAL were searched to identify studies comparing IMF and PF. We extracted data on union rates, complications, early hardware removal rates, reoperation rates, and radiographic, clinical, and perioperative outcomes.

Results

Sixteen studies were included in the analysis, with a total of 922 patients (539 IMF and 383 PF). Similar union rates were achieved by both fixation technique. IMF was associated with a higher incidence of symptomatic hardware, and early hardware removal. Better restoration of the radial bow was observed with the PF group, especially in older children and adolescents. The rate of excellent function was comparable between groups, whereas better cosmesis was reported with the IMF group. Despite shorter fluoroscopy time and immobilization time, PF demonstrated longer tourniquet time, operating time, and hospital stay compared to IMF.

Conclusions

We found no significant difference between IMF and PF in terms of union rates and functional outcomes taking in consideration the merits and demerits of each technique. High-quality randomized controlled trials are, therefore, necessary to determine the superiority of one fixation technique over the other.

Level of evidence

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Title: Intramedullary versus plate fixation of both bone forearm fractures in skeletally immature patients: a systematic review and meta-analysis
Authors: Ahmed Mohamed Ahmed
Elsayed Said
Ahmad Addosooki
Hossam Ahmed Attya
Ahmad Khairy Awad
Emad Hamdy Ahmed
Hamdy Tammam
Publication date: 20-04-2024
Publisher: Springer Paris
Keywords: Forearm Fracture
Refracture
Published in: European Journal of Orthopaedic Surgery & Traumatology
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-024-03925-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intramedullary versus plate fixation of both bone forearm fractures in skeletally immature patients: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Level of evidence

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