Absorbable Screws Versus Metallic Screws for Distal Tibiofibular Syndesmosis Injuries: A Meta-Analysis

Abstract A meta-analysis was performed to investigate the outcomes between absorbable screw (AS) and metallic screw (MS) fixation for distal tibiofibular syndesmosis injuries (DTSIs). Randomized controlled trials comparing AS versus MS fixation in DTSIs were searched systematically, and the outcomes...

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Bibliographic Details
Published in:The Journal of foot and ankle surgery 2015-07, Vol.54 (4), p.663-670
Main Authors: Xie, Yuanlong, MCM, Cai, Lin, MD, Deng, Zhouming, MD, Ran, Bing, MM, Hu, Chao, MD
Format: Article
Language:English
Subjects:
Absorbable Implants
absorbable screw
Ankle Fractures - surgery
Bone Screws
foreign body reaction
Foreign-Body Reaction - etiology
Fracture Fixation, Internal - instrumentation
Humans
meta-analysis
metallic screw
Metals
Orthopedics
Postoperative Complications
reoperation
syndesmosis injuries
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Summary:Abstract A meta-analysis was performed to investigate the outcomes between absorbable screw (AS) and metallic screw (MS) fixation for distal tibiofibular syndesmosis injuries (DTSIs). Randomized controlled trials comparing AS versus MS fixation in DTSIs were searched systematically, and the outcomes were analyzed using Review Manager Software, version 5.2. The risk ratio (RR) or mean difference with the 95% confidence interval (CI) was calculated using the fixed effects or random effects model. A total of 16 studies were included in the meta-analysis. No statistically significant difference was found between AS and MS fixation in excellent and good functional recovery rate (RR 1.11, 95% CI 1.00 to 1.23, I2  = 60%, p  = .06), infection (RR 1.66, 95% CI 0.73 to 3.79, I2  = 0%, p  = .23), incidence of pain (RR 0.68, 95% CI 0.24 to 1.92, I2  = 12%, p  = .47), screw broken (RR 0.31, 95% CI 0.03 to 2.93, I2  = %, p  = .31), heterotopic ossification (RR 1.93, 95% CI 0.21 to 17.62, I2  = 51%, p  = .56; 472 cases in 4 studies), fracture healing time (mean difference −1.88, 95% CI −3.51 to −0.26, I2  = 93%, p  = .02,), duration of operation time (mean difference 7.64, 95% CI −3.80 to 19.09, I2  = 98%, p  = .19). The incidence of foreign body reaction was higher with AS fixation (RR 6.07, 95% CI 2.54 to 14.50, I2  = 0%, p < .001). The reoperation rate was higher with MS fixation (RR 0.08, 95% CI 0.03 to 0.18, I2  = 77%, p  
ISSN:1067-2516
1542-2224
DOI:10.1053/j.jfas.2015.03.010