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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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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cites cdi_FETCH-LOGICAL-c411t-46682c79bc90be30087f6ce7c1b32274f6361a1e18266d40b661ae2a1aa9dbae3
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creator Xie, Yuanlong, MCM
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description 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  
doi_str_mv 10.1053/j.jfas.2015.03.010
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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 &lt; .001). The reoperation rate was higher with MS fixation (RR 0.08, 95% CI 0.03 to 0.18, I2  = 77%, p  &lt; .01). The functional outcomes of AS were as good as those with MS for DTSIs. Other than the foreign body reaction, the complications occurring after AS fixation were not as serious as those with MS fixation. AS fixation might be a preferable alternative for reconstruction of DTSIs.</description><identifier>ISSN: 1067-2516</identifier><identifier>EISSN: 1542-2224</identifier><identifier>DOI: 10.1053/j.jfas.2015.03.010</identifier><identifier>PMID: 25956019</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>The Journal of foot and ankle surgery, 2015-07, Vol.54 (4), p.663-670</ispartof><rights>American College of Foot and Ankle Surgeons</rights><rights>2015 American College of Foot and Ankle Surgeons</rights><rights>Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-46682c79bc90be30087f6ce7c1b32274f6361a1e18266d40b661ae2a1aa9dbae3</citedby><cites>FETCH-LOGICAL-c411t-46682c79bc90be30087f6ce7c1b32274f6361a1e18266d40b661ae2a1aa9dbae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25956019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xie, Yuanlong, MCM</creatorcontrib><creatorcontrib>Cai, Lin, MD</creatorcontrib><creatorcontrib>Deng, Zhouming, MD</creatorcontrib><creatorcontrib>Ran, Bing, MM</creatorcontrib><creatorcontrib>Hu, Chao, MD</creatorcontrib><title>Absorbable Screws Versus Metallic Screws for Distal Tibiofibular Syndesmosis Injuries: A Meta-Analysis</title><title>The Journal of foot and ankle surgery</title><addtitle>J Foot Ankle Surg</addtitle><description>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 &lt; .001). The reoperation rate was higher with MS fixation (RR 0.08, 95% CI 0.03 to 0.18, I2  = 77%, p  &lt; .01). The functional outcomes of AS were as good as those with MS for DTSIs. Other than the foreign body reaction, the complications occurring after AS fixation were not as serious as those with MS fixation. AS fixation might be a preferable alternative for reconstruction of DTSIs.</description><subject>Absorbable Implants</subject><subject>absorbable screw</subject><subject>Ankle Fractures - surgery</subject><subject>Bone Screws</subject><subject>foreign body reaction</subject><subject>Foreign-Body Reaction - etiology</subject><subject>Fracture Fixation, Internal - instrumentation</subject><subject>Humans</subject><subject>meta-analysis</subject><subject>metallic screw</subject><subject>Metals</subject><subject>Orthopedics</subject><subject>Postoperative Complications</subject><subject>reoperation</subject><subject>syndesmosis injuries</subject><issn>1067-2516</issn><issn>1542-2224</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp9kU9v1DAQxSMEoqXlC3BAOXJJmHESJ0EIaVX-tFJRD1u4WrYzkRy8cfFsqPbb47AtBw6c7Jl570nzmyx7hVAiNNXbqZxGzaUAbEqoSkB4kp1iU4tCCFE_TX-QbSEalCfZC-YJQIi-a55nJ6LpGwnYn2bjxnCIRhtP-dZGuuf8O0VeOP9Ke-29s4_tMcT8o-PUzG-dcWF0ZvE65tvDPBDvAjvOr-ZpiY74Xb754y82s_aHNDnPno3aM718eM-yb58_3V5cFtc3X64uNteFrRH3RS1lJ2zbG9uDoQqga0dpqbVoKiHaepSVRI2EnZByqMHIVJLQqHU_GE3VWfbmmHsXw8-FeK92ji15r2cKCyuUPabduwqSVBylNgbmSKO6i26n40EhqJWvmtTKV618FVQq8U2m1w_5i9nR8NfyCDQJ3h8FlLb85Sgqto5mS4OLZPdqCO7_-R_-sVvvZme1_0EH4iksMRFNeygWCtR2vfB6YGwAMBXVbxKooP4</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Xie, Yuanlong, MCM</creator><creator>Cai, Lin, MD</creator><creator>Deng, Zhouming, MD</creator><creator>Ran, Bing, MM</creator><creator>Hu, Chao, MD</creator><general>Elsevier Inc</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>7X8</scope></search><sort><creationdate>20150701</creationdate><title>Absorbable Screws Versus Metallic Screws for Distal Tibiofibular Syndesmosis Injuries: A Meta-Analysis</title><author>Xie, Yuanlong, MCM ; Cai, Lin, MD ; Deng, Zhouming, MD ; Ran, Bing, MM ; Hu, Chao, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-46682c79bc90be30087f6ce7c1b32274f6361a1e18266d40b661ae2a1aa9dbae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Absorbable Implants</topic><topic>absorbable screw</topic><topic>Ankle Fractures - surgery</topic><topic>Bone Screws</topic><topic>foreign body reaction</topic><topic>Foreign-Body Reaction - etiology</topic><topic>Fracture Fixation, Internal - instrumentation</topic><topic>Humans</topic><topic>meta-analysis</topic><topic>metallic screw</topic><topic>Metals</topic><topic>Orthopedics</topic><topic>Postoperative Complications</topic><topic>reoperation</topic><topic>syndesmosis injuries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xie, Yuanlong, MCM</creatorcontrib><creatorcontrib>Cai, Lin, MD</creatorcontrib><creatorcontrib>Deng, Zhouming, MD</creatorcontrib><creatorcontrib>Ran, Bing, MM</creatorcontrib><creatorcontrib>Hu, Chao, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of foot and ankle surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xie, Yuanlong, MCM</au><au>Cai, Lin, MD</au><au>Deng, Zhouming, MD</au><au>Ran, Bing, MM</au><au>Hu, Chao, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Absorbable Screws Versus Metallic Screws for Distal Tibiofibular Syndesmosis Injuries: A Meta-Analysis</atitle><jtitle>The Journal of foot and ankle surgery</jtitle><addtitle>J Foot Ankle Surg</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>54</volume><issue>4</issue><spage>663</spage><epage>670</epage><pages>663-670</pages><issn>1067-2516</issn><eissn>1542-2224</eissn><abstract>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 &lt; .001). The reoperation rate was higher with MS fixation (RR 0.08, 95% CI 0.03 to 0.18, I2  = 77%, p  &lt; .01). The functional outcomes of AS were as good as those with MS for DTSIs. Other than the foreign body reaction, the complications occurring after AS fixation were not as serious as those with MS fixation. AS fixation might be a preferable alternative for reconstruction of DTSIs.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25956019</pmid><doi>10.1053/j.jfas.2015.03.010</doi><tpages>8</tpages></addata></record>
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source ScienceDirect Journals
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
title Absorbable Screws Versus Metallic Screws for Distal Tibiofibular Syndesmosis Injuries: A Meta-Analysis
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