External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

Julie Ladeby Erichsen, Carsten Jensen, Frank Lindhøj Damborg, Bjarke Viberg, Lonnie Froberg

Research output: Contribution to conference without publisher/journalConference abstract for conferenceResearchpeer-review

Abstract

Background: Distal Intra-Articular Tibia Fractures (DIATF) is challenging to treat and severe loss of physical function affecting working abilities has been reported. Aim: To investigate differences in physical function and complications following DIATF surgery with two-stage Open Reduction Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients (>18 years) were included for review. 3071 studies were identified and screened by two independent authors according to the PRISMA guidelines. Cochrane Risk of bias Tool for RCT and non-randomised studies (ROBIN-1) were used to assess risk of bias. Results: One RCT study and four cohort studies with 254 patients, 150 two-stage ORIF and 104 EF, was included. The median follow-up ranged from 12-38 months. The RCT had low risk of bias while the cohort studies had moderate risk. All studies reported decreased physical function. A comparison of results was difficult because a variety of function scores were used. EF had a higher superficial infection frequency due to pinn infection (18/63 EF vs 9/103 two-stage ORIF) and a tendency towards higher mal- and non-union frequency (9/63 EF vs 7/103 two-stage ORIF; 6/104 EF vs 4/150 two-stage ORIF). Conclusion: Current evidence for physical function and complications following DIATF surgery with either two-stage ORIF or EF is low. However, all present studies report decreased physical function following DIATF operated on with either two-stage ORIF or EF. The number of complications was generally low. A well-designed multi-centre study with a large sample size is needed.
Original languageEnglish
Publication date28. Oct 2016
Publication statusPublished - 28. Oct 2016
EventDansk Ortopædisk Selskab: Årskongress - SAS Radisson, København, Denmark
Duration: 26. Oct 201628. Oct 2016
http://www.ortopaedi.dk/dos-kongressen-2016/program/

Conference

ConferenceDansk Ortopædisk Selskab
LocationSAS Radisson
CountryDenmark
CityKøbenhavn
Period26/10/201628/10/2016
Internet address

Cite this

Ladeby Erichsen, J., Jensen, C., Damborg, F. L., Viberg, B., & Froberg, L. (2016). External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review. Abstract from Dansk Ortopædisk Selskab, København, Denmark.
Ladeby Erichsen, Julie ; Jensen, Carsten ; Damborg, Frank Lindhøj ; Viberg, Bjarke ; Froberg, Lonnie. / External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review. Abstract from Dansk Ortopædisk Selskab, København, Denmark.
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abstract = "Background: Distal Intra-Articular Tibia Fractures (DIATF) is challenging to treat and severe loss of physical function affecting working abilities has been reported. Aim: To investigate differences in physical function and complications following DIATF surgery with two-stage Open Reduction Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients (>18 years) were included for review. 3071 studies were identified and screened by two independent authors according to the PRISMA guidelines. Cochrane Risk of bias Tool for RCT and non-randomised studies (ROBIN-1) were used to assess risk of bias. Results: One RCT study and four cohort studies with 254 patients, 150 two-stage ORIF and 104 EF, was included. The median follow-up ranged from 12-38 months. The RCT had low risk of bias while the cohort studies had moderate risk. All studies reported decreased physical function. A comparison of results was difficult because a variety of function scores were used. EF had a higher superficial infection frequency due to pinn infection (18/63 EF vs 9/103 two-stage ORIF) and a tendency towards higher mal- and non-union frequency (9/63 EF vs 7/103 two-stage ORIF; 6/104 EF vs 4/150 two-stage ORIF). Conclusion: Current evidence for physical function and complications following DIATF surgery with either two-stage ORIF or EF is low. However, all present studies report decreased physical function following DIATF operated on with either two-stage ORIF or EF. The number of complications was generally low. A well-designed multi-centre study with a large sample size is needed.",
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author = "{Ladeby Erichsen}, Julie and Carsten Jensen and Damborg, {Frank Lindh{\o}j} and Bjarke Viberg and Lonnie Froberg",
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Ladeby Erichsen, J, Jensen, C, Damborg, FL, Viberg, B & Froberg, L 2016, 'External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review', Dansk Ortopædisk Selskab, København, Denmark, 26/10/2016 - 28/10/2016.

External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review. / Ladeby Erichsen, Julie ; Jensen, Carsten; Damborg, Frank Lindhøj; Viberg, Bjarke; Froberg, Lonnie.

2016. Abstract from Dansk Ortopædisk Selskab, København, Denmark.

Research output: Contribution to conference without publisher/journalConference abstract for conferenceResearchpeer-review

TY - ABST

T1 - External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

AU - Ladeby Erichsen, Julie

AU - Jensen, Carsten

AU - Damborg, Frank Lindhøj

AU - Viberg, Bjarke

AU - Froberg, Lonnie

PY - 2016/10/28

Y1 - 2016/10/28

N2 - Background: Distal Intra-Articular Tibia Fractures (DIATF) is challenging to treat and severe loss of physical function affecting working abilities has been reported. Aim: To investigate differences in physical function and complications following DIATF surgery with two-stage Open Reduction Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients (>18 years) were included for review. 3071 studies were identified and screened by two independent authors according to the PRISMA guidelines. Cochrane Risk of bias Tool for RCT and non-randomised studies (ROBIN-1) were used to assess risk of bias. Results: One RCT study and four cohort studies with 254 patients, 150 two-stage ORIF and 104 EF, was included. The median follow-up ranged from 12-38 months. The RCT had low risk of bias while the cohort studies had moderate risk. All studies reported decreased physical function. A comparison of results was difficult because a variety of function scores were used. EF had a higher superficial infection frequency due to pinn infection (18/63 EF vs 9/103 two-stage ORIF) and a tendency towards higher mal- and non-union frequency (9/63 EF vs 7/103 two-stage ORIF; 6/104 EF vs 4/150 two-stage ORIF). Conclusion: Current evidence for physical function and complications following DIATF surgery with either two-stage ORIF or EF is low. However, all present studies report decreased physical function following DIATF operated on with either two-stage ORIF or EF. The number of complications was generally low. A well-designed multi-centre study with a large sample size is needed.

AB - Background: Distal Intra-Articular Tibia Fractures (DIATF) is challenging to treat and severe loss of physical function affecting working abilities has been reported. Aim: To investigate differences in physical function and complications following DIATF surgery with two-stage Open Reduction Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients (>18 years) were included for review. 3071 studies were identified and screened by two independent authors according to the PRISMA guidelines. Cochrane Risk of bias Tool for RCT and non-randomised studies (ROBIN-1) were used to assess risk of bias. Results: One RCT study and four cohort studies with 254 patients, 150 two-stage ORIF and 104 EF, was included. The median follow-up ranged from 12-38 months. The RCT had low risk of bias while the cohort studies had moderate risk. All studies reported decreased physical function. A comparison of results was difficult because a variety of function scores were used. EF had a higher superficial infection frequency due to pinn infection (18/63 EF vs 9/103 two-stage ORIF) and a tendency towards higher mal- and non-union frequency (9/63 EF vs 7/103 two-stage ORIF; 6/104 EF vs 4/150 two-stage ORIF). Conclusion: Current evidence for physical function and complications following DIATF surgery with either two-stage ORIF or EF is low. However, all present studies report decreased physical function following DIATF operated on with either two-stage ORIF or EF. The number of complications was generally low. A well-designed multi-centre study with a large sample size is needed.

KW - Distal Intra-Articular Tibia Fractures

KW - Systematic literature review

KW - Physical function

KW - complications

KW - External Fixators

M3 - Conference abstract for conference

ER -

Ladeby Erichsen J, Jensen C, Damborg FL, Viberg B, Froberg L. External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review. 2016. Abstract from Dansk Ortopædisk Selskab, København, Denmark.