Imperial College London
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Mr. Gareth G. Jones

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Orthopaedic Surgery
 
 
 
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Contact

 

+44 (0)20 7594 5465g.g.jones

 
 
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Location

 

203Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Goh:2018:sicotj/2018055,
author = {Goh, EL and Chidambaram, S and Eigenmann, D and Ma, S and Jones, GG},
doi = {sicotj/2018055},
journal = {SICOT-J},
title = {Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for closed distal tibial fractures: a meta-analysis of the clinical outcomes},
url = {http://dx.doi.org/10.1051/sicotj/2018055},
volume = {4},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Introduction: Minimally invasive percutaneous plate osteosynthesis (MIPPO) has emerged as a viable alternative for the treatment of distal tibial fractures. However, the clinical outcomes of this procedure compared to intramedullary (IM) nail fixation have yet to be established. The present meta-analysis aims to compare the clinical outcomes following MIPPO and IM nail fixation for closed distal tibial fractures.Methods: MEDLINE and EMBASE databases were searched from date of inception to 10th April 2017. Randomized controlled trials (RCTs) comparing MIPPO with IM nail fixation for closed and Gustilo Grade I distal tibial fractures were included. Outcomes assessed included time to union, complications and functional outcomes. Quality and risk of bias of the RCTs were assessed using the Cochrane Collaboration Tool.Results: Five RCTs comprising 497 patients were included. MIPPO was associated with a longer time to union (MD: 1.08, 95% CI: 0.26, 1.90, p = 0.010, I 2 = 84%) and increased risk of wound complications (RR: 1.58, 95% CI: 1.01, 2.46, p = 0.04, I 2 = 0%). Both MIPPO and IM nail fixation had comparable risks of malunion, delayed union, non-union and deep infections, with similar functional outcomes.Discussion: Compared to IM nail fixation, a MIPPO fixation technique for distal tibial fractures is associated with a longer time to fracture union and an increased risk of wound complications. Neither technique demonstrates a clear advantage with regard to risk of malunion/non-union, or functional outcome. Assuming equivalent surgical expertise with both techniques, the results suggest that IM nail fixation is the treatment modality of choice for these challenging fractures.
AU  - Goh,EL
AU  - Chidambaram,S
AU  - Eigenmann,D
AU  - Ma,S
AU  - Jones,GG
DO  - sicotj/2018055
PY  - 2018///
SN  - 2426-8887
TI  - Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for closed distal tibial fractures: a meta-analysis of the clinical outcomes
T2  - SICOT-J
UR  - http://dx.doi.org/10.1051/sicotj/2018055
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000453791500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/66934
VL  - 4
ER  -
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