Scott D. Purdie , Niamh Hoskins , Regina Jesslyn Sumarlie , Natthaya Eiamampai , Paul Lebeslé , Fergus Wood , Anagha Chinmayee , Wei Qi Lim , Sriskandarasa Senthilkumaran , Louise Fisher , Santosh Baliga
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引用次数: 0
摘要
背景：微创手术技术（MIS）的发展引发了对跟骨骨折最佳干预措施的争论。本荟萃分析比较了可伸展侧入路（ELA）和两种MIS技术；鼻窦入路和经皮入路。方法：对7个随机对照试验（rct）数据库进行系统检索。临床结果包括伤口并发症、功能评分（美国骨科足踝协会评分和马里兰足部评分）和放射学测量（Böhler's和Gissane's角）。结果：14项随机对照试验(n = 1367；平均年龄36.3岁；25.7 %女性)。与ELA相比，MIS明显减少了伤口并发症（RR 6.48, 95 %CI 4.03-10.41, p ）结论：两种MIS技术都减少了伤口并发症，改善了功能预后，并实现了相当的解剖复位，使其成为可伸展外侧入路的合适选择，显著改善了患者的预后。证据等级：一级。
Minimally invasive surgical techniques compared to an extensile lateral approach in the management of displaced intra-articular calcaneal fractures. A systematic review and meta-analysis of randomised controlled trials
Background
Developments in minimally invasive surgical techniques (MIS) have sparked debate over the optimal intervention for calcaneal fractures. This meta-analysis compares the extensile lateral approach (ELA) to two MIS techniques; the sinus tarsi approach and percutaneous approaches.
Methods
A systematic search was conducted across seven databases for randomised control trials (RCTs). The clinical outcomes were wound complications, functional scores (American Orthopaedic Foot & Ankle Society score, and Maryland Foot Score) and radiological measures (Böhler’s and Gissane’s angles).
Results
Fourteen RCTs (n = 1367; mean age: 36.3 years; 25.7 % female) were included. MIS significantly reduced wound complications compared to ELA (RR 6.48, 95 %CI 4.03–10.41, p < 0.00001, n = 1380, GRADE: High). Functional scores favoured MIS, and radiological outcomes were equivalent.
Conclusions
Both MIS techniques reduce wound complications, improve functional outcomes, and achieve comparable anatomical reduction, making them suitable alternatives to the extensile lateral approach, to significantly improve patient’s outcomes.
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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