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Meta-Analysis
. 2016 Jul 26:6:30480.
doi: 10.1038/srep30480.

Percutaneous Reduction and Fixation with Kirschner Wires versus Open Reduction Internal Fixation for the Management of Calcaneal Fractures: A Meta-Analysis

Jianbin Wu  1 , Feiya Zhou  1 , Lei Yang  1 , Jun Tan  1
Affiliations
Meta-Analysis

Percutaneous Reduction and Fixation with Kirschner Wires versus Open Reduction Internal Fixation for the Management of Calcaneal Fractures: A Meta-Analysis

Jianbin Wu et al. Sci Rep. .

Abstract

The aim of our meta-analysis was to compare outcomes for two surgical treatments of calcaneal fractures, percutaneous reduction and fixation with Kirschner wires (PRFK) and open reduction internal fixation (ORIF), with the intent of evaluating the quality of evidence to inform practice. Search of MEDLINE, Cochrane and CNKI databases to identify randomized controlled trials (RCTs) comparing PRKF and ORIF on the following outcomes: post-operative function, complications and quality of the reduction. Odd ratios (OR) and weighted mean differences were pooled using either a fixed-effects or random-effects model, depending on the heterogeneity of the trials included in the analysis. Eighteen RCTs provided the data from 1407 patients. PRFK was associated with a lower risk of surgical wound complications, and ORIF with better post-operative function, angle of Gissane, calcaneal height, and calcaneal width. There were no statistically significant differences between the techniques with regards to post-operative Böhler's angle. PRFK does not provide a substantive advantage over ORIF for the treatment of calcaneal fractures in adults. PRFK may, however, yield comparable functional outcomes to ORIF for closed Sanders type II calcaneal fractures but with less complication related to surgical wound healing.

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Figures

Figure 1
Figure 1. Flow Diagram of Search.
Figure 2
Figure 2. Summary of Risk Bias Assessment.
Note: Reviewers’ assessment of each risk of bias item; “+”, low risk of bias; “?”, unclear risk of bias; and “−”, high risk of bias.
Figure 3
Figure 3. Risk of Bias Graph.
Note: Reviewers’ assessment of each risk bias item, presented as a percent across all included RCTs.
Figure 4
Figure 4. Forest Plot of SMDs and Associated 95% Confidence Intervals for Functional Outcomes.
Figure 5
Figure 5. Forest Plot of OR, and Associated Confidence Intervals, for Complications Related to the Surgical Wound.
Figure 6
Figure 6. Forest Plot of MD, and Associated Confidence Intervals, for the Angle of Böhler’s.
Figure 7
Figure 7. Forest Plot of MD, and Associated Confidence Intervals, for the Angle of Gissane.
Figure 8
Figure 8. Forest Plot of MD, and Associated Confidence Intervals, for Calcaneal Widths.
Figure 9
Figure 9. Forest Plot of MD, and Associated Confidence Intervals, for Calcaneal Height.
See this image and copyright information in PMC

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