Which is the best treatment for displaced intra-articular calcaneal fractures
Notice bibliographique
Résumé
Category: Trauma Introduction/Purpose: Displaced Intra-Articular Calcaneus Fractures (DIACFs) represent a source of tremendous disability to the patient, economic burden to the society and a treatment challenge to the average orthopaedic surgeon. Open reduction and internal fixation (ORIF), minimally invasive surgery (MIS), external fixator (EF), external fixator combined with limited internal fixation (EFLIF) and non-surgical treatment (NST) are mostly used for the treatment of DIACFs. However, no single approach is universally applicable to all calcaneus fractures. More over, previous studies was still unclear and have offered conflicting recommendations. The purpose of this study is to comprehensively review the literature and ascertain the relative efficacy and safety of ORIF, MIS, EF, EFLIF and NST for patients with DIACFs using a Bayesian network meta-analysis. Methods: We will comprehensively search PubMed, EMBASE, Cochrane Library, Medline, Science Direct, CBM and CNKI from the inception dates to January 01, 2018, to include potentially relevant randomized controlled trials (RCTs) and cohort studies (CSs) that evaluated interventions for treating adults with DIACFs. The quality of included studies was assessed using the Newcastle-Ottawa Scale and the risk of bias according to the Cochrane Handbook. After independent study selection by 2 authors, data were extracted and collected independently. The primary outcome measures were anatomical measures, functional measures, and complications. The data of RCTs and CSs were pooled respectively using the fixed-effect model or random-effect model. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated for continuous data, and relative risks (RRs) with 95% CIs were calculated for dichotomous data. Statistical heterogeneity was assessed with the Q test and I2. Sensitivity analysis was developed to assess the reliability of pooled results. Results: Seventeen trials (5 RCTs and 12 CSs) including 2369 patients were considered in the study. EFLIF had significantly the highest AOFAS Ankle Hindfoot Scale (MD, 9.54 [95% CI, 5.97 to 17.42]) and lower total incidence of complications (RR, 1.65 [95% CI, 1.27 to 2.54]) than ORIF, MIS, EF and NST. Moreover, EFLIF resulted in a lower incidence of additional surgery (RR, 3.47 [95% CI, 2.28 to 6.95]) than ORIF and NST. The rank of anatomical recovery was: EFLIF, ORIF, EF, MIS and NST. The rank of functional recovery was: EFLIF, ORIF, MIS, EF and NST. For reduction in total incidence of complications, the rank was: EFLIF, NST, EF, MIS and ORIF. Conclusion: EFLIF has the highest probability of improving the functional outcome and reducing the total incidence of complications and additional surgery among the five interventions for treating adults with DIACFs.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».