Comparison of open and closed reduction and percutaneous pinning for pediatric lateral humeral condyle fractures: A systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Open reduction and percutaneous pinning (ORPP) is commonly regarded as the primary treatment option for serious displaced lateral condyle fractures of the humerus (LCFs) in children. However, some authors have suggested that closed reduction and percutaneous pinning (CRPP) may be an appropriate method for treating LCFs. This meta-analysis aims to compare the outcomes of these 2 fixation techniques. METHODS: Our study conducted a search of the Pubmed, Embase, and Cochrane Library databases for published research up to October 1, 2022. Our analysis comprehensively compared the operation failure rate, elbow function, and complication rate between CRPP and ORPP. This study was registered with PROSPERO (CRD42022379655). RESULTS: Our analysis included 6 non-randomized controlled trials and 532 patients. We used the Newcastle Ottawa Scale to assess the bias risk of these studies, with scores ranging from 6 to 9. The results indicate that both CRPP and ORPP yielded satisfactory elbow function outcomes (OR = 0.35, 95% CI = 0.07-1.88, P = .22). However, CRPP had a significant rate of operative failure (17.65%, OR = 21.77, 95% CI = 3.98-119.08, P = .0004) but a lower likelihood of unsightly scars (OR = 0.06, 95% CI = 0.01-0.31, P = .008). The failure rate of surgery is 0% in ORPP. There were no significant differences found in total infection (OR = 0.46, 95% CI = 0.21-1.01, P = .05), avascular necrosis (OR = 0.84, 95% CI = 0.09-7.79, P = .88), delayed union (OR = 1.49, 95% CI = 0.06-37.35, P = .81), or surgical time (MD = 4.46, 95% CI = -25.92 to 34.84, P = .77). CONCLUSIONS: In comparison to ORPP, CRPP may result in a higher rate of operative failure but has been found to significantly reduce the occurrence of unsightly scars. Both CRPP and ORPP showed similar levels of postoperative functional satisfaction, with no statistical difference in other complications. Our research suggests that qualified closed reduction is a viable option for doctors to treat LCF. LEVELS OF EVIDENCE: IV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.026 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.021 | 0.036 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".