Meta – analysis of Pinning in Supracondylar Fracture of the Humerus in Children
Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine Ramathibodi Hospital
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October 24, 2019Meta – analysis of Pinning in Supracondylar Fracture of the Humerus in Children
Title :
Meta – analysis of Pinning in Supracondylar Fracture of the Humerus in Children
Researchers :
Patarawan Woratanarat
Chanika Angsanuntsukh
Sasivimol Ratanasiri
John Attia
Thira Woratanarat
Ammarin Thakkinstian
OBJECTIVES : The purpose of this study was to compare the outcomes of lateral pinning versus cross pinning in pediatric supracondylar humerus fractures.
DATA SOURCES : The Cochrane library, MEDLINE, CINAHL, specific orthopaedic journals, abstracts/papers from conferences and meetings, and reference lists of articles were searched from inception to September 2007.
STUDY SELECTION : All randomized controlled trials and cohort studies comparing outcomes (ie, loss of fixation, iatrogenic ulnar nerve injury, and Flynn criteria) between crossed and lateral pinning were identified.
DATA EXTRACTION : Two authors independently assessed methodological quality and extracted data by using a standardized data extraction form.
DATA SYNTHESIS : Heterogeneity among studies was assessed using the Q test. Pooled relative risk was estimated using the Mantel-Haenszel method. Eighteen of 1829 studies were included with 1615 supracondylar fractures (837 and 778 children with cross and lateral pinning, respectively). The average age was 6.1 ± 0.9 years. The risk of iatrogenic ulnar nerve injury was 4.3 (95% confidence interval, 2.1-9.1) times higher in cross pinning compared with lateral pinning. There was no significant difference for loss of fixation, late deformity, or Flynn criteria between the two types of pinning.
CONCLUSIONS : Lateral pinning is preferable to cross pinning for fixation of pediatric supracondylar humerus fractures as a result of decreased risk of ulnar nerve injury.
Applied Research Project to Usage : 44 Citations included Standard Textbook.
Award Grant related to the Project : Henry Bensahel Award, SICOT Meeting 2009.
Publishing : Journal Orthopaedic Trauma 2012; 26:48 – 53.
Key Contact Person :
Patarawan Woratanrat, MD, PhD
Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University