TY - JOUR
T1 - Comparative Analysis of Posterior Approach Versus Anterior Approach for Posterior Tibial Plateau Fractures
T2 - A Systematic Review and Meta-Analysis
AU - Laurent Tsai, Sung Huang
AU - Lin, Chun Ru
AU - Lin, You Rui
AU - Liu, Yi Chen
AU - Tischler, Eric H.
AU - Tang, Hao Che
AU - Chen, Chien Hao
AU - Su, Chun Yi
AU - Chan, Yi Sheng
N1 - Publisher Copyright:
© 2023 Journal of Bone and Joint Surgery Inc.. All rights reserved.
PY - 2023/7/11
Y1 - 2023/7/11
N2 - Background:Posterior tibial plateau fractures can lead to significant posttraumatic instability if not treated properly. It remains unclear which surgical approach achieves better patient outcomes. The objective of this systematic review and meta-Analysis was to assess postoperative outcomes in patients undergoing anterior, posterior, or combined approach for posterior tibial plateau fractures.Methods:The PubMed, Embase, Web of Science, The Cochrane Library, and Scopus were searched for studies published before October 26, 2022, comparing anterior, posterior, or combined approaches for posterior tibial plateau fractures. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcomes included complications, infections, range of motion (ROM), operation time, union rates, and functional scores. Significance was set at p < 0.05. Meta-Analysis was conducted with STATA software.Results:In total, 29 studies with a total of 747 patients were included for quantitative and qualitative analysis. Compared with other approaches, the posterior approach for posterior tibial plateau fractures was associated with a better ROM and shorter operative time. The complication rates, infection rates, union time, and hospital for special surgery (HSS) scores were not significantly different between surgical approaches.Conclusions:The posterior approach for posterior tibial plateau fractures offers advantages such as improved ROM and shorter operative time. However, there are concerns regarding prone positioning in patients with medical or pulmonary comorbidities and indications in polytrauma cases. Further prospective studies are needed to determine the optimal approach for these fractures.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
AB - Background:Posterior tibial plateau fractures can lead to significant posttraumatic instability if not treated properly. It remains unclear which surgical approach achieves better patient outcomes. The objective of this systematic review and meta-Analysis was to assess postoperative outcomes in patients undergoing anterior, posterior, or combined approach for posterior tibial plateau fractures.Methods:The PubMed, Embase, Web of Science, The Cochrane Library, and Scopus were searched for studies published before October 26, 2022, comparing anterior, posterior, or combined approaches for posterior tibial plateau fractures. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcomes included complications, infections, range of motion (ROM), operation time, union rates, and functional scores. Significance was set at p < 0.05. Meta-Analysis was conducted with STATA software.Results:In total, 29 studies with a total of 747 patients were included for quantitative and qualitative analysis. Compared with other approaches, the posterior approach for posterior tibial plateau fractures was associated with a better ROM and shorter operative time. The complication rates, infection rates, union time, and hospital for special surgery (HSS) scores were not significantly different between surgical approaches.Conclusions:The posterior approach for posterior tibial plateau fractures offers advantages such as improved ROM and shorter operative time. However, there are concerns regarding prone positioning in patients with medical or pulmonary comorbidities and indications in polytrauma cases. Further prospective studies are needed to determine the optimal approach for these fractures.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
UR - http://www.scopus.com/inward/record.url?scp=85164387141&partnerID=8YFLogxK
U2 - 10.2106/JBJS.RVW.23.00030
DO - 10.2106/JBJS.RVW.23.00030
M3 - 文献综述
C2 - 37433013
AN - SCOPUS:85164387141
SN - 2329-9185
VL - 11
JO - JBJS Reviews
JF - JBJS Reviews
IS - 7
M1 - e23.00030
ER -