A Meta Analysis About CRPP Vs ORPP Of Supracondylar Humeral Fractures In Children

Objective:Supracondylar fracture of the humerus is a kind of common fracture in children.Many methods are used in the treatment of this kind of fracture.CRPP and ORPP are two kinds of treatment.the purpose of this study is to compare the discrepancy between the two methods in the treatment of complete displaced supracondylar humeral fractures(GartlandIII).We therefore performed a systematic review of the literature to investigate the existing evidence regarding radiological and functional outcomes as well as postsurgical Ulnar nerve injury of closed compared to open reduction..Methods:A search of the electronic literature databases EMBASE,MEDLINE,CNKI,CBM,Wanfang data and the Cochrane Library was performed for publications.The following search terms were used: Child,children,pediatric,humerus,humeral,supracondylar,closed reduction,open reduction,CRIF,ORIF,random*,randomized controlled trial.Duplicate studies were excluded using End Note X7,after that,the title and abstract of each identified study were screened.After full-text reviews of the remaining studies were performed,6 studies of these studies were included.The methodological quality of RCT studies were estimated using criteria of Jadad.The methodological quality of cohort studies were estimated using criteria of NOS.statistical analysis were performed using STATA,version 12.0 after data extraction.Results:The initial literature retrieval identified 453 reports,118 of which were included in Medline,123 of which were included in EMbase,7 of which were included in cochranelibrary,18 of which were included in CBM,159 of which were included in CNKI,28 of which were included in Wanfang data.6 studies of these studies were included.2 of the included studies are RCT.4 of the included studies are retrospective cohort studies.after meta analysis about these 6 studies together was performed,Results are found.the closed reduction group revealed better functional outcome(OR=1.77(0.96 3.27)),the open reduction group revealed better radiological outcome(OR=0.92(0.40 2.10)),No significant difference was found.Conclusion:We recommend that closed reduction with percutaneous pinning should be performed first unless some special circumstances are present,for example: complex fractures,closed reduction fails.