| Objective:To evaluate the curative effect between open reduction and internal fixtion(ORIF) and arthrodesis to treat lisfranc injuries by using meta-analysis.Methods:This meta-analysis search all articles which compare the curative effect between open reduction and internal fixtion(ORIF) and arthrodesis by searching datebases of Cnki,Wanfang,Vip,Pubmed,Embase,Cochrane library.According to the inclusion and exclusion criteria,we filter the literature and extract the data.Evaluation index includes function score, hardware removal, secondary operation, anatomical reduction.We use Revman5.3 for data heterogeneity test.According to the results,we select the model of between fixed effect model or random effect model, and conduce the meta-analysis.Results:This meta-analysis contains 6 control study including two randomized controlled study articles and 4 retrospective case-control study articles.The amount of the patients is247, including open reduction and internal fixation group 123, joint fusion group124.Maryland function scores for open reduction and internal fixation is better than that of joint fusion group(P = 0.01).In the aspect of hardware removal, the arthrodes is superior to open reduction and internal fixation(P<0.00001).In the aspect of secondary surgery, the arthrodes is superior to open reduction and internal fixation(P =0.04).No statistically significant differences of the anatomical reduction between open reduction and internal fixation group and joint fusion were showed in the result(P =0.80).Conclusion:Arthrodesis is superior to open reduction and internal fixation in the aspect of hardware removal, secondary operation,although it is inferior in the aspect of Maryland functional scores.There are no differences between the arthrodesis and open reduction and internal fixation in the aspect of anatomical reduction..Because of the low incidence of lisfranc injuries,the randomized controlled study is lack somehow,and it caused some limitation to this article.This conclusion needs more large sample, high quality, multicenter,rigorous designed randomized controlled study to supply the evidence-based medicine evidence to let clinical doctors make choices more easily. |
