Clinic Outcomes Of Prosthetic Replacement To Open Reduction And Internal Fixation In Treating Radial Head Fracture Of Mason ? Type:A Meta-analysis

Objective:to study and analyze articles related to prosthetic replacement(PR)and open reduction and internal fixation(ORIF)in treating radial head fracture of Mason?type between January 2008 and December2018,and all relevant data were collected,retracted,recorded and analyzed separately for clinic therapeutic alternatives.Method:based on retrieval guidance and design requirement of Cochrane Musculoskeletal Group,literatures published in Pubmed,Embase,Cochrane Library,Springer link,Google scholar,Elsevier Science Direct,Chinese biomedical literature database,China Wanfang data,China National Knowledge Internet,China Weipu network between January 2008 and December 2018 were searched and retrieved,and searching words in Chinese were radial head,fracture,replacement,internal fixation,therapy;English key searching items were radial head,fracture,replacement,arthroplasty,fixation,therapeutic,therapy,treatment and disease management,meanwhile,our school library was also included to expand literature searching fields.All papers collected were pooled and then meta analyzed to assess clinic values of the two different therapy methods by Review Manager 5.3 statistically.Result:From the retrieved database,548 article related to our searching subjects were primarily found,consisting of 175 in English and 373 in Chinese.Finally,13 articles were filtered in our ultimate meta-analysis including 5 RCT,5 non-RCT and 3retrospective papers.In this research,655 patients were incorporated,333 in ORIF and 322 in PR,and the study items cover distinguished achiever ratio of MEPS,postoperative complication,Broberg and Morrey score and range motion of elbow.Meta analysis of distinguished achiever ratio showed no heterogeneity existed in all groups(P=0.80,I~2=0%),total OR=0.37,95%CI(0.24,0.56),P<0.00001,subgroup distinguished achiever ratio byMEPS were:heterogeneity acceptable(P=0.25,I~2=27%),total OR=0.42,95%CI(0.22,0.81),P=0.01;subgroup distinguished achiever ratio by Broberg and Morrey score were:heterogeneity acceptable(P=0.86,I~2=0%),total OR=0.34,95%CI(0.19,0.59),P=0.0001.Conclusion:distinguished achiever ratio between prosthetic replacement(PR)and open reduction and internal fixation(ORIF)in treating radial head fracture of Mason?type had statistical differences,showing PR method had more advantages in treating radial head fracture of Mason?type than ORIF did.But somevarying elements may play an role in reaching this result,like variation of fixation materials and types,operation methods and concomitant injuries.Therefore,more clinic evidences and data should be taken in to reach the final conclusion.